Two Minute Warning Drill For Having a Heart Attack
In seeing patients in cardiology follow-up on a 6 month basis, I usually give the patient a chance to bring me up to date on symptoms and then proceed to do the physical examination interpreting for the patient what I perceive to be the direction for the next several months. Most importantly I let the patient know that should any changes in symptoms take place I need to know early, and that if I don't hear from them, I assume that they are okay. I then finish by giving what I call the "two minute warning drill" aimed directly at intervening at the early stages of a heart attack. I have been asked many times, "what do I tell patients in the last two minutes of their visit that makes them understand clearly what needs to be carried out". The following is given:
- I let patients know that heart attacks kill.... and that they kill frequently... and that they
need not kill.
- I let them know that in a large percentage of patients (50%) with heart attacks there are
beginning signs that are recognizable and detectable prodromal symptoms).
- I let them know that these prodromal symptoms usually do not get much attention because of four
characteristics:
- Such chest discomfort is not perceived as chest pain and thus not felt emergency enough to go to the emergency department. Such symptoms are usually milder forms of chest discomfort described as chest pressure, chest ache, burning sensation, or a lulIness within the chest.
- Chest symptoms are usually intermittent which allows the patient to be deceived into thinking that they may not come back or if present will go away. This stuttering effect allows the patient to minimize the diagnosis rather than face the reality that it may be a heart attack.
- As one can expect, such symptoms are not usually recognizable in a crowd such as the patient with a cardiac arrest or a crushing chest pain. First responders take advantage of this and enable the non-response to take place.
- Finally, patients with mild symptoms are very reluctant to call 911 with the disturbances that ambulances with loud sirens bring to one's neighborhood.
Heart attacks are vulnerable if they can be intercepted at an earlier stage. This type of intervention prevents not only death to the individual, but prevents loss of heart muscle which is very much important in the pleasures of life (EHAC Message).
All of this can be given to the patient within two minutes as a "pep talk" and is analogous to a "half-time pep talk" that the patient needs before being sent out of the office. This message is given to you at this time so that you also can benefit from this two minute EHAC drill.
It is very important to realize the fact that primary risk factor reduction can reduce the incidence of coronary disease but it is equally as important to know that when rupture of an atherosclerotic plack has taken place and thrombus formation is forming that it is very important to act early since this could easily become the final risk factor in once's life. Thus chest pain or chest discomfort needs to be emphasized as a major risk factor in acute myocardial infarction. It is important to have an alert system and a plan of action to take advantage of this EHAC knowledge.
Raymond D. Bahr, MD, FACP, FACC
Medical Director
The Paul Dudley White Coronary Care System
St. Agnes HealthCare
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 |