Treatments for Heart Attack & Unstable Angina

Heart attack

Immediate treatment

Emergency assessment and treatment should be conducted quickly. Treatment will depend on when your symptoms started and how soon you can access treatment.
If your symptoms started within the last 12 hours, percutaneous coronary intervention (PCI) will likely be offered if available.1
If your symptoms started within the past 12 hours but you cannot access PCI quickly, medication to break down the blood clots will be prescribed.
If symptoms started more than 12 hours ago, and symptoms have improved, the best course of treatment will be determined by an angiogram. The following may be proposed: medication, PCI or bypass surgery.1


Anticoagulant medications2,3

Anticoagulants are drugs that manipulate the blood coagulation process. They inhibit thrombus formation, meaning that they prevent blood clots from forming too easily. Anticoagulants generally include non-vitamin K antagonist oral anticoagulants (NOACs), heparins and vitamin K antagonists. All of these have different ways of working. Due to the pharmacological mode of action, the use of anticoagulants may be associated with an increased risk of occult or overt bleeding from any tissue or organ. The signs, symptoms and severity may vary according to the location of the bleeding (e.g. blood in urine, severe bruising). Although all anticoagulants can increase the risk of bleeding, strategies are available to reduce or stop bleeding.

What are anticoagulants? Anticoagulants play an important role in the management of unstable angina and heart attack, find out more about them here Read more

Antiplatelet medicines4-10

Antiplatelet medicines (e.g. aspirin5, clopidogrel,6 ticagrelor7, prasugrel8) are types of drugs that decrease platelet aggregation. They inhibit blood clot formation and are mainly effective in the arterial circulation. Your doctor will work out which antiplatelet is right for you based on the indication and the presence of any other medical conditions. Although all antiplatelets can increase the risk of bleeding, strategies are available to reduce or stop bleeding.


Fibrinolytic drugs1-9

Fibrinolytic drugs break down fibrin, which, in turn, breaks up blood clots. Drugs in this class include streptokinase, alteplase, tenecteplase and urokinase.


Post-occurrence treatment

The following drug treatments are usually prescribed to a person who has recently had a heart attack:


Angiotensin-converting enzyme (ACE) inhibitors10

ACE inhibitors are a class of medicines that cause blood vessels to relax, lowering blood pressure and increasing the supply of oxygen to the heart.
Drugs in this class include ramipril and enalapril.



Are a class of drugs that may help to prevent attacks of angina and reduce your risk of having a further heart attack, by reducing the rate and force of the heartbeat and lowering high blood pressure.
Drugs in this class include propranolol and atenolol.



Are a class of drugs that reduce blood cholesterol levels, by reducing the amount of low-density lipoprotein cholesterol (often referred to as “bad cholesterol”) produced by the liver.
Drugs in this class include simvastatin and atorvastatin.


Unstable angina13

As a result of having unstable angina you may be at a higher risk of having a heart attack, so tests can be conducted to look at the level of risk. If there is a high risk, an examination to assess the size and location of the blockage in the coronary artery can be carried out. If the blockage is large, surgery may be necessary in the form of a coronary artery bypass graft or a PCI.1


Glycerol trinitrate (GTN)14

GTN acts to relax blood vessel walls, which reduces blood pressure and alleviates chest pain. Tablet and spray preparations of GTN are taken to provide immediate relief during an episode of angina, or to prevent an episode from occurring imminently (e.g. before climbing the stairs). Longer-acting formulations such as skin patches and ointments may be prescribed to prevent the pain from developing.

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