For a few days following a heart attack, patients are observed in a special area of the hospital called the cardiac care or intensive care unit (CCU or ICU). During this time physical activity and visitors may be restricted and patients are encouraged to rest. Special monitoring devices are used to help the medical team identify and treat any complications that may occur.

For many people a heart attack is the first sign that they have coronary artery disease. Before a patient is discharged from the hospital, he or she will often undergo another series of diagnostic tests to assist the physician in evaluating the extent of the heart disease. Some examples of these tests include:

Cardiac catheterization

During this test a small catheter is inserted through a vein or artery in the arm or leg is then guided into the coronary vessels of the heart. Information can be obtained about the patency of the coronary arteries, the condition of the heart muscle and the heart valves themselves, and the amount of oxygen that the heart is receiving. Dye may be used to enhance visualization during this test. The test is not painful but some patients report a warm sensation when the dye is injected.

Angioplasty

If thrombolytic agents were not given or did not relieve the heart attack symptoms, your physician may decide to perform angioplasty. Angioplasty can be done during a cardiac catherization. It involves the placement and blowing up of a small balloon at the site of a coronary artery blockage. The balloon can cause the vessel to stretch or it can compress the area of blockage, with the end result of increasing blood flow to the heart. At times, a stent is also placed in the vessel to prevent it from collapsing or from having a blood clot form at the site of the blockage.

Coronary artery bypass grafting (CABG)(Yes it’s pronounced “cabbage.”)

If angioplasty is not indicated, either because of the site of the blockage or the degree of blockage present, the physician may recommend bypass surgery. This procedure involves a major surgical operation where a portion of a vein taken from the patient’s leg or an artery taken from the chest is used to enable blood to flow around the blockage. If needed, several areas of blockage can be bypassed during this procedure. This surgery involves splitting the chest bone in order to gain access to the heart. Hospital stays vary but usually involve at least one week.

A newer technique, called minimally invasive bypass surgery, which involves smaller incisions and does not necessitate opening the chest bone, is now being used for a small percentage of patients requiring coronary artery bypasses.

What can I expect after hospital discharge?

Following discharge from the hospital patients continue their recovery at home. It is not unusual for your physician to prescribe medications that you will need to take on a daily basis. These medications will vary depending on the extent of heart disease and other existing medical conditions. It is important to take the medication as directed and to report any unusual side effects to your physician.

Activity may be restricted initially. Before you leave the hospital your physician will discuss limitations regarding employment and sexual activity. Your treatment plan may include modifications to your diet and exercise routine. Certainly, if you smoke it is essential that you quit.

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