Is it a Heart Attack? Read Bob's Story
"The first hour of a heart attack is the most critical."
When the pressure in your chest keeps coming long after you've devoured that bowl of chili, you may wonder whether the discomfort is something more serious. Continuous monitoring of the heart and vital signs.
Oxygen therapy to provide oxygen to damaged heart muscle.
Pain medication to relieve pain and anxiety.
Cardiac medication such as nitroglycerin and beta-blockers to promote blood flow and stabilize the heart rate and blood pressure.
Thrombolytic and Fibrinolyctic threapy to dissolve blood clots and restore blood flow.
Antithrombin/Antiplatelet therapy to prevent further blood clots.
Coronary angioplasty, using a balloon to create a larger opening in the blood vessel, restoring blood flow. This may involve the placement of a coronary artery stent, a small coil that expands in the blocked artery; it is left in place to keep the artery open.
Pain can derive from any organ or tissue in your chest. And it can reveal a number of different conditions — some more dangerous than others — including heart attack (myocaridal infarction).
Taking No Chances
Any time you're experiencing chest pain or discomfort, you should get to an emergency room because heart muscle begins to die quickly, causing permanent damage. "It's a potentially life-threatening mistake to try to self-diagnose your chest pain. Even if it's a false alarm, you're better safe than sorry, because the first hour of a heart attack is the most critical," says Eileen Singer, DO, chair of emergency medicine at RWJ Hamilton.
Coronary heart disease, which can cause chest pain called angina-pectoris, is the leading cause of death. About 1.1 million Americans suffer a heart attack each year, and about 460,000 of them are fatal. Most are between 50 and 75 years of age, but heart attacks can strike people in their 20s, and women account for almost half of all heart attack fatalities.
A heart attack often starts with mild discomfort or a pressure sensation in the middle of the chest, says Singer. The situation can be deceiving because discomfort may come and go, even for several days, she adds. Keep in mind that when you get to the emergency department, medical guidelines require that an electrocardiogram is obtained quickly.
Treating a Heart Attack
The goal of treatment is to relieve pain, preserve the heart muscle function and prevent death. Treatment may include:
What if the doctor rules out heart disease as the source of your chest pain? "The most important thing is to stop a heart attack in its tracks. If it's not the heart, we consider other causes, including gastroesophageal reflux disease, or GERD, in which stomach acid backs up into the esophagus, causing a burning sensation in the chest area," Singer explains. The esophagus is located behind the heart, so the symptoms can be indistinguishable from pain associated with a heart attack. "If someone has symptoms, convince them to get help immediately. Challenge their excuses, such as 'I haven't got time, I'll go tomorrow.' It can be very serious."
| Meet Bob Justin of Hamilton
Bob Justin's first heart attack in 1991 was truly life-changing but not just for health reasons. "I couldn't work anymore and I didn't know what to do with myself, so I did a lot of drawings. Then I started with the sculptures a couple year's later." Today, the self-taught artist's pieces - called found object sculpture - are seen in nearby galleries and with serious folk art collectors in far away places like China and Germany.
During the 18 years since that first heart attack, Bob has been to the emergency department many times; on five occasions angioplasty was a required intervention. "When I had my first heart attack I had to go into Philadelphia because the services weren't offered here. Now I can get the care I need right here."
For Bob, heart disease is a debilitating condition, yet he was inspired to take control. "I tell my doctors they may have hundreds of patients, but I only have one. It's important to learn about your condition so you can learn how to function." People should not be intimidated by medical terms and science, he says. "The first step toward learning is to become interested and I am because I want to live. Anyone can learn. I like to learn about how things work, so I think of my heart and my body like plumbing or a car."
Bob learned about all of his medications and how to listen to his body, he says, so that he can recognize signs of distress and know when to slow down. "I'm doing my job so the doctors can do theirs. I am always paying attention. Why am I hot? Why did my blood pressure go up? If I think I'm in trouble, I go to the emergency room - and it's a good thing, because on many occasions, they have saved my life."