A blood clot in the heart, also called a heart attack, is a very serious and life-threatening problem. It is treated very aggressively due to the time sensitivity, and the purpose of treatment is to restore blood flow to or from the heart. Treatments include emergency surgery procedures such as angioplasty or arterial bypass surgery and medications such as anti-platelet agents, anticoagulants, and thrombolytics.
Surgery is often required to treat a blood clot in the heart. A common procedure is called a cardiac catheterization, also known as an angioplasty, which involves locating the blood vessel that is blocked and inserting a balloon into it. The balloon is blown up slightly to open up the walls of the vessel and restore blood flow. A stent is then placed to keep the vessel open.
Another type of surgery used to treat a blood clot in the heart is arterial bypass surgery. This is usually a last result, when the heart has already stopped. The name arterial bypass indicates that the surgery creates a new source of blood flow to and from the heart that bypasses the clotted or otherwise damaged arteries. Double, triple, or quadruple bypass surgery indicates the number of arteries bypassed in the procedure.
At the first signs of heart attack, if a health care professional is nearby, he or she will recommend chewing an adult-strength 325-mg tablet of aspirin. Studies have shown that this step can improve chances of survival by 20 percent. The anti-platelet agent in aspirin will thin the blood and help break up the blood clot in the heart, preventing further injury to the heart.
Additional oral anti-platelet agents may be given to the patient to further increase chances of survival, such as clopidogrel. Intravenous anti-platelet therapy may also be given to further thin the blood and increase chances of survival. Such a strong dose of anti-platelets can lead to major bleeding complications, like stomach ulcer bleeding, but these instances are very rare.
Anticoagulant medication may also be administered to treat a blood clot in the heart. Intravenous heparin is the most commonly administered anticoagulant for heart attack patients. This medication can be administered to prevent blood clots, or during a heart attack the dose is adjusted to target the blood clot within 50 to 70 seconds. Anticoagulants can also cause bleeding problems.
Thrombolytic agents are another type of medication used to treat a blood clot in the heart. This medication dissolves arterial clots more effectively than anti-platelets or anticoagulants, but at a higher risk of bleeding problems. Thrombolytic agents are responsible for a 20 percent improvement in survival rates but also have a brain hemorrhage rate of about 1 percent.