Pearls of Early Heart Attack Care (EHAC)
EHAC "available in carryout..."
CPR is for the dead...EHAC is for the living...
The secret is out. The heart attack problem is vulnerable. The war is winnable. It has an Achilles' heel. The key is to act early when prodromal symptoms occur. These are present in half of the cases. When they occur, listen to them...be in touch and respond...it may be your only chance.
Chest pain is a risk factor for a heart attack damage and death. Failing to detect leads to a poor prognosis. Only when we call it a risk factor can we begin to find the solution to the heart attack problem.
The secret to the solution of the heart attack problem is in listening to the patient...The clue to the Rosetta Stone is here...Listen to this message that we call EHAC, the acronym for Early Heart Attack Care.
THE QUICK MESSAGE:
EARLY SYMPTOM RECOGNITION OF A HEART ATTACK
Heart attack may present as various types of chest discomfort that is:
Not perceived as "PAIN" (mild onset)
Not perceived as "EMERGENCY" enough to warrant going to the Emergency Department
Often "INTERMITTENT", giving way to excuses. Very deceptive.
Easy to deceive others in not giving it away.
Bystanders not aware.
PUBLIC AWARENESS OF EARLY HEART ATTACK CARE SYMPTOMS.
As health care professionals we often hear the words and thoughts that victims who survive heart attacks have before the event."I might be having a heart attack...Nah."
"I am an active energetic 45 year old man who neither has the time nor the inclination to fool around with a heart attack."
"I know the symptoms:crushing chest pain or severe pain radiating down the left arm."
"I know if I limit fatty foods, and if I exercise regularly then I will not have to worry about heart problems until I'm much, much older."
"I'm in good physical shape with no family history of heart disease, so I'm not concerned."
"So I'm a little overweight, I don't over eat but you know how those fast food restaurants are so convenient. My cholesterol and triglycerides are a little high."
"I really need to exercise more. My mother died of a heart attack, but she smoked and I don't smoke."
"You can only do so much, do you know what I mean?"
"I get a little short of breath when I exercise, but generally I'm in pretty good health. I mow my own lawn and take care of things around the house. If I had heart problems, I'd never be able to do all of the things I do so I'm sure any symptoms are meaningless."
"I've had a heart attack. I know what it is like. The pain knocked me down. I've got what they call collaterals so I'm really safer than most anybody else. I just have to be aware of my limits and not push myself."
"I know all of the symptoms. It doesn't matter what you do, something is going to get you anyway. When your number is up, it's up; besides my parents lived to a ripe old age."
All of these potential heart attack survivors have one thing in common. And that thing severely decreases their chances of avoiding a heart attack. They all have selective attention. They each attend to the part of their lives that allows them to ignore, overlook, rationalize, modify, minimize, or deny the possibility of a heart attack.
"I know if I limit fatty foods and if I exercise regularly..."
"My mother died of a heart attack, but she smoked and I don't smoke."
"If I had heart problems, I'd never be able to do the things I do."
"I've got what they call collaterals so I'm really safer..."
"When your number is up, it's up..."
CAN YOU THINK OF ANY OTHERS THAT WERE NOT LISTED? LET US KNOW...
Selective attention refers to the brain's capacity to limit and choose between stimuli and thoughts. Without selective attention, we would not be able to distinguish the singer's voice from the background music: we would not be able to watch a tennis ball volley back and forth across the net; and in our thoughts we would not be able to distinguish relevant from irrelevant information and to prioritize the importance of that information.
Therein lies the problem of selective attention. We prioritize and choose information that is relevant. That is, information that we choose to make relevant. Unfortunately, relevance has little to do with reality and a lot to do with perception. Equally unfortunate is the fact that perception is distorted by the brain's willingness to accept reality. Some realities are clearly more appealing than others. There would be significantly fewer bankruptcies if we selected to attend to the consequences of over charging on credit cards. The marriage rate and subsequently the divorce rate would substantially be reduce if we attended to who our future partner is rather than who we wanted him or her to be.
The death rate and amount of damage from heart attacks could be significantly reduced if we selectively attended to warning signals rather than selectively unattending to them.
Fact 1: There are risk factors that increase your chances of having a heart attack.
Fact 2: Some of these risk factors; for example, smoking, high cholesterol, inactivity, and high stress can be managed and their effects minimized.
Fact 3: There are warning signs for a pending heart attack that may precede the event by days or weeks, for example, mild chest discomfort.
Fact 4: If you react to these warning signs by seeking a care facility, a heart attack can be prevented, not treated but PREVENTED, and you become a heart attack SURVIVOR.
Fact 5: If you prevent the heart attack and consequent heart damage, you can maintain a healthy heart rather than change your lifestyle to compensate for a damaged heart.
For those of us who regularly change the oil in our cars, who periodically notice the temperature, battery and oil gauges, and who recognize the squeak from the brakes as a sign of a pending problem; we generally spend much less time in the auto shop getting repairs.
Fact 6: If you selectively attend to the gauges of your body, and accept them as warning signs worthy of taking yourself to a care facility, you will be less likely to need "the big repair".
Your selective attention can significantly increase your chances for - not just surviving a heart attack - but for avoiding it all together.
If you knew that by ignoring the squeaky brakes you would quadruple the cost of repair, wouldn't you attend to them sooner?
If you knew that when the temperature gauges showed "hot", you would soon burst your hoses and crack gaskets necessitating a major repair wouldn't you pull into a service station for repair?
If you knew that when your oil pressure gauge showed zero, you were minutes away from "blowing your engine" forcing you to buy a new one, wouldn't you stop and get help?
WHAT ARE THE WARNING SIGNS OF AN EARLY HEART ATTACK?
Since you know that quickly getting yourself or your loved one to a care facility may prevent any heart damage at all, selectively attending to and acting on warning signs will make you a non heart attack survivor rather than a heart attack victim.
"Am I having a heart attack? Maybe! Can I do something to help myself? YES, I CAN!"
Raymond D. Bahr, MD, FACP, FACC
Jack Long, LCSW, BCD
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