First Aid: Heart Attacks
Participants enrolled in emergency first aid will learn about cardiovascular diseases and emergencies that relate to and include heart attacks. Cardiovascular disease is the number one killer of North Americans over the age of 44. Emergency first aid teaches candidates how to recognize and provide care for patients suffering from a heart attack. This page will outline the signs and symptoms and the ideal care for a patient showing signs of a heart attack. The material posted on this page is for information purposes only. To learn to recognize and treat a heart attack patient take an emergency first aid course in Saskatoon. Other training partner locations include Vancouver, Ottawa, Edmonton, Calgary, Kelowna, Surrey, Regina and Winnipeg.
How Is Heart Attack Diagnosed
You may need several tests to determine the cause of your symptoms.
- Electrocardiogram. This test records the electrical activity of your heart. It can help diagnose heart rhythm problems. It can also find damage from a decrease in blood flow.
- Blood tests.When blood flow decreases, special proteins leak into the blood system. A blood test can detect these proteins. Your doctor will want to test your blood several times during the first 24 to 48 hours after yours symptoms start.
Other tests your doctor may want you to have include:
- Echocardiogram. This test uses sound waves to create pictures of your heart. The pictures show how well your heart is pumping. It can show if there are problems with your heart valves.
- Chest X-ray.This looks at the size and shape of your heart. It can show if there is any fluid in your lungs.
- Nuclear imaging.This test injects a tiny radioactive substance into your blood. This substance travels to your heart to create pictures of it. It shows how well your heart is pumping. The radioactive substance is safe and leaves your body after the test is finished.
- Coronary angiography. This test is sometimes called cardiac catheterization. It involves inserting a long tube into a blood vessel. The tube is guided to the heart or arteries that carry blood to the heart. A substance is injected into the tube that makes it visible by X-ray. It allows your doctor to see where the blockage that caused the decrease in blood flow to your heart is located.
Changes In Oxygen Recommendations From Mona
Routine oxygen therapy during heart attack is a long-standing tradition, however there were questions about whether this practice was beneficial, or if it caused additional problems as early as 1976.
Later research studies have had mixed results, from some showing increased complications with oxygen therapy and others showing no difference in patient outcomes. These studies compared heart attack patients who were normoxemic despite their current cardiac problemsthat means their oxygen saturation was normal.
Bottom line: Dont routinely administer oxygen therapy during myocardial infarction. Only consider oxygen therapy if the patient is also showing signs of hypoxemia. If the patient is normoxemic, then skip the oxygen.
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Whats The Difference Between A Heart Attack And A Cardiac Arrest
A heart attack is a sudden interruption to the blood supply to part of the heart muscle. Its likely to cause chest pain and permanent damage to the heart. The heart is still sending blood around the body, and the person remains conscious and is still breathing.
A cardiac arrest happens when the heart suddenly stops pumping blood around the body. Someone whos having a cardiac arrest will suddenly lose consciousness and will stop breathing – or stop breathing normally. Unless immediately treated by cardiopulmonary resuscitation , this always leads to death within minutes.
A person having a heart attack is at high risk of experiencing a cardiac arrest.
Both a heart attack and a cardiac arrest are life-threatening medical emergencies and require immediate medical help.
Aspirin As A Preventive Measure
A healthcare professional may prescribe a daily low dosage of aspirin to prevent heart attacks.
One 2019 study found that people who regularly took aspirin had a 14% reduced risk of experiencing a first heart attack. However, the same study cautions against the widespread use of aspirin for this purpose. This is because regularly taking aspirin may increase the risk of major bleeding problems by 46%.
Also, a 2020 study concluded that the potential benefits of aspirin are not the same for everyone. For example, the researchers found that regular aspirin use only reduced the chances of a first heart attack for some people who had an increased risk of cardiovascular disease.
People with this increased risk include those who:
- currently smoke
- have a history of high blood pressure
- have a history of high blood cholesterol
So, while aspirin can help prevent a first heart attack for some people, this benefit may not be widespread.
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Heart With Muscle Damage And A Blocked Artery
A less common cause of heart attack is a severe spasm of a coronary artery. The spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren’t affected by atherosclerosis.
Heart attacks can be associated with or lead to severe health problems, such as heart failure and life-threatening arrhythmias.
Heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. Arrhythmias are irregular heartbeats. Ventricular fibrillation is a life-threatening arrhythmia that can cause death if not treated right away.
