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How to
Survive a Heart Attack
Why is it important to know about this stuff?
There are two good reasons everybody should know the most basic
information about heart attacks. First, odds are very high that
either you or someone you love will suffer from a heart attack
during your lifetime. And second, whether you (or your loved one)
survive that heart attack may depend on what you – and your
doctors – do during the first few hours.
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The purpose of this article is to help you understand
what you should do, and what your doctors should do, if you
think you might be having a heart attack |
Why are the first few hours critical?
The first 3 – 6 hours after the onset of the heart attack are
utterly critical. First, most of the lethal arrhythmias seen with
acute heart attacks occur during the first few hours. If these
arrhythmias occur while the victim is under medical attention,
they can virtually always be stopped in time to prevent a
catastrophe.
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Further, if the artery can be opened within the first few
hours after the blockage occurs, much of the dying heart
muscle can be saved, much of the permanent heart damage can
be avoided, and the patient’s risk of death or permanent
disability can be greatly diminished. But if treatment is
delayed beyond 6 hours, the amount of heart muscle that can
still be saved drops off significantly. |
If you are having a heart attack, the difference between
life and death, or health and permanent disability, is
measured in minutes.
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What this means, of course, is that if a patient having a heart
attack tries to "ride it out" at home for a while,
hoping the symptoms are due to indigestion or muscle strain, or if
the medical personnel delay instituting therapy for any reason,
the delay can lead to devastating and permanent results.
What symptoms should tip you off?
The classic symptoms of a heart attack include intense,
sometimes squeezing, chest pressure or pain, often radiating to
the jaw or left arm, and frequently accompanied by profuse
sweating, or a nearly overwhelming sense of fear or impending
doom.
Unfortunately, many patients with heart attacks do not have
this classic presentation. Their discomfort may be relatively
mild, and may be localized to the back, abdomen, shoulders, or
either or both arms. Nausea and vomiting, or merely a feeling of
heartburn, may be the only symptom. These less classic symptoms
may not make patients think of a heart problem, and may keep them
from seeking medical help. Indeed, up to 30% of heart attacks are
diagnosed by taking a routine ECG long after the fact.
This is why people with one or more risk factors for coronary
artery disease need to pay close attention to any unusual
symptoms involving the upper half of the body. This warning would
apply, for instance, for any middle-aged or older person who is
obese, sedentary, a smoker, a diabetic, overweight, has high
cholesterol, or has a family history of heart disease. (Ideally,
of course, such people will have been evaluated by a competent
physician who will have screened them for the presence of coronary
artery disease, coached them on risk factor modification, and
heightened their awareness of potential cardiac problems.)
What should you do if you think you might be having a heart
attack?
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If you experience any symptoms suggestive of heart
attack, especially if you know you have risk factors for
coronary artery disease, your key to avoiding death or
permanent disability is to get yourself to medical help as
soon as possible. If you live in an area where paramedics
can get to you within a few minutes, then call for them. If
it would be quicker to have someone drive you to a hospital,
then do that. But get help right away. If you are having
a heart attack, every minute is vitally important. And while
you’re waiting for the paramedics, or while being driven
to the hospital, take an aspirin. |
If you think you might be having a heart attack,
get yourself to a hospital as fast as humanly possible.
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The patient’s reluctance to get medical help is the most
common reason for critical delays in therapy for heart attacks. It
is probably coded into all of our genes to want to say, "This
can’t be my heart. It’s got to be something else. I’ll
just wait a little while and see if it goes away." As
difficult as it is to push aside this natural tendency toward
denial, if you know you’ve got an increased risk of heart
disease, that’s what you need to do. This is one time you really
need to listen to your body; if it feels like there is
something terribly wrong, there probably is.
What medical personnel should do when you arrive
They should be taking your symptoms very seriously. This is not
one of those times when you should expect to show up in the
emergency room and sit around for two hours waiting for a sullen,
gum-snapping clerk to take your insurance information. This is one
of those times when they should immediately place you into a
treatment room, and several individuals should simultaneously hook
you up to a cardiac monitor, start an I.V., give you some oxygen,
get an ECG, draw some blood tests, and begin asking you questions
about your symptoms and examining your heart.
To make sure you elicit the correct response from emergency
personnel, you’ve got to say the magic words as soon as you
arrive. The magic words are, "I
think I’m having a heart attack."
Don’t tell them you’re here because your shoulder hurts, or
you think you have heartburn, or that you have any of the other
alternate possibilities you’ve imagined for yourself. Your
attitude should not be, "It’s probably nothing, so I
won’t make a big deal. Let them figure out if it’s my
heart." If that’s your approach, you’ll get the sullen,
gum-snapping treatment, precious minutes (or even hours) will be
wasted, and you’ll pay a heavy price.
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