Heart Attack

Heart attack (also known as a cardiac infarct, coronary occlusion, coronary thrombosis or acute myocardial infarction) is the most serious form of heart disease. It is common for persons suddenly affected to drop dead during their normal activities.

It is essential that you be aware of the symptoms of a sudden heart attack.

Today, modern treatment is very effective. The sooner this is started, the greater are the chances of complete recovery. The symptoms of a heart attack are well-established. The underlying causes of heart disease have been well-documented, and the ways of reducing a heart attack are clear-cut and well-established. Much research has given many answers. Sensible people will follow the straightforward recommendations offered. These are set out at the end of this section.

It is essential to recognize and provide emergency first aid treatment for a possible heart attack.

Heart Attack Symptoms

Here are the key heart attack symptoms as set out by the National Heart Foundation:

  1. A prolonged oppressive pain or unusual discomfort in the centre of the chest, behind the breastbone.
  2. The pain may radiate to the shoulder, arm, neck, or jaw.
  3. Often the pain or discomfort is accompanied by sweating.
  4. Nausea, vomiting and shortness of breath may occur.
  5. Sometimes the symptoms subside then recur.
  6. Never forget: A chest pain that does not go away after 15 – 20 minutes of rest should never be ignored. It could be a heart attack.

What to Do in the Case of a Heart Attack – Take Immediate Action

  1. Make patient comfortable. If conscious, sit the person up.
  2. Allay anxiety. Speak encouraging words.
  3. Call ambulance. If possible, suggest it may be a heart attack, and a special coronary-care ambulance may be available.
  4. If patient collapses, breathing stops or heart stops, expired air resuscitation and external cardiac compression must be started.
  5. If no assistance is available, get the patient to the nearest hospital as urgently as possible.
  6. Time may mean a life saved. The quicker the patient receives expert attention the more likely are the chances of survival and complete recovery. They reduce with the passage of time and no help.
  7. Do not be embarrassed about seeking help. It is better to be wrong than make an error of judgment.
  8. Keep calm. Do not panic. A life could depend on your prompt, efficient, calm manner.

The symptoms of an infarction are extremely variable, according to the size of the infarct. Some are major, and can produce sudden death. But the majority are smaller, and produce a varying range of symptoms. Attacks are not necessarily related to exercise (as angina is). Indeed, attacks may come on while at rest or even during sleep.

However, usually symptoms and signs are fairly typical, and allow a doctor to make a prompt diagnosis. Indeed, a person affected can often form an accurate diagnosis.

An important rule of thumb is that it is better to inaccurately self-diagnose a heart attack than miss it. Early diagnosis and prompt treatment may be lifesaving. No age group is immune from cardiac infarcts. However, they are far more common in males aged 40 – 70 years. Males outnumber females by 4 to 1.

It seems that increasing numbers of younger males are being afflicted with “coronaries.” This may be related to the added stresses of modern living (although others deny this), the high level of living (with an increase in fat content of food there is a greater cholesterol intake), and other factors.

In recent years, the importance of smoking as a cause of heart disease has become recognized. It is now well documented as a leading cause of this disability.

Although the heart may have suffered relatively minor muscle damage, the chances of severe (and usually fatal) change in heart rhythm are about 25 times greater during the first four hours than during the next 24.

Many heart-attack patients believe they have “indigestion,” “colic,” “dyspepsia,” or some other trivial stomach upset. Many feel embarrassed to make a fuss or summon assistance, fearing they are wrong in their beliefs. Others deliberately neglect to call help, fearing the worst, but hoping their inner fears may be wrong.

Each year more than 910000 Americans die from heart attacks and diseases of the cardiovascular system (i.e. heart and blood vessel systems). Prompt, expert treatment can radically reduce a disastrous outcome. Indeed, it is believed that with proper attention, 75 per cent of heart-attack patients recover, and can return to a near-normal life again.

Heart Attack Treatment

A heart attack is a medical emergency. If a person has any of the symptoms enumerated, it is imperative to obtain immediate expert medical assistance. There is no place for home remedies in these cases, apart from allaying the anxiety of the patient and making him or her feel more comfortable. Taking an aspirin can help.

While awaiting this attention, if sudden collapse occurs, and the heart stops beating, expired-air resuscitation and external cardiac compression will help maintain breathing and circulation. If you have had some basic training in this field, it is worth commencing, and may be lifesaving.

Call an ambulance at once, and briefly explain the nature of the symptoms. If the ambulance is not available, get the patient to the nearest hospital as a matter of urgency.

Special mobile intensive-care ambulances fitted to meet cardiac emergencies and equipped with highly trained teams (called “paramedic units”) are now available in most capital cities in Australia and New Zealand. They can often be at the patient’s side within a few minutes and so can initiate lifesaving treatment within only a few moments. Immediately emergency care has been administered, the patient is then transported to the special coronary care ward (or intensive care unit) of a major hospital. Here highly skilled and very specialized treatment with constant supervision is available.

The patient is usually attached to a constant electrocardiograph machine and a screen reveals a continuous picture of the heart’s action.

The relevant tests that are needed are carried out quickly. Treatment is maintained at a high level of efficiency. A prompt and accurate diagnosis is made. Modern tests that seek certain chemicals called enzymes in the blood assist the experts in pinpointing an accurate diagnosis. These are called “cardiac enzymes.” Their presence can tell the extent of the heart attack. Subsequent serial tests indicate the progress of the patient. Death from a “coronary” is usually due to the failure of the heart to continue pumping adequately, or to a breakdown in the nervous control of the heart, which leads to a serious condition called ventricular fibrillation.

Newer drugs that assist in bringing this condition back to normal are now being used.

The drug lignocaine (Xylocaine) assists in reinstating a normal heartbeat. A large family of medications called the beta-blockers can also assist in gross heartbeat irregularities. A machine called a defibrillator can also help re-establish normal heartbeat activity.

Pain-relieving preparations (such as morphine), oxygen, sedation and the medications that have stood the test of time are still widely used for infarcts. Reassurances and supportive measures are as important today as in earlier days when facilities for emergency treatment were far less sophisticated than they are now.

Act promptly. Studies have shown that it takes the average heart attack victim three hours to do anything about his symptoms. The average time-lapse between the onset of warning symptoms and hospital admission is eight hours. The first four hours are of paramount importance. The earlier a heart attack patient can be admitted to hospital and get expert attention, the greater are the chances of survival.

There are many general measures that the anginal patient can carry out, and which may effectively assist in keeping symptoms at a minimum level.

Avoiding the known precipitating factors will help immeasurably. The patient should make an effort to avoid undue exercise that is known to produce symptoms. Similarly, social and environmental predisposing factors must be avoided.

It is best to avoid circumstances where emotional crises and flaring tempers are involved, for this will only breed more and greater problems if allowed to persist.

It would be best if the patient could adopt a philosophical attitude to life in general, accept the position and make the most of the remaining years of life.

Meals of moderate size and easily digestible food, preferably low fat in content and free from fried foods, are best. If there is obvious overweight, sticking to a 4200 kJ (1000-calorie)-a-day diet for a while will help lower the weight and so diminish the risk factors.

Regular sleep often assists. Eight hours a night is preferable. Sometimes, with carp- onset of the symptoms, a period of bed rest may be advisable. Gearing life to meet one’s ability at coping is essential. The same applies to work, with due retard to the social and economic circumstances of the individual.