Be Prepared For A Heart Attack
What does a heart attack feel like? For women , its not the crushing, chest-grabbing pain you often see in the movies. While women may experience debilitating pain, its more likely youll feel an uncomfortable chest pressure or squeezing, shortness of breath, something like heartburn, or even mild symptoms like fatigue or lightheadedness.
But even before symptoms strike, you can prepare by knowing which hospitals in your area have 24-hour emergency cardiac care. Also, keep a list of emergency phone numbers next to your phone and with you at all times, as well as a list of your medications.
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Tests Can Help Make A Diagnosis
A number of diagnostic tests may be used to find out whether youve had a heart attack.
Electrocardiogram This test uses electrodes that attach to your skin to record your hearts electrical activity. The results are shown as waves on a monitor or paper.
Since injured heart tissue doesnt send electrical signals normally, an ECG can show that a heart attack is happening or has happened. It can also help your doctors determine the likely location of your heart attack.
Blood tests When you have a heart attack, heart muscle cells die and release proteins into your bloodstream. By measuring levels of these proteins, doctors can learn the timing and severity of your heart attack.
Common blood tests in this category include troponin, CK or CK-MB, and serum myoglobin.
Coronary angiography This test involves injecting a special dye through a catheter into your coronary arteries and using X-rays to view how the dye moves through the vessels, looking especially for any blockages.
If a blockage is found, your doctor may recommend a procedure to open the vessel with a stent or possibly a surgery to bypass the blockage.
Echocardiogram This test uses sound waves to create a moving image of your heart on a monitor. Its used to look for possible damage to certain structures of your heart, such as your valves and heart muscle.
What Should I Do If I Have A Heart Attack While I’m Alone
Call 9-1-1 immediatelydo not attempt to drive yourself to the emergency room. While you wait for help:
- If you’ve been prescribed nitroglycerin, take it as directed.
- Whether you have nitroglycerin or not, take 325 milligrams of aspirin. It will work faster if you chew the tablet rather than swallow it whole.
- Make sure your door is unlocked so the emergency team and friend or family member can get in.
- Wrap up in a blanket to stay warm.
- Sit comfortably propped up and try to stay calm.
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Would You Know What To Do In Case Your Loved One Suffers A Heart Attack Well Here Are Expert Tips That Can Help You Save Someone’s Life
Written by Editorial Team | Updated : February 9, 2017 5:50 PM IST
A heart attack is a serious condition where the arteries supplying blood to your heart is unable to do so because of a blockage or other complications. Quickly becoming a common occurrence with even people in their 20s and 30s suffering from the condition, a person may suffer a heart attack without any warning signs. In this post, our expert Dr Vijay Surase tells you exactly what you need to do to help the person who might be suffering from a heart attack before you can take him/her to a hospital for treatment.
What should you do when someone has a heart attack?
Dr Surase says, ‘ If a person is having chest pain, even if there s a chance that he might not be suffering from a heart attack, he deserves the benefit of doubt. The first step is to help the patient relax. Loosen their clothes and open the windows. Next pop a tablet of aspirin into their mouth. Don t give it to them with water. Ask them to chew it instead. If that s not possible crush the tablet in a little water and give it to them. Another medicine you can use is sorbitrate. Place the tablet under the patient’s tongue. You can give up to three sorbitrates in five minutes. Both aspirin and sorbitrate have anti-coagulant properties and help dissolve blood clots. However DO NOT GIVE sorbitrate to people who have low blood pressure or/and are sweating profusely.’
What Should You Do If You Think You Are Having A Heart Attack
If you have symptoms of a heart attack, act fast. Quick treatment could save your life.
If your doctor has prescribed nitroglycerin for angina:
If you do not have nitroglycerin:
The best choice is to go to the hospital in an ambulance. The paramedics can begin life-saving treatments even before you arrive at the hospital. If you cannot reach emergency services, have someone drive you to the hospital right away. Do not drive yourself unless you have absolutely no other choice.
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What Causes A Heart Attack
Heart attacks happen when blood flow to the heart is blocked. This usually occurs because fatty deposits called plaque have built up inside the coronary arteries, which supply blood to the heart. If a plaque breaks open, the body tries to fix it by forming a clot around it. The clot can block the artery, preventing the flow of blood and oxygen to the heart.
This process of plaque buildup in the coronary arteries is called coronary artery disease, or CAD. In many people, plaque begins to form in childhood and gradually builds up over a lifetime. Plaque deposits may limit blood flow to the heart and cause angina. But too often, a heart attack is the first sign of CAD.
