Why you should act quickly at first sign of heart attack
December 18th, 2012
01:40 PM ET

Why you should act quickly at first sign of heart attack

Calling 911 as soon as symptoms of a heart attack begin saves lives, according to the American Heart Association/American College of Cardiology new guidelines published in the AHA journal Circulation and the Journal of the American College of Cardiology.

The newly developed standards are designed to be user-friendly and focus on streamlining care for patients.  They focus on balloon angioplasty and stenting as the best treatment plan for severe heart attacks.

When it comes to heart attacks, helping people understand "time is muscle" is key, says Dr. James Fang, one of the co-authors of the guidelines and director of the Advanced Heart Failure & Transplant Center at University Hospitals Case Medical Center in Cleveland, Ohio. "The longer the heart muscle goes without oxygen, e.g. blood flow, the greater the heart muscle damage," he says.

Doctors work hard to open the blocked blood vessel responsible for the heart attack as soon as possible, says Fang. How fast doctors treat severe heart attacks directly determines a patient's prognosis. But doctors can do nothing if patients don't call for help and get to a hospital as soon as possible.

It's important to increase awareness of heart attack symptoms, says cardiologist Dr. Chandan Devireddy of Atlanta's Emory University Hospital, who was not involved with determining the new guidelines.

The most common and classic symptom is chest pain or discomfort. Other indicators include a nagging stomach ache; unexplained pain in the shoulder, jaw, or arm; unexplained shortness of breath; or just an unexplained feeling of malaise.

"If there is a suspicion, it's better to be careful and seek medical attention because the risk is too great," Devireddy says. "Once a heart attack has happened, there is no way to bring that heart muscle back."

"If you have chest discomfort of any sort between your neck and your waist, you really need to have that evaluated urgently," Fang adds, warning against self-diagnosis - "that's our job. The consequences of being wrong can be catastrophic."

Fang talks about "the golden hour," in which it's critical to open a blocked vessel. If the blockage is remedied within an hour, "your survival (chances are) excellent. The sooner the better - if you can make it five minutes, it's better than one hour."

In the past, physicians have been limited in how quickly they could treat a patient because they couldn't perform an EKG until the patient arrived at the hospital, Devireddy says. Now, with the new guidelines allowing for emergency responders to complete an electrocardiogram on patients with a suspected heart attack, "the second the patient rolls through the door, the medical staff can be waiting and ready to deliver appropriate care," says Devireddy.

The new guidelines make it clear  "placement of a stent is (the) preferred strategy to open the artery causing a heart attack, as long as stenting can be delivered within two hours of (the) patient getting attention," says Devireddy.  And with EMS performing tests such as EKG in the field, "we can get these patients stented as soon as they arrive at the hospital."

The guidelines also call for field medical personnel to be trained in preserving neurological function in a patient in cardiac arrest through hypothermia. "Patients who have cardiac arrest and lose delivery of oxygen and blood to the brain, if we can cool down patients' core body temperature (we) will see dramatic improvements in saving and maintaining cognitive function, or (the) brain's ability to survive," says Devireddy.

Hypothermia protects the brain from further injury from lack of blood flow. "If not dealt with urgently it will lead to death," Fang says.

soundoff (11 Responses)
  1. Oxygen4Energy

    If you need Oxygen get it in a Portable Can at http://Oxygen4Retailers.com

    December 19, 2012 at 00:49 | Report abuse | Reply

    free will to decide

    December 19, 2012 at 03:10 | Report abuse | Reply
  3. donweissman

    Enteric coated baby aspirin every day with a family or personal history of MI is a great idea and lowers the incidence of secondary attack

    December 20, 2012 at 20:23 | Report abuse | Reply
  4. sampler

    After having a couple of panic attacks a couple of years ago that felt like heart attack, II now follow the old "sleep on it" strategy for chest pain and other heart attack symptoms. Simply put, just ignore it and if you wake up in the morning, it wasn't a heart attack...

    P.S. And yes my life insurance policy is paid up...

    December 21, 2012 at 23:53 | Report abuse | Reply
  5. gail

    people in alaska are being subjected to prescription drugs all over and treated like gunea pigs all the time...in our native communities

    December 29, 2012 at 15:22 | Report abuse | Reply
  6. RLTJ's

    It is faster heartbeat and greater blood pressure that causes clog. I am not an MD. I am a construction worker.

    How do I know? Pumping-in, forcefully at the first signs of clogging more often only resulted to a total clog.

    De clogging is best by applying the rubber pump with a backward or pull force. It sucks the clot back and forth as normal natural pressure keep pushing them forward. But in a train-like-manner now instead of all-in a lump all the clogs are sucked through the drain.

    So I think keeping heartbeats slow and keeping pressure down is good.

    January 1, 2013 at 20:13 | Report abuse | Reply
  7. Dan H

    Two comments: First, it's interesting to note that studies have shown significant decrease in risk of fatality from a secondary MI in patients who use preventative aspirin therapy. but that aspirin actually has little impact on life expectancy for those who have never experienced MI. Second, anxiety/panic attacks do tend to manifest many of the same symptoms of MI. It's important to continue your routine visits with your PCP, so that these issues are not overlooked and explained away as simply symptoms of anxiety. Even a panic attack can cause a hypertensive emergency. It's still nothing to be taken lightly. An adjustment in medication or lifestyle may be needed to avoid a repeat of this life-threatening event.

    January 4, 2013 at 21:58 | Report abuse | Reply
  8. Demosthenes P

    We need more info than: "If you have chest discomfort of any sort between your neck and your waist, you really need to have that evaluated urgently," Most of us have had heartburn that fits this loose description.. We can't go running to ER every time we suspect heartburn or a cramp. Can a cardiologist please give us more concrete guidelines that differentiate a heart attack from heartburn? That would be very helpful and probably save lives.

    For example, will our pulse go up or down? Will our BP and breathing rate go up or down? How about dizziness and nausea? Will the chest pain be slight, moderate or severe? Any information along these lines will be very helpful.


    January 7, 2013 at 05:50 | Report abuse | Reply
  9. midnull

    Most symptoms of a heart attack differ between male and female. For males it'll be blaintly obvious but with females because of them being used to loosing a lot of blood..it's tricky.
    Also, panic attacks, heartburn, carpal tunnel, all have similar symptoms of a heart attack...

    I came into the ER with the symptoms of a heart attack, dizzyness, light headedness, severely fatigued where I couldn't even keep my head up, heart racing...and I was let go because they didn't find anything. Next day I did my routine exercise...and started having cold sweats, blurred vision (mind you that I exercise daily, just jogging, nothing stranious) I went back to the Dr. once again nothing showed up...
    She recomanded a cardiologist...but I have no insurance.

    January 22, 2013 at 15:40 | Report abuse | Reply
  10. SandiStorm

    After having bouts of chest pains, irregular heart beats and fainting spells, I went to see a cardiologist. He took one look at me and said "it's probably nothing". I insisted on testing and luckly he left the practice before the results came in. His replacement was a female cardiologist who prescribed an event monitor I wore for one month. As a result, she found a very serious heart arrythmia that would have likely led to a deadly stroke or heart attack. Do yourself a favor, girls. Skip the male doctors and insist on a female physician.

    January 29, 2013 at 20:06 | Report abuse | Reply
  11. Regine Rasnake

    In the human body, the carpal tunnel or carpal canal is the passageway on the palmar side of the wrist that connects the forearm to the middle compartment of the deep plane of the palm.*....;

    Our own webpage

    June 15, 2013 at 11:47 | Report abuse | Reply

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