What To Do If You Think You’re Having A Heart Attack
Daniel Krauss, MD

Once you’ve identified the warning signs, you need to check it out promptly. During a heart attack, a blood clot causes one of the heart’s arteries to become completely blocked, depriving the heart muscle of the oxygen and nutrition needed to function normally. This causes a "myocardial infarction," or death of that part of the muscle fed by the blocked artery. Fortunately, techniques to open the blockage like angioplasty immediately stop a heart attack. The earlier normal blood flow is restored in the blocked artery, the more heart muscle is saved and the greater the chances for a full recovery.

There are lots of reasons to get help right away if you think you’re having a heart attack. People having heart attacks can die suddenly. The benefits of opening up a blocked artery during the attack are diminished as time goes on. So call 9-1-1 immediately. Why call an ambulance instead of driving to the hospital?

• Paramedics can begin treatment right away, even before you get to the hospital.
• Your heart rhythm will be monitored during the trip, so that if dangerous heart beats begin they can be managed before becoming fatal.
• Emergency personnel often communicate with the hospital while en route, enabling you to receive faster care when you get there.

What Will Happen In the Emergency Room?

You will be asked lots of questions:

• What time did your discomfort begin? What were you doing? On a scale of 1 to 10 with 10 being the worst, how severe is your discomfort right now? Did you have other symptoms besides chest discomfort such as shortness of breath, sweating, nausea, palpitations, or lightheadedness?
• What other medical problems have you had? High blood pressure? Diabetes? High cholesterol? Stroke? Bleeding problems? Ulcers? Recent surgeries?
• What medicines do you take? Bring a list!
• Do you have any medication allergies?

• EKG — This is an inexpensive noninvasive test which records the electrical activity of the heart transmitted through the skin of the chest. Abnormal heart rhythms, chamber enlargement, and evidence of past or present cardiac injury can be detected.
• Blood Tests — Damage to the heart muscle from a heart attack causes release of special proteins not normally found in the bloodstream. Levels of these proteins are used to confirm the diagnosis of a heart attack and, if found early in the process, alert doctors to a "high risk" situation for which specialized medicines and procedures may be useful.
• Echocardiogram — Ultrasound pictures can be used to detect abnormalities of the heart muscle or valves, and are easily obtained by placing a microphone emitting sound waves against the chest. This test is noninvasive, painless, and free of side effects.
• Nuclear Scan — This test is often performed both at rest and with exercise. A minute amount of a radioactive substance (giving off less radiation than a chest x-ray) is injected through an I.V. and follows blood flow into the heart. A scanning camera positioned over the chest records uptake of the nuclear material by healthy heart tissue in comparison to the absence of uptake in areas with blood flow problems due to artery blockage.
• Coronary Angiogram, or "heart catheterization" — This is the definitive test for heart artery blockages causing chest pain or heart attacks. It is performed by threading a small plastic catheter through the artery of the leg or arm into the heart, where special x-ray dye is then injected to visualize the heart and its arteries.

Plan Ahead

So make a plan now for what you can do to protect yourself or your loved ones if a heart attack is suspected.

• Learn the heart attack warning signs.
• Talk with your doctor about how you can reduce your risk of heart attack with aspirin or other medicines.
• Don’t delay; call 9-1-1 right away to check out suspicious symptoms.

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