Things like intense exercise, sudden strong emotion, or illegal drug use can trigger a heart attack. But in many cases, there is no clear reason why heart attacks occur when they do.
Other Ways To Describe Chest Pain
People who are having a heart attack often describe their chest pain in various ways. The pain:
- May feel like pressure, heaviness, weight, tightness, squeezing, discomfort, burning, a sharp ache , or a dull ache. People often put a fist to the chest when describing the pain.
- May radiate from the chest down the left shoulder and arm and also to other areas, including the left shoulder, middle of the back, upper portion of the abdomen, right arm, neck, and jaw.
- May be diffuseâthe exact location of the pain is usually difficult to point out.
- Is not made worse by taking a deep breath or pressing on the chest.
- Usually begins at a low level, then gradually increases over several minutes to a peak. The discomfort may come and go. Chest pain that reaches its maximum intensity within seconds may represent another serious problem, such as an aortic dissection.
It is possible to have a “silent heart attack” without any symptoms, but this is rare.
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Other Common Signs And Symptoms
Pay attention to these other possible symptoms of a heart attack:
- Breaking out in a cold sweat
- Feeling unusually tired for no reason, sometimes for days
- Nausea and vomiting
- Light-headedness or sudden dizziness
- Any sudden, new symptoms or a change in the pattern of symptoms you already have
Not everyone having a heart attack has typical symptoms. If you’ve already had a heart attack, your symptoms may not be the same for another one. However, some people may have a pattern of symptoms that recur.
The more signs and symptoms you have, the more likely it is that you’re having a heart attack.
What This Means For Nursing Students
Always look at the context of the question if you see a question like this on an exam. If the patient is hypoxic and in a medical setting, then you will probably still see Oxygen as an answer because of the ABCs . Hypoxia would be a circulation issue, so oxygen may be indicated in this situation.
If they are in a non-medical setting, then the patient might need to take nitrates first , or aspirin first if nitrates are not available and a heart attack is suspected.
But if the patient is otherwise stable or has received appropriate treatment, but is still in severe pain, then Morphine may be indicated.
All in all, remember that NCLEX tests if you are a safe, effective, beginning nurse. They are not going to be testing you to see if you can provide complete medical care for a complicated cardiac case using cutting edge research. Thats why understanding the principles behind MONAboth in the way it was used in the past AND in the presentwill be your key to answering exam questions on this topic.
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Learn First Aid For Someone Who May Be Having A Heart Attack
1. The person may have persistent, vice-like chest pain, which may spread to their arms, neck, jaw, back or stomach.
This pain happens because a blockage stops blood getting to the heart muscle. The pain will not ease with rest.
2. Call 999 as soon as possible.
If you cant call 999, get someone else to do it. The person needs medical help as soon as possible. A heart attack can be very serious and needs immediate attention.
3. Help the person to sit down.
Ensure they are comfortable for example, sitting on the floor and leaning against a chair or a wall. Sitting will ease the strain on the heart. Sitting them on the floor also means they are less likely to hurt themselves if they collapse.
4. Reassure them while you wait for the ambulance.
Taking Aspirin During A Heart Attack
Aspirin can help reduce the severity of a heart attack. However, as the American Heart Association note, aspirin alone cannot treat a heart attack.
Before taking an aspirin for a suspected heart attack, contact 911 or the local emergency number. The operator can advise whether to take aspirin and how much to take.
If the operator does not suggest aspirin, the person may receive it in the emergency department.
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Smi: Unaware Of Possible Danger
The number of people who suffer an SMI and don’t realize it is alarming. A study in the Nov. 10, 2015, Journal of the American Medical Association looked at almost 2,000 people ages 45 to 84 who were free of cardiovascular disease.
After 10 years, 8% had myocardial scars, which are evidence of a heart attack. Most surprising was that 80% of these people were unaware of their condition. Overall, the prevalence of myocardial scars was five times higher in men than in women.
SMI and regular heart attacks share the same risk factors: smoking, being overweight, lack of exercise, high blood pressure, high cholesterol levels, and diabetes. They can be just as dangerous, too. “SMI often leaves scarring and damage to the heart, which, combined with the fact that many people who have an SMI don’t seek immediate care, can further raise a person’s risk of a second and potentially more harmful heart attack,” says Dr. Plutzky. In fact, people who have an SMI and don’t get treatment have a three times greater risk of dying from coronary artery disease. “A silent heart attack is a loud signal your body sends that you have some kind of underlying health issue that needs attention,” says Dr. Plutzky.