Recognizing and treating a heart attack

A heart attack (acute myocardial infarction) occurs when a buildup of cholesterol in one or more of the coronary arteries causes blood to clot.

This blockage restricts the supply of oxygen rich blood to the heart muscle causing the muscle to become damaged.

The damage can become irreversible and parts of the heart muscle will die if medical help is not received promptly.

Unfortunately symptoms of a heart attack are often dismissed as something less severe such as indigestion. Not all symptoms occur with every patient and some may occur then disappear and return later.

It is generally accepted by medical professionals that during a heart attack the body will usually send one or more of the following signals:

Uncomfortable pressure, pain, squeezing or fullness in the center of the chest lasting for more than a few minutes. This condition is also referred to as angina.

Pain, pressure, tightness or burning spreading to the shoulders, neck, jaw, arms or abdomen.

Lightheadedness, fainting, sweating, nausea or shortness of breath.

Anxiety, nervousness and/or cold, sweaty skin.

Paleness or pallor.

Increased or irregular heart rate.

Feeling of impending doom.

Chest discomfort lasting for more than a few minutes is usually the first symptom to occur and if the patient displays any of the other symptoms or is at risk of heart attack due to advanced age, poor health, obesity or previous medical history, it is important to adopt a ‘better safe than sorry’ attitude and get medical help fast.

Asses the scene, activate EMS and don your barriers (gloves). Be prepared to perform CPR if the patient’s condition worsens to cardiac arrest. Perform your primary assessment (ABCD’s) and monitor the patient’s ‘lifeline’.

Conduct an illness assessment and record your observations (have a bystander do this for you if possible). Information you obtain from the patient such as pulse rate, respirations, reported symptoms, etc. can be very valuable to EMS when they arrive.

If the patient has a history of angina and has nitroglycerin you may assist them in taking their medication. If directed to do so by EMS personnel you may also administer Aspirin (ASA) to the patient. Aspirin is a potent inhibitor of blood clots and can decrease the risk of death from heart attack.

Help the patient into a comfortable position and loosen any tight fitting clothing. Consider administering oxygen if available and continue to monitor the patient’s lifeline until EMS arrives.

This column is only an introduction to emergency care skills and is designed to increase interest in First-Aid/CPR training. For information on courses please contact the Red Cross, a medical professional or a local dive shop.

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