It is quite likely that you have coronary artery disease (CAD) if you have ever suffered a heart attack, which is sometimes referred to as a myocardial infarction (MI). (You should consult a doctor to determine if or not you have coronary artery disease.) Even though various illnesses can bring on a heart attack, coronary artery disease is by far the most common cause.
CAD is a chronic condition that most frequently impacts the coronary arteries in more than one region and that has a tendency to progress throughout one's lifetime. This indicates that you need to take measures to lower the likelihood of experiencing a myocardial infarction (MI) again in the future.
You and your healthcare practitioner will need to address two unique issues to reduce the risk of you having another heart attack. To begin, you will need to take measures to reduce the risk of the atherosclerotic plaque that caused your myocardial infarction from rupturing again. Second, you need to do all in your power to either reduce the rate of advancement of your underlying CAD or stop it altogether.
Eliminating or Minimizing the Threat Right Now
Patients who experience a myocardial infarction (MI) and survive it may be at an elevated risk of having a second episode of acute coronary syndrome (ACS) within a month or between one and two years.1 episode of unstable angina or another myocardial infarction is the result of ACS, which is caused when a plaque ruptures.
These "early" recurrences of ACS are typically brought on by the re-rupture of the same plaque that brought on the initial MI. This can be fatal. When the "culprit" plaque is still creating a large partial blockage in the coronary artery, the patient's chance of having an early recurrence is significantly increased.2
If your acute MI was treated using the invasive strategy (that is, with prompt angioplasty and stenting), then it is most likely that the plaque that was causing the problem has already been removed.
If you had instead been treated non-invasively with thrombolytic medicines, the narrative would have turned out differently. These medications, which are often referred to as "clot-busters," unblock the artery that is blocked by dissolving the acute blood clot that is caused by ACS. Plaque, however, continues to be a problem after all this time. In light of this, it will be necessary, before you are discharged from the hospital, to determine whether or not a large partial obstruction is still present. Either a nuclear stress test or a cardiac catheterization can accomplish this examination of the patient's heart condition.
If it is discovered that a major blockage still exists, your healthcare practitioner will discuss the several treatment options that are available to prevent an early recurrence of ACS with you. These options include medical treatment for CAD, angioplasty, stenting, or coronary artery bypass grafting.
Reducing the Danger Over the Longer Term
When a patient has a myocardial infarction (MI), they are frequently given the notion that although they previously had a severe medical problem, it has been resolved, and they may now carry on with their lives as if nothing has changed. This is a dangerous misconception.
Atherosclerosis, on the other hand, is a persistent condition that worsens with time and typically manifests itself in multiple areas of the coronary arteries. This is a point that cannot be emphasized enough. ACS can be caused by a rupture in any atherosclerotic plaque, regardless of how large the plaque may be.
After having a myocardial infarction, you must do everything in your power to slow or stop the advancement of the underlying disease process, notably through the use of pharmacological therapy and lifestyle changes.
Treatment with Medication Following a Heart Attack
It has been demonstrated that certain medications, such as statins and aspirin, can either slow the progression of coronary artery disease (CAD) or prevent the sudden occlusion of a sick coronary artery (by preventing the acute blood clotting that causes the occlusion). Therefore, you should be prescribed these medications to help avoid future heart attacks.
Statins
After suffering a myocardial infarction (MI), taking a statin medication has been shown in multiple clinical trials to dramatically lower the chance of having another MI as well as the risk of passing away. 2 This result holds even for patients whose cholesterol levels are not considered to be particularly high. After a heart attack, you ought to start taking a statin unless you're allergic to them or just unable to handle them.
Aspirin
Because aspirin lessens the "stickiness" of blood platelets, it lessens the likelihood that a blood clot would form at the site of an atherosclerotic plaque. Aspirin has been demonstrated to greatly lower the risk of death in individuals who are already diagnosed with CAD3. Because of this, aspirin should be recommended in every MI unless there are compelling reasons not to do so.
Your healthcare provider may also opt to treat you with medications that are aimed at avoiding angina, such as nitrates or calcium channel blockers. They may also decide to treat you with medications that are focused on preventing heart failures, such as beta blockers and ACE inhibitors.
Concerns Regarding One's Way of Life After Having a Heart Attack
Alterations to your way of life, in conjunction with medical treatment, are essential for lowering your long-term risk of complications following a myocardial infarction (MI). These include reaching and keeping an ideal weight, beginning and maintaining a diet that is good for the heart, giving up tobacco usage, reaching great management of diabetes and hypertension (if they are present), and engaging in regular physical activity.2
Everyone is aware that making these changes to one's lifestyle is going to be a lot more challenging than simply taking a pill. But keep in mind that being given a diagnosis of CAD is more of a call to action. You have a condition that unless you treat it similarly to how one would a cancer diagnosis, will get progressively worse over time. The treatment is not simple, but it is almost always quite successful. Therefore, gird up your loins, get your priorities straight, and make the necessary adjustments to your way of life.
Your healthcare physician should refer you to an effective cardiac rehabilitation program as an essential step in the process of assisting you in achieving these essential adjustments to your lifestyle. Regrettably, a significant proportion of healthcare providers go over this necessary step. If yours forgets, be sure to remind them.
You will also want to inquire explicitly when it is safe for you to resume driving, sexual intercourse, and any other potentially strenuous or dangerous activities with your healthcare physician to get an answer to this question.
FREQUENTLY ASKED QUESTIONS
Will the symptoms of a second heart attack be the same as those of the first?
Certainly not in every case. The symptoms can vary from person to person. In addition to this, some people feel chest pain known as angina while they are physically active, and they may believe that they are having a second heart attack because of it. Have a conversation with your healthcare practitioner about what warning signs to look out for and when to get help. 9-1-1.4
What dosage of aspirin should I take to reduce the risk of having another heart attack?
Ask your cardiologist: Although taking a daily low-dose aspirin may be beneficial for some individuals who are at high risk for a heart attack, including those who have already suffered from one, doing so is not recommended or even safe for everyone, such as individuals who are over the age of 70 or who have a bleeding issue. You should not take aspirin unless specifically directed to do so by your healthcare physician.5
What steps should I take to protect myself if I suffer a second heart attack?
You must have a plan in place for what to do if you believe you are experiencing another heart attack, such as taking nitroglycerin or chewing an aspirin. In addition, compile a list of your medications, the names and contact information of your healthcare providers and emergency contacts, and a note of any additional medical conditions you may have.4