What do We Know About Heart Attacks?
1. What do we know about heart attacks?
It is the number one killer of the adult population in the United States. There are 4,100 heart attacks per day and it accounts for 600,000 deaths each year.
2. What causes a heart attack and why do people die?
Consider the heart as a pump and a great pump with tremendous reserve capacity. It is a muscular pump and as such needs a blood supply with nutrients to survive. There are three major blood vessels supplying it. When blockage takes place, there is interference of blood supply and the muscle supplied by the blocked vessel easily dies. This damages the pump and we either die or live with less of a pump and become less of a person.
3. What causes the blockage?
A disease called atherosclerosis or "hardening of the vessels". Our life style allows the risk factors such as hypertension, cholesterol and cigarette smoking to incubate over a long period of years leading to a 90 to 95 percent cholesterol plaque which finally ruptures allowing a clot and spasm to close the vessel. Within six hours there is usually total damage.
4. What kinds of heart attacks are there?
There are actually three presentations of heart attacks. First, there is a type that stops you dead in your tracks. Second, there is a heart attack where damage is taking place (the six hours we have talked about). Third, there is the heart attack that is just beginning.
5. How can we help the person who is having a heart attack?
We call this the first responder, one who is upon the scene. In the first case we need to know cardiopulmonary resuscitation (CPR) and perform it well. In the second case we need to call 911 the emergency medical system and behave as an executive spouse. Here the patient usually does not put up much of a fuss, the patient is in severe pain and is weak like a kitten. The third is the most difficult one and requires the first responder to be alert and have to act in the absence of peer pressure. We call this person the early heart attack care giver who we will be talking more about.
6. Can heart attack be helped?
Yes, it can be helped. We have seen that risk factor reduction when the disease is in the incubation stage can reduce heart disease. What we need is the identification of a risk factor when the heart attack is starting. Chest pain is that risk factor and we have to understand it. Life begins and life ends. Let's put this under a microscope and look at what is taking place. Somewhere in there, a tear in the building plaque takes place and serves as the event marker for the acute event and the heart attack begins. The sequence in most cases is; chest discomfort leading to chest pain, leading to unstable angina worsening, leading to damaging myocardial infarction, leading to sudden death. Thus, before chest pain there is in most cases a milder form of chest discomfort that is centrally located coming and going that may be present for hours to days before the chest pain becomes severe and does not go away. The real problem of the heart attack situation lies here, in that patients don't come into the hospital until the Mack truck is sitting on the chest or when the crash takes place. The early symptoms are called prodromal and can he likened to the prodromal symptoms of a cold. If it is treated early prevention can take place, namely, sudden death and cardiac damage can be averted.
7. Why is the heart attack problem a tough nut to crack?
To bring home the answer here it is important to act out the three scenarios of heart attacks and see for yourself why it is a problem and see what you can offer to help. Act one is the CPR scene. Act two is the patient experiencing the Mack truck sitting on his chest. Act three is the patient having minimal symptoms and maximal deniability and interaction with a bystander whose usual response is to contribute to the denial. The paramedics coming upon the scene find it difficult to convince a conscious patient that he must go to the hospital. What is needed then is something to turn this around. The problem then lies in this setting or the beginning of a heart attack when the patient is experiencing minimal chest discomfort and practicing maximal deniability, may not be recognized in the crowd aud the first responder is not driven by peer pressure. This is the problem why the heart attack remains the number one killer of the adult population.
8. Is there a secret to working out the problem? How can it be turned around?
The first responder has to become knowledgeable and know that the time to help the patient is when the heart attack is in the beginning stages. There is no peer pressure to act, expect denial and be prepared to argue for the patient to seek out an early check out in an emergency room. We call this approach the emergency or early heart attack care giver. It is important to be active or proactive, be heart smart, be an emergency heart attack care giver. Good Samaritans in this area will solve a problem by their timely actions.
9. Why is denial such an important part of the unraveling of the heart attack problem?
Because it is part of our life style. We constantly forget about ourselves and live our lives as if we are indestructible or immortal, and only are brought to reality when we are burnt. If that is so, perhaps we can minimize the burn and thereafter change the person. Heart attack is a great transformer aud a great reality check. The secret is to nip it when it is in
the beginning stage, i.e., chest discomfort before the severe damage or the sudden death.
10. How important is the heart to life activities?
It is very important. That reserve capacity we talked about allows us to increase the amount of blood pump five fold to do the things we want, such as tennis, marathon running, etc. With less heart action we do less and our quality of life suffers.
11. Any final words?
Yes, I would challenge the viewers and ask them if they were to develop a blockage in one of their heart vessels, what subset would they like to be in and have action taken? Pumping on the chest for a cardiac arrest victim, helping a patient with a Mack truck sitting on his chest and trying to get him into the hospital or perhaps encouraging a patient with minimal symptoms to have it checked out, to be safe rather than sorry. Several hours here can make the difference between pleasurable aud enjoyable life versus no life or cardiac invalidism. Be alert, be active, be heart smart, be an early heart attack care giver.
Home | What's New | What is EHAC? | Abstracts & Articles
Reader's Digest | Contact Us | Search
Tips for Searching
www.ehac.org.
Site by AllSoldOut Internet Solutions
Visit the Clinical Information EHAC site at www.chestpaincenters.org.
Copyright © 1996-2001
by St. Agnes Healthcare. All Rights Reserved.
|
ABOUT
US FROM
DR. BAHR MORE
INFO SUBSCRIBE |