Heart Attack

Introduction :

A heart attack occurs when an artery supplying your heart with blood and oxygen becomes partially or completely blocked. This loss of blood flow injures or destroys part of your heart muscle. A heart attack generally causes chest pain for more than 15 minutes, but it can also have no symptoms at all.

Many people who experience a heart attack have warning symptoms hours, days or weeks in advance. The earliest warning sign of an attack may be ongoing episodes of chest pain that start when you're physically active, but are relieved by rest.

Some points :

• Occurs when blood supply to vital organs gets blocked

• >50years / menopausal women at greater risk

• Occurs with / without chest pain

• Sudden arrest of breathing / heart function

• May result in cardiopulmonary arrest

• Clot in the arteries blocks blood supply

• Occurs due to:

  a. Deposits of calcium / cholesterol
  b. Hereditary factors
  c. Tobacco
  d. Obesity
  e. High blood pressure
  f. Emotional stress
  g. Inflammatory disease of arteries
  h. Trauma / disease of heart

Symptoms :

The classic symptoms are:

· Chest pain

· Pressure, heaviness or tightness in the chest

· Pain or pressure in the neck or jaw

· Pain or pressure in one or both arms (especially the left)

· Shortness of breath

· Sweating

· Nausea

· Pain or throbbing between the shoulder blades.

What help is needed?

• If possible, raise the legs up 12 to 18 inches to allow more blood to flow towards the heart
• Immediately place the palm of your hand flat on the patient's chest just over the lower part of the sternum (breast bone) and press your hand in a pumping motion once or twice by using the other hand. This may make the heart beat again.

If these actions do not restore a pulse or if the subject doesn't begin to breathe again:

• call for help, stating that the casualty is having a cardiac arrest but stay with the patient.
• find out if any one else present knows CPR.
• provide artificial respiration immediately (see below).
• begin CPR immediately (see below).

How to give artificial respiration :

• Tilt the head back and lift up the chin.
• Pinch the nostrils shut with two fingers to prevent leakage of air.
• Take a deep breath and seal your own mouth over the person's mouth.
• Breathe slowly into the person's mouth - it should take about two seconds to adequately inflate the chest.
• Do this twice.
• Check to see if the chest rises as you breathe into the patient.
• If it does, enough air is being blown in.
• If there is resistance, try to hold the head back further and lift the chin again.
• Repeat this procedure until help arrives or the person starts breathing again.

How do I perform CPR (cardiopulmonary resuscitation) :

See if there is breathing. If not, start artificial respiration as described above. Checking for a pulse in the neck (carotid artery) may waste valuable time if the rescuer is inexperienced in this check. The procedure is:

• place your fingers in the groove between the windpipe and the muscles of the side of the neck. Press backwards here to check for a pulse.

If there is no pulse, or if you are unsure, then proceed without delay thus:

• look at the person's chest and find the 'upside-down V' shaped notch that is made by the lower edge of the ribcage. Place your middle finger in this notch and then place your index finger beside it, resting on the breastbone. Take the heel of your other hand and slide it down the breastbone until it is touching this index finger. The heel of your hand should now be positioned on the middle of the lower half of the breastbone.
• now place the heel of your other hand on top of the first. Keep your fingers off the chest, by locking them together. Your pressure should be applied through the heels of the hands only.
• keep your elbows straight, and bring your body weight over your hands to make it easier to press down.
• press down firmly and quickly to achieve a downwards movement of 4 to 5cm, then relax and repeat the compression.
• do this 15 times, then give artificial respiration twice, and continue this 15:2 procedure until help arrives.
• aim for a rate of compression of about 100 per minute. You can help your timing and counting by saying out loud 'one and two and three and four ...' etc.

Artificial respiration and CPR should both be performed at the same time :

• If possible, get someone else to help - one person to perform artificial respiration and the other to perform CPR. (This is not easily done without prior practice and it is well worth attending sessions on CPR training to become familiar with the technique.)
• The ratio of chest compressions to breaths is 15:2 for both one-person and two-person CPR.
• Continue until the ambulance arrives or the patient gets a pulse and starts to breathe again.
• If the pulse returns and breathing begins but the person remains unconscious, roll them gently onto their side into the recovery position. This way mucus or vomit can get out of the mouth and will not obstruct the patient's breathing. It also prevents the tongue from falling back and blocking the air passage.

Make sure the patient continues breathing and has a pulse until the ambulance arrives :

• If you succeed in resuscitating the person who has been taken ill, he or she may be confused and alarmed by all the commotion. Keep the patient warm and calm by quietly, but clearly, telling them what has happened.

Again, it needs to be emphasised that the only way to provide proper first aid and resuscitation is through learning the technique, then regular practice and guidance.

Mind it :

• Call emergency medical number. Don't tough out the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options, and realize that it places you and others at risk when you drive under these circumstances.
• Chew and swallow an aspirin, unless you're allergic to aspirin or have been told by your doctor never to take aspirin. But seek emergency help first.
• Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else's nitroglycerin, because that could put you in more danger.
• Begin CPR.

What's the Difference Between a Heart Attack and a Stroke?

Answer: Heart attack refers to damage to the muscle of the heart, usually from a lack of blood flow. Most of the time, a blood clot forms in one of the arteries that supplies the heart muscle with blood, blocking the flow of blood. As the heart muscle starves, it begins to die, causing chest pain and other heart attack symptoms.

A stroke is a similar blockage in an artery that supplies blood to the brain. When a clot forms in one of those arteries and stops blood flow, a section of the brain begins to die. Stroke symptoms often don't include any pain or discomfort, and are more likely associated with losing feeling or the ability to move. Much of the time, strokes affect only one side of the body.

These two terms are so often misunderstood that some in the medical community are attempting to do away with stroke and replace it with the term brain attack.

Prevention :

• Routine health check-up

• Avoid stress

• Quit smoking / alcohol

• Eat sensibly

• Control blood pressure / diabetes

• Control weight.

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