How to Survive a Heart Attack

Heart disease is the number one killer in the U.S. Every day, more than 2600 Americans die from cardiovascular disease, which amounts to one death every 33 seconds, according to the Web site Emedicinehealth.com.

Most of these deaths occur with little or no warning, from a syndrome called sudden cardiac arrest. The most common cause of sudden cardiac arrest is a disturbance in the heart rhythm called ventricular fibrillation.

Ventricular fibrillation is dangerous because it cuts off blood supply to the brain and other vital organs.
Ventricular fibrillation often can be treated successfully by applying an electric shock to the chest with a procedure called defibrillation.

• In coronary care units, most people who experience ventricular fibrillation survive, because defibrillation is performed almost immediately.
• The situation is just the opposite when cardiac arrest occurs outside a hospital setting. Unless defibrillation can be performed within the first few minutes after the onset of ventricular fibrillation, the chances for reviving the person (resuscitation) are very poor.
• For every minute that goes by that a person remains in ventricular fibrillation and defibrillation is not provided, the chances of resuscitation drop by almost 10 percent. After 10 minutes, the chances of resuscitating a victim of cardiac arrest are near zero.

Cardiopulmonary resuscitation, usually known as CPR, provides temporary artificial breathing and circulation.

• It can deliver a limited amount of blood and oxygen to the brain until a defibrillator becomes available.
• However, defibrillation is the only effective way to resuscitate a victim of ventricular fibrillation.

What should you do if you think you might be having a heart attack?

If you experience any symptoms suggestive of heart attack, especially if you know you have risk factors for coronary artery disease, your key to avoiding death or permanent disability is to get yourself to medical help as soon as possible. If you live in an area where paramedics can get to you within a few minutes, then call for them. If it would be quicker to have someone drive you to a hospital, then do that. But get help right away. If you are having a heart attack, every minute is vitally important. And while you’re waiting for the paramedics, or while being driven to the hospital, take an aspirin.

The patient’s reluctance to get medical help is the most common reason for critical delays in therapy for heart attacks. It is probably coded into all of our genes to want to say, “This can’t be my heart. It’s got to be something else. I’ll just wait a little while and see if it goes away.” As difficult as it is to push aside this natural tendency toward denial, if you know you’ve got an increased risk of heart disease, that’s what you need to do. This is one time you really need to listen to your body; if it feels like there is something terribly wrong, there probably is.

What medical personnel should do when you arrive

They should be taking your symptoms very seriously. This is not one of those times when you should expect to show up in the emergency room and sit around for two hours waiting for a sullen, gum-snapping clerk to take your insurance information. Instead, this is one of those times when they should immediately place you into a treatment room, and several individuals should simultaneously hook you up to a cardiac monitor, start an I.V., give you some oxygen, get an ECG, draw some blood tests, and begin asking you questions about your symptoms and examining your heart.

To make sure you elicit the correct response from emergency personnel, you’ve got to say the magic words as soon as you arrive. The magic words are, "I think I’m having a heart attack."

Don’t tell them you’re here because your shoulder hurts, or you think you have heartburn, or that you have any of the other alternate possibilities you’ve imagined for yourself. Your attitude should not be, “It’s probably nothing, so I won’t make a big deal. Let them figure out if it’s my heart.” If that’s your approach, you’ll get the sullen, gum-snapping treatment, precious minutes (or even hours) will be wasted, and you’ll pay a heavy price.

The first priorities of the medical personnel are a) to make sure your vital signs (pulse and blood pressure) are stable, b) to prepare to deal with life-threatening conditions that may appear (such as ventricular fibrillation), and c) to decide whether or not you’re actually having a heart attack.

In most cases, diagnosing a heart attack is straightforward. By taking a quick medical history and looking for characteristic changes on an ECG, the diagnosis is usually quite apparent. Measuring elevations in cardiac enzymes - proteins released into the bloodstream by damaged cardiac muscle cells - can confirm the diagnosis of heart attack, but usually treatment should begin before waiting for the results of blood tests.

Once a heart attack is diagnosed, immediate steps must be taken to relieve the blockage, and to get the blood flowing through the coronary artery once again.