Heart Attack

Knowing the symptoms of a heart attack can be the difference between life and death. More than 50% of the persons having a heart attack wait two hours or more before getting medical assistance, a complication that causes half of them (over 250,000 a year) to die before they get to a hospital.

Possibly many heart attack sufferers don't want to cause a panic for what they think (and hope) is only a minor problem. It's so much more comforting to believe that it is nothing serious, and keep that river in Egypt, Denial, flowing through our hopes. A second reason, which may actually account for more of the delayed action, is that most people aren't fully aware of the signs of a heart attack. Movie and TV portrayals, where a person grips his chest and falls over, are not quite accurate and may lead people to believe that a heart attack has to look like that. Profuse sweating, dizziness and nausea is common, and an ache or tingling in the shoulders and arms often occurs. Sometimes there's a feeling that something hit the funnybone in the elbow. When questioned, most heart attack victims did not know, before they had the attack, where the pain would be and what it would feel like. The common belief was that it would be like a knife plunged into the left side of the chest. More often they reported afterwards that they felt a crushing feeling in the center of the body.

Some common symptoms of a heart attack (myocardial infarction) are:

 Feeling of fullness in the chest that lasts two minutes or more.

 Intermittent or consistent mild ache or pressure to a severe squeezing or crushing feeling in the center of the chest or spreading out across the whole chest, up to the neck, jaw, shoulders or down the arms.

 Cold sweats, weakness, nausea, vomiting, shortness of breath, and fainting.

What happens during a heart attack:

 Muscles need constantly renewed oxygen-enriched blood from the lungs. If the supply is cut off or slowed down by blocked or spasming arteries, the muscles cannot continue to work. As the blood supply to the heart decreases, muscle cells start to die. A mild heart attack can last up to an hour, possibly causing relatively slight damage. Although any damage usually leaves some scarring, the heart may be able to overcome the effect of these scars and continue its work as a pump. If the damage is greater, large areas of the heart may be destroyed and lead to permanent disability or death. Even moderate heart attacks can cause complications, such as rapid and irregular heart rhythms, which affect how much blood is circulated in the body.

What a doctor or paramedic might do in the case of a heart attack:

 An IV (a tube to carry medications directly into the blood stream) will usually be placed into a vein in an arm or hand. Oxygen may also be given, usually through a breathing mask. TPA, a specialized clot dissolving agent, given within the first three hours of the beginning of the attack, can rapidly dissolve the clots which cause most heart attacks. When the equipment is available, electronic sensors attached to the chest will monitor the heart's activity (EKG). These will be hooked up to a TV-like monitor, and the medical staff can see how things are progressing both at bedside and from a central location away from the patient. Blood samples will be drawn to check for specific enzymes that are commonly present after a heart attack. The patient may feel ready to get up and walk around, but may be kept immobilized for a while, often the best medical option at the moment.

Avoiding delay in getting medical attention is the most important key to survival. It is far better to call an ambulance or have someone take you to a nearby emergency room than to wait a while to see what happens. Unless your doctor has the proper emergency equipment in the office, going directly to an emergency facility or calling an ambulance may be more life-saving than going to your doctor's office. Just receiving a dose of TPA at the right time may be enough to save a life. Many heart attack victims lose consciousness very suddenly, so driving alone to a hospital may be dangerous to the victim, pedestrians and other drivers.

Next: Angiogram

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©1994, 1996, 2002
Dr. Neal Pinckney
Healing Heart Foundation