It is the stuff of nightmares. You, or a loved one, has a heart attack – and you are frozen to the spot, unable to offer any emergency help.
As most of us are not medical professionals, this panic in the face of trauma is understandable.
The good news is that there are simple ways to recognise the signs of a heart attack and proactive steps we can take to offer interim help to the person – or even ourselves.
First, let’s understand: what is a heart attack?
A heart attack is caused by a lack of blood – and the oxygen that it supplies – to the heart. This happens when the heart’s own set of arteries become clogged by fatty deposits, making it difficult for the blood to reach the heart.
Are you at risk?
The most common risk factors include:
- Family history of heart disease.
- High cholesterol.
- Uncontrolled hypertension.
- A pressing pain in the centre of the chest that often spreads to the neck, jaw or arms.
- Shortness of breath.
- Dizziness or light-headedness.
- Nausea or vomitting.
- Increased perspiration.
- Fast or irregular pulse.
- Falling blood pressure, which causes you to look pale and grey.
In women, the warning signs of a heart attack are more vague and confusing. Chest pain is often confused with indigestion or heartburn, and as a result, women are misdiagnosed with gastrointestinal problems or depression.
What to do if you think it’s a heart attack
If you experience any of the symptoms or suspect someone is having a heart attack, call the emergency service immediately. A heart attack is an emergency and must be diagnosed and treated in hospital as soon as possible.
Once hospitalised, the first priority is to keep the patient alive with adequate oxygenation. An oxygen mask or breathing tube may be used. Relieving the patient’s pain should be the next step. Morphine may be required for this.
To prevent damage to the heart muscle and lower the chance of death from abnormal heart rhythms, treatment with “clot-busting” medication needs to be given. This should be done within the first two to four hours of the heart attack.
If there is a life-threatening rhythm disturbance, such as severe ventricular tachycardia or ventricular fibrillation, this must be corrected immediately with defibrillation (shock).
Once the diagnosis is confirmed, a cardiologist takes over for further management. This may involve admission to a special coronary care unit for a few days until the patient can be discharged.
If the patient remains unstable or is still experiencing pain, the cardiologist may do an angiogram to examine the coronary arteries for blockages. If these are identified, corrective measures must be taken.
Blockages may be opened up through balloon angioplasty. For this procedure, a tiny balloon is placed inside the narrowed artery and inflated to push open the walls again. Then, a stent (expandable metal mesh tube) may be inserted at the site to ensure that the artery remains open.
While awaiting surgery, some unstable patients will need to have an intra-aortic balloon pump inserted. This is a computer-controlled heart-assist pump, which is used to temporarily improve blood flow through the coronary arteries. This helps avoid a full-blown heart attack, or limit the extent of an ongoing heart attack while waiting for surgery.
Once the patient has been stented or has had surgery, the focus should be on rehabilitation. This means controlling and reducing the risk factors associated with a heart attack, and making healthier lifestyle choices. These include:
- Quitting smoking.
- Avoiding foods that contain saturated fat and cholesterol.
- Exercising regularly.
- Maintaining a normal body weight and body-mass index (BMI).
- Controlling high blood pressure.
- Controlling cholesterol levels.
http://www.health24.com/Medical/First-aid/Specific-medical-emergencies/Heart-attack-Client-20120721; Health24 (Online), Accessed w/c 2 May
http://www.medicinenet.com/heart_attack_symptoms_and_early_warning_signs/article.htm; Medicine Net (Online), Accessed w/c 2 May