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Heart attack - discharge

You were in the hospital because you had a heart attack. A heart attack occurs when blood flow to a part of your heart is blocked long enough that part of the heart muscle is damaged or dies.

What to Expect at Home

You may feel sad. You may feel anxious and as though you have to be very careful about what you do. All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home.

Activity

You should know the signs and symptoms of angina.

  • You may feel pressure, squeezing, burning, or tightness in your chest. You may also notice these symptoms in your arms, shoulders, neck, jaw, throat, or back.
  • Women may feel discomfort in their back, shoulders, and stomach area.
  • You may have indigestion or feel sick to your stomach.
  • You may feel tired and be short of breath, sweaty, lightheaded, or weak.
  • You may have angina during physical activity, such as climbing stairs or walking uphill, lifting, sexual activity, or when you are out in cold weather. It can also happen when you are resting or wake you up when you are sleeping.

Know how to treat your chest pain when it happens. Talk with your doctor or nurse about what to do.

Take it easy for the first 4 - 6 weeks.

  • Avoid heavy lifting. Get some help with household chores if you can.
  • Take 30 - 60 minutes to rest in the afternoon for first 4 - 6 weeks. Try to go to bed early and get plenty of sleep.
  • Before starting to exercise, your doctor will do an exercise test and recommend an exercise plan. This may happen before you leave the hospital or soon afterward. Do not change your exercise plan before talking with your health care provider.

You should be able to talk comfortably when you are doing any activity -- such as walking, setting the table, and doing laundry. If you cannot, stop the activity.

Ask your doctor about when you can return to work. Expect to be away from work for at least 4 - 6 weeks.

Your doctor may refer you to cardiac rehabilitation program. There, you will learn how to slowly increase your exercise and how to take care of your heart disease.

Wait at least 2 weeks before sexual activity. Ask your doctor when it is okay to start again. Do not take Viagra, Levitra, Cialis or any herbal remedy for erection problems without checking with your doctor first.

How long you will have to wait to return to your normal activities will depend on:

  • Your physical condition before your heart attack
  • The size of your heart attack
  • If you had complications
  • The overall speed of your recovery

Diet and Lifestyle

Do not drink any alcohol for at least 2 weeks. Ask your doctor when you may start. Limit how much you drink. Women should have only 1 drink a day, and men should have no more than 2 a day. Try to drink alcohol only when you are eating.

If you smoke, stop. Ask your doctor for help quitting if you need it. Do not let anybody smoke in your home, since second-hand smoke can harm you. Try to stay away from things that are stressful for you. If you are feeling stressed all the time, or if you are feeling very sad, talk with your doctor or nurse. They can refer you to a counselor.

Learn more about what you should eat to make your heart and blood vessels healthier.

Taking Your Heart Medicines

Have your drug prescriptions filled before you go home. It is very important that you take your drugs the way your doctor or nurse told you to. Do not take any other drugs or herbal supplements without asking your doctor first if they are safe for you.

Take your drugs with water. Do NOT take them with grapefruit juice, since it may change how your body absorbs certain medicines. Ask your doctor or pharmacist for more information about this.

The drugs below are given to most people after they have had a heart attack. Sometimes there is a reason they may not be safe to take, though. These drugs help prevent another heart attack. Talk with your doctor or nurse if you are not already on any of these drugs:

Do NOT suddenly stop taking these drugs for your heart. Do NOT stop taking drugs for your diabetes, high blood pressure, or any other medical conditions you may have without talking with your doctor first.

If you are taking a blood thinner such as warfarin (Coumadin), you may need to have extra blood tests on a regular basis to make sure your dose is correct.

When to Call the Doctor

Call your doctor if you feel:

  • Pain, pressure, tightness, or heaviness in your chest, arm, neck, or jaw
  • Shortness of breath
  • Gas pains or indigestion
  • Numbness in your arms
  • Sweaty, or if you lose color
  • Lightheaded

Changes in your angina may mean your heart disease is getting worse. Call your doctor if your angina:

  • Becomes stronger
  • Happens more often
  • Lasts longer
  • Occurs when you are not active or when you are resting
  • Medicines do not help ease your symptoms as well as they used to

Alternate Names

Myocardial infarction - discharge; MI - discharge; Coronary event - discharge; Infarct - discharge

References

Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol. 2007 Aug 14;50(7):e1-e157.

Antman EM, Hand M, Armstrong PW, Bates ER, Green LA, Halasyamani LK, Hochman JS, et al. 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee. Circulation. 2008 Jan 15;117(2):296-329. Epub 2007 Dec 10.  

Smith SC Jr, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. J Am Coll Cardiol. 2011 Nov 29;58(23):2432-46. Epub 2011 Nov 3.

Antman EM and Morrow DA. ST-Elevation myocardial infarction: management. In Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald'sHeart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Saunders; 2011:chap 55.

Cannon CP and Braunwald E. Unstable angina and non-ST elevation myocardial infarction. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald'sHeart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Saunders; 2011:chap

Update Date: 8/28/2012

Updated by: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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