Heart attack: What happens after?

Heart attack (also known as a myocardial infarction) patients may need to take life-saving medication in the long term. Dr Fam Jiang Ming, Associate Consultant, Department of Cardiology, National Heart Centre Singapore (NHCS), a member of the SingHealth group, describes the most common types of heart attack medication and their possible side effects.

“After a heart attack, a patient will be given medicine to reduce the risk of recurrent episodes, relieve chest pain and control risk factors such as diabetes, high blood pressure and high cholesterol,” says Dr Fam.

It is important that you follow the medication regimen even if you feel fine. Do inform your doctor or pharmacist if you notice side effects or are unable to take the medication regularly.

6 common medications prescribed after a heart attack (myocardial infarction):

1. Antiplatelet agents

Platelets are tiny particles in the blood that cause blood to clot. Antiplatelet agents can thin the blood (making platelets “less sticky”), hence reducing the risk of blood clots. This lowers your risk of getting a stroke and heart attack.

Examples of antiplatelet agents are aspirin [tablet or enteric coated (EC) capsule], clopidogrel, prasugrel, ticagrelor and ticlopidine.

Potential side effects of antiplatelet agents:

  • Unusual bleeding such as pink or brown urine
  • Red or black sticky stools
  • Bloody vomit or vomit that resembles coffee grounds
  • Coughing blood or blood clots
  • Nose bleeds
  • Purple patches or bleeding under the skin

Aspirin: If you experience heartburn or gastric pain or irritation, please inform your doctor.

Tricagrelor: This agent has been known to cause shortness of breath but this effect usually subsides with continuous treatment.

Ticlopidine: Your doctor may recommend tests, especially during the first three months of treatment, to monitor your response to the drug. Should you develop unexplained fatigue, headaches, bruises, or fever, chills and sore throat (or any sign of infection), seek medical attention immediately. Also, inform your doctor if the medication gives you nausea, diarrhoea or an upset stomach.

2. ACE (Angiotensin Converting Enzyme) inhibitors

ACE inhibitors reduce the production of angiotensin II in the body – a substance that causes blood vessels to constrict – hence improving blood flow and lowering blood pressure.

Examples of ACE inhibitors are captopril, enalapril, lisinopril, perindopril and ramipril.

Potential side effects of ACE inhibitors:

  • Dizziness
  • Persistent dry, hacking cough
  • Feeling lightheaded when getting up

If lightheadedness is a problem, take your time to get up after sitting or lying down.

Read on for more commonly prescribed heart attack (myocardial infarction) medicines and their side effects.

Ref: R14