May 29, 2012

Heart Attack: Three Key Survival Strategies

I had my annual physical checkup two weeks ago, and my internist gave me a lecture: "What To Do If You Think You're Having a Heart Attack." To reinforce the important advice, he gave me a copy of a Wall Street Journal article that explains what needs to happen... and why. It was pretty clear he was sharing this advice with all his senior patients.

Minutes Matter, Yet Many People Delay Acting
Every year, heart attacks claim about 133,000 Americans, while another 300,000 die from sudden cardiac arrest... mainly because they didn't get help in time. Of all the efforts to reduce deaths from cardiovascular disease in the U.S., "this is our Achilles' heel, and it's the area where we've made the least progress," says Ralph Brindis, a past president of the American College of Cardiology.

Heart attack sufferers fare best when they get to the hospital within one hour after symptoms appear. But on average, it takes two to four hours for patients to arrive. Some wait days before seeking medical care.

The more time it takes to get help, the more heart muscle dies. Even if the initial heart attack isn't fatal, damaged heart muscle can lead to congestive heart failure later -- one of the reasons why 19% of men and 26% of women over age 45 die within one year of their first heart attack, according to the American Heart Association.

The Three Crucial Things To Do
The advice sounds simple. The best way to survive a heart attack is:
  1. Recognize the symptoms.
  2. Call 911.
  3. Chew an aspirin while waiting for emergency personnel to arrive.
Recognizing the Symptoms
Heart attack victims typically have some warning, and the stereotypical "Hollywood heart attack" -- clutching the chest in agony -- is only one (less frequent) scenario. The feeling in the chest may be more like a squeezing, a tightening of heavy pressure. It may radiate down the left arm or up to the jaw around the back between the shoulder blades. Women often experience flu-like symptoms, with no chest pain at all.

Both men and women may have indigestion, nausea, light-headedness, profuse sweating, shortness of breath, and overwhelming fatigue. People experiencing this fatigue may decide to lie down and take a nap. Not a good idea!

Call 911
Most of us have heard this advice before. But we still may not act on it when experiencing symptoms of a possible heart attack.  

For example, I'm only a few minutes away from Sibley Hospital. I can easily imagine myself deciding to drive there myself, rather than calling 911 and waiting for the EMTs to arrive. A Yale University survey of heart attack survivors found that 41% said someone else drove them to the hospital, and 13% drove themselves.

Calling 911 has many important advantages. "Rescue squad" personnel can perform CPR or use a defibrillator before you get to the hospital. They can initiate other important procedures or tests, and administer medications. They can alert the hospital to position appropriate equipment. They can significantly reduce that key time between your arrival at the hospital and the reopening of a blocked artery. Then there's this simple reality: patients arriving by ambulance are treated more quickly than those who show up on their own.

But if you do go to the hospital on your own, be sure to announce "I think I'm having a heart attack" as soon as you arrive.

Don't call your doctor first; doing so only wastes precious time. CALL 911 FIRST.

Even if you only suspect that you might be experiencing a heart attack, call 911 as soon as possible. "It takes skilled physicians and nurses and lab technicians and often some kind of imaging tests to actually diagnose a heart attack, so there's no way you can diagnose it yourself at home." says cardiologist Janet Wright. She's executive director of the Department of Health and Human Service's Million Hearts campaign, which aims to   prevent one million heart attacks and strokes in the next five years.

Chew an Aspirin
While waiting for help to arrive, CHEW one adult-strength aspirin, since aspirin helps prevent blood clotting and may help keep an artery partially open. Don't just swallow the aspirin. Chewing delivers the pill's benefits to the bloodstream much faster. The brand doesn't matter as long as it's uncoated. Tylenol, Advil, and other pain pills that aren't aspirin-based will not provide the same potentially life-saving effects.

Each time I leave my house, I try to remember to carry a pill container with one of my Parkinson's carbidopa-levodopa pills. Now, I'm also including an aspirin. An old contact lens container works perfectly.

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