Advancing Quality NHS Advancing Quality Alliance

Heart Attack

A heart attack occurs when blood flow to any part of the heart is stopped, this results in damage to the heart due to the lack of oxygen. The most common reason for a block in blood flow is an artery developing an unstable buildup of cholesterol and fat.

Heart attacks are referred to as a Myocardial (tissue of the heart) Infarction (obstruction of blood), this is often shortened to MI or AMI. Symptoms of an AMI can include sudden chest pain which sometimes travels to the left arm, shortness of breath, sweating, nausea, vomiting, abnormal heartbeats, and anxiety.

Through research, clinical input and clinical guidelines Advancing Quality has developed 11 measures that, when applied at the appropriate time, can greatly increase the outcomes for patients. Advancing Quality uses these measures to monitor the quality of care given to patients across the North West with the aim of improving standards and reducing variation in care.


Measures

1. Blood thinning medication on arrival

Blood thinning medication, such as aspirin, reduces the risk of clotting and makes it easier for blood to get to your heart.

2. Blood thinning medication when you leave hospital

You may be asked to continue this treatment as it will help manage any pain you have and also reduce the risk of clotting and another heart attack

3. Medication to lower blood pressure

If doctors believe the 'pumping' part of the left side of your heart is not working properly they will prescribe you specific medications that widen the blood vessels and lower blood pressure.

define:

ACEi:  A medicine that relaxes blood vessel walls and lowers blood pressure. ARB : A medicine group assists in the widening of  blood vessels and and reduces hypertension

4. Help to stop smoking

If you are a smoker you will be offered support and advice to stop smoking. Stopping smoking reduces the chance of further health problems.

5. Medication to slow the heart rate given when you leave hospital

Beta blockers help reduce the heart rate. A slower heart rate means the heart has to do less work as it needs less blood, oxygen and nutrients.  

define:

Beta blockers are medicines that affect the body's response to certain nerve impulses. This, in turn, decreases the force and rate of the heart's contractions, which lowers blood pressure and reduces the heart's demand for oxygen.

6. Medication to slow the heart rate given when you arrive at hospital (Retired Y2)

Beta blockers help reduce the heart rate. A slower heart rate means the heart has to do less work as it needs less blood, oxygen and nutrients.  

define:

Beta blockers are medicines that affect the body's response to certain nerve impulses. This, in turn, decreases the force and rate of the heart's contractions, which lowers blood pressure and reduces the heart's demand for oxygen.

7. Clot-busting medication within 30 minutes of arrival

Fibrinolytic therapy uses these clot-busting drugs to break up clots and make it easier for blood to get to your heart

define:

Fibrinolysis is a process that prevents blood clots from growing and becoming problematic. This process has two types: primary fibrinolysis and secondary fibrinolysis. The primary type is a normal body process, whereas secondary fibrinolysis is the breakdown of clots due to a medicine, a medical disorder, or some other cause.

8. Artery widening procedure within 90 minutes of arrival

You may be suitable for a procedure that widens the arteries in your heart using a special type of balloon. If you are it is important it is done as quickly as possible.

define:

Primary PCI is treatment that occurs while the blood clot is still forming - usually within 12 hours of onset, but ideally within 2 hours of onset of symptoms.

9. Checks for long term damage to your heart (Introduced Y6)

Doctors should check to see if there has been any long term damage to the 'pumping' left side of the heart. These checks enable doctors to tailor treatment for each patient. This check is undertaken by an echocardiogram.

define:

An echocardiogram (also called an echo) is a type of ultrasound test that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of your heart. These echoes are turned into moving pictures of your heart that can be seen on a video screen.
 

10. Cholesterol reducing medication when you leave hospital (Introduced Y6)

Statins are a medication that reduce blood cholesterol. Lower cholesterol reduces the risk of you having another heart attack.

11. Referral to cardiac rehab (Introduced Y6)

You should be referred to cardiac rehab before you leave hospital. Cardiac rehab helps you to get back to everyday life as soon as possible through exercise, health eating and stress management.
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