What do we mean by Early Heart Attack Care?

It may be somewhat confusing and misinterpretation may take place. To be specific, it is really early heart attack care (EHAC). The American Heart Association teaches about early heart attack care when it describes symptoms that lead to cardiac arrest and severe heart damage. However, this aspect is often lost. It needs to be highlighted and magnified many times so as to generate an awareness program for this with the same intensity as that seen with cardiopulmonary resuscitation. Thus early heart attack care applies to patients who present with milder type of chest discomfort before late cardiac care needs to take place, namely CPR or clot dissolving therapy for occlusive coronary disease.

Why is it so important to separate Early Heart Attack Care?

Perhaps the most important reason is to allow us to see this more clearly in exposing the dynamics that take place when the heart attack begins. This approach will get us on the learning curve necessary for behavior modification of the community and give us a better game plan on how to specifically treat early cardiac symptoms.

Why is this necessary?

This message if widely applied can penetrate the communities of the United States and may be the force that topples heart disease as the number one killer of the adult population in the United States. Heart disease has been number one since the turn of the century. No one can ever remember it being out of first place.

What is the game plan?

1. Heart attacks have beginnings (so called prodromal stage).
2. This message can be taught to the public (history taking).
3. Intervention early prevents crashes to sudden death and damage.
4. This can be acted upon by:
   a) The individual who has been reprogrammed to act when early heart attack symptoms are present.
   b) The bystander or first responder who moves from a passive (enabler position) to one of activating the process (so called early cardiac care giver). The Latin expression "bis dat qui cito dat" applies here, "He gives twice who gives early".

How can it be taught to others?

This program of early heart attack care (EHAC) can be taught in many ways and at various levels in the educational system. Provider courses can be self-taught courses such as the video/quiz available at the 1800 BlockBuster video stores and through the "Cardiac Deputies to the Rescue" as taught by the Speakers Bureau at St. Agnes Hospital. It can also be taught at the community college level, where it can provide a means to train instructors, certifying them in this teaching process. In addition to this, the college can serve as a focus for research as it will take several generations of thought to develop early heart attack care more fully. The target audience may differ but should include not only the general public but also paramedics, firemen, policemen, educators in health programs, physical fitness instructors, etc.

Why don't patients come in early?

There are a number of different reasons for this:

1. The patient may perceive this as "not pain" and since it is not real pain and thesymptoms are only mild, it is easily put on the back burner. The patient may even be upset if he is made to feel that he has to have mild symptoms checked out.
2. Patients may try to work through their problem, tough it out. This comes from childhood experiences in which parents program children to work through it. To counter this, reprogramming needs to take place if we are ever to make inroads on this number one health problem.
3. The emergency rooms are perceived as "pits" that are only for very sick patients.
4. The paramedic 911 response is perceived as sirens and ambulances and as an embarrassing situation with neighbors trying to see what is going on.
5. Potential first responders at the scene are easily swayed by rationalizations of the patient so as to get on with their own lives. It is an active good samaritan process to have people act as an early heart attack care giver.
6. Patients may not come in because they are not aware of the true importance of these symptoms. To overcome this, an awareness program is needed with knowledge about what actually is taking place and what will take place within a short period of time should intervention not be available.
7. Lack of appreciation of the heart pump for its marvelous role in the pursuit of full activity. The cardiac engine should be looked upon as a finely built apparatus, one that has to be looked after and not beaten into the ground or have tar spilled into the cylinders (cigarettes).
8. Patients just simply wait it out, hoping that the symptoms will go away. But time is like a river without banks, it easily gets away from you and that short period of time amounts to hours allowing for full damage to take place.

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