What To Do in a Heart Attack Emergency

A heart attack is one of the most critical medical emergencies a person can face, yet the subtle nature of its onset often leads to fatal delays.

According to the World Health Organisation (WHO), cardiovascular diseases are the leading cause of death globally, claiming an estimated 17.9 million lives each year. When blood flow to a portion of the heart muscle becomes blocked, most commonly by a buildup of fat, cholesterol, and other substances forming a plaque in the coronary arteries, the affected tissue begins to starve of oxygen.

RECOGNISING THE WARNING SIGNS

Symptoms can manifest differently depending on individual health profiles. While classic presentation involves crushing chest pain, symptoms can be far more subtle.

The most common warning sign is discomfort in the centre of the chest, according to the American Heart Association (AHA). It may feel like pressure, squeezing, fullness or pain, and can last for several minutes before easing and returning.

Other symptoms may include pain or discomfort spreading to one or both arms, the back, neck, jaw or stomach; shortness of breath; cold sweating; nausea; dizziness; unusual tiredness and a rapid or irregular heartbeat.

Goke Akinrogunde, lead doctor at GTAK Health, told TheCable that some people, particularly women and people with diabetes, may not experience the typical severe chest pain.

Akinrogunde said diabetics may instead experience symptoms such as sudden breathlessness, sweating and acute fatigue, with little or no chest pain.

The AHA also noted that women may experience symptoms such as anxiety, nausea, vomiting, upset stomach, pain in the shoulder, back or arm, and unusual tiredness or weakness.

IMMEDIATE ACTION PLAN

Medical guidelines, including those from the AHA, emphasise that early intervention drastically improves survival rates.

If you suspect someone is experiencing a heart attack, have the person sit down and rest in a slightly reclined position with their back supported. Loosen any tight clothing around the neck and waist to ease breathing.

Panic increases heart rate and cardiac workload. It’s important to stay with the individual, reassure them, and monitor their condition. Do not permit them to walk around or drive themselves to the medical facility.

Akinrogunde said heart attacks are “time-critical” and that knowing what to do in the first few minutes can save a life.

He advised calling for emergency medical help immediately rather than waiting to see if the symptoms disappear.

In Nigeria, the National Emergency Medical Service and Ambulance System (NEMSAS) recently reaffirmed 112 as the national emergency medical line, while the Lagos state government lists 112 and 767 as toll-free emergency numbers.

Akinrogunde said an alert person suspected of having a heart attack may chew a 300mg aspirin, provided they are not allergic to aspirin and have not previously been advised by a healthcare professional not to take it.

This advice is broadly consistent with first-aid guidance from the AHA and American Red Cross, which says an alert adult with non-traumatic chest pain may be encouraged to chew and swallow 162- 325 mg of aspirin while waiting for emergency medical services, unless they have a known aspirin allergy or have been advised against taking it. If there is uncertainty, the guidelines say it is reasonable to wait for emergency medical help without giving aspirin.

The AHA also recommends that ambulance transport is preferable to having someone drive the patient because emergency medical personnel can begin treatment if the patient’s condition suddenly deteriorates.

WHEN CPR IS NEEDED

If the individual loses consciousness and stops breathing normally or is only gasping, their heart may have gone into cardiac arrest. Immediate cardiopulmonary resuscitation (CPR) must begin to keep oxygenated blood flowing to the brain and vital organs.

A heart attack and cardiac arrest are not the same thing. A heart attack occurs when blood flow to part of the heart is blocked or severely reduced. Cardiac arrest occurs when the heart suddenly stops pumping blood effectively. A heart attack can lead to cardiac arrest, but not every person having a heart attack needs CPR.

Akinrogunde said CPR should begin if the person collapses, becomes unresponsive, and is not breathing normally or is only gasping.

He said people who have never received CPR training should still attempt hands-only CPR rather than doing nothing.

He advised an untrained bystander to:

• Place the heel of one hand in the centre of the chest (between the nipples) with the other hand placed on top.
• Push the chest down hard and fast at a rate of 100 to 120 compressions per minute.
• Allow the chest to return fully between compressions. Continue until medical help arrives or the person starts breathing normally.

If available, an automated external defibrillator (AED) can be turned on to provide step-by-step instructions and determine whether a shock is needed.

WHAT NOT TO DO

During a medical crisis, well-intentioned but incorrect interventions can cause severe harm. Akinrogunde warned against several actions that could delay appropriate treatment, including:

• Delaying Care: Visiting a local pharmacy or waiting to see if symptoms ease wastes precious time during which heart muscle is actively dying.
• Administering Food or Liquids: Do not give water, food, alcohol, or unprescribed medications. If the patient’s consciousness fluctuates, anything in the mouth poses a severe choking hazard.
• Unproven Remedies: Avoid applying palm oil, rubbing menthol concoctions, or attempting chest incisions (“cutting”). None of these address arterial blockage and only delay professional intervention.
• Unprescribed Drugs: Do not administer extra blood pressure medications or strong pain relievers unless specifically directed by emergency medical responders or a treating physician.

For individuals with risk factors such as hypertension, high cholesterol, diabetes, smoking history, or a family background of cardiovascular disease, consulting a doctor for a personalised prevention strategy remains the best defence.

Source: TheCable