Your heart attack procedure explained - Patient information guide

Golden Jubilee National Hospital
NHS National Waiting Times Centre

Your heart attack procedure
explained
Patient information guide

Agamemnon Street
Clydebank, G81 4DY
(: 0141 951 5000
www.nhsgoldenjubilee.co.uk

You have been admitted to the West of Scotland Regional Heart and
    Lung Centre at the Golden Jubilee National Hospital because you
    suffered a ‘heart attack’ or myocardial infarction. Our role is to treat
    your blocked artery as quickly as possible before sending you back to
    your local hospital for recovery.

    What is a myocardial infarction?

    Most heart attacks occur as a result of coronary heart disease (CHD).
    Coronary heart disease occurs when the coronary arteries (the arteries
    that supply blood and oxygen to the heart muscle) become narrowed
    by a gradual build-up of fatty materials within their walls. This fatty
    material is called atheroma or plaque. If the plaque becomes unstable,
    it may lead to a blood clot forming. If the blood clot blocks the
    coronary artery, the heart muscle is starved of blood and oxygen, and
    may become permanently damaged. This is called a heart attack. A
    heart attack is sometimes called acute coronary syndrome, myocardial
    infarction or coronary thrombosis.

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Sometimes clot busting drugs called thrombolytics are given to
dissolve the clot. However, it is now more common to be treated
with coronary angioplasty also known as Percutaneous Coronary
Intervention (PCI) to open the artery and get the blood flow back to the
heart muscle. When PCI is performed in an emergency situation like
this it is called Primary PCI.

If the initial treatment has involved thrombolytic drugs and they have
not worked effectively, you may undergo so-called Rescue PCI to
ensure the artery is effectively opened. Both of these emergency heart
attack PCI procedures will be carried out in a specialised area called
the Cardiac Catheterisation Laboratory (Cath Lab) with a team of
doctors, nurses, radiographers and cardiac physiologists.

What is PCI?

Percutaneous Coronary Intervention (PCI) with or without a stent is a
treatment to widen or unblock the artery. The procedure is performed
via the radial (in your arm) or femoral (at the top of your leg) artery
using specialist equipment designed to deal with coronary artery
disease.

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Other treatments you may have:

    The doctors or nurses may also give you a
    combination of drugs which could include:
    • Statins
    • Beta-blockers, or
    • ACE inhibitors.

    The ambulance staff or hospital doctors will already have given you
    aspirin. You will also be prescribed a drug called Ticagrelor or
    Clopidogrel to take regularly to reduce the risk of blood clots. It is
    very important that you take these tablets as prescribed by your
    cardiologist.

    This combination of Primary or Rescue PCI and drug treatment will
    help to:
    •    improve the blood supply through your coronary artery;
    •    ease your chest pain; and
    •    reduce the risk of ongoing damage to your heart muscle.

    Transfer to your local hospital

    You will usually be transferred back to your local hospital within 12-
    24 hours of your procedure and can expect to stay there for a further
    day or two. Before you go home, you will be referred to a cardiac
    rehabilitation programme.

    Cardiac Rehabilitation

    Some people think that, because they were in and out of hospital so
    quickly, their heart attack was not a serious event and they need not
    attend the cardiac rehabilitation programme.

    All heart attacks are serious and it is important that you attend the
    programme so that you can make any changes to your lifestyle to help
    to protect your heart In future.

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Driving

By law, you must not drive for up to four weeks following your heart
attack and should only start driving again when your doctor tells you
that you are safe to do so. The following link will provide you with
more information: https://www.gov.uk/government/uploads/system/
uploads/attachment_data/file/232964/At_a_glance.pdf

Coming to terms with a heart attack

A heart attack can be a frightening experience, especially if you
have, until now, enjoyed excellent health. While in hospital, many
people react with fear and anxiety, possibly made worse by pain
and the distress of being surrounded by machines in an unfamiliar
environment.

When the early hours of the heart attack are safely over, most people
usually feel less anxious. Some people may start to feel anxious again
when they are transferred to their local hospital. At your local hospital
there are many new people to get to know and there may not be the
same intense observation by hospital staff. But moving to your local
hospital means doctors feel that the period of danger has passed and
that the treatment has been effective.

Many people feel worried when it is time to go home, especially if they
are discharged from hospital after a very short time as is likely after
your Primary PCI. Away from medical care, you may worry about being
left alone, or about what to do if the pain comes back. This early period
at home may also be difficult for partners, who have to strike a balance
between ‘wrapping you up in cotton wool’ and allowing you to do too
much.

Make sure that you have detailed talks with the hospital staff, cardiac
rehabilitation team, your GP and the district/cardiac nurses, so that you
know what you are allowed or encouraged to do.

Everyone is different and you must get advice which is relevant to you.

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Cardiac rehabilitation is an extremely important part of your ongoing
    care, giving you support, reassurance and advice on how to reduce
    your risk of further heart disease.

    Data protection act

    All of the hospitals in Scotland, which carry out cardiac catheterisation,
    store the patient details on the same computer database. Your
    information is used to record the care you are given and also to
    compare and hopefully improve the results of treatment in different
    hospitals. All medical records are confidential. Only the doctor and
    other healthcare professionals looking after you will be allowed to look
    at your medical records.

    Any information given by you is gathered together centrally to allow
    us to compare our practice with other hospitals. The results are
    gathered anonymously, your records cannot be identified as you. This
    type of information collection is carried out in accordance with the
    Data Protection Act. If you do not want your information stored in this
    way you have the right to refuse permission. If you do not wish us to
    include your information in this database please tick this box o.

    Taking part in Research

    As a regional centre for the West of Scotland in the treatment of heart
    disease, the Golden Jubilee National Hospital participates in a number
    of research studies. During your stay here, you may be approached
    by a member of the Research Team and invited to take part in such a
    study. Participation in research is entirely voluntary and will not affect
    the standard of care you receive.

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Review date: May 2016                      Version 4   HL09