Every 40 seconds, someone in the United States has a heart attack. Knowing what to do when someone has a heart attack and acting quickly may help save a life.
Also called a myocardial infarction, a heart attack happens when the flow of blood that brings oxygen to the heart muscle is blocked. Often, this is due to a build-up of plaque in the blood vessels that narrows it, and a blood clot blocks the path. Without oxygen, that area of the heart begins to die. This is why it is so important to take immediate action when you suspect a heart attack.
Heart attack is often confused with cardiac arrest, but they are not the same. In cardiac arrest, the heart suddenly stops beating. However, a heart attack can lead to sudden cardiac arrest.
Men and women often have different heart attack symptoms. Chest pain is the thought to be a common symptom, but more than 40 percent of women have no chest pain before or during a heart attack. When chest pain does happen, it usually occurs in the center or left side of the chest. It may feel like sharp or dull pain, pressure, squeezing or heaviness, and last for a few minutes or go away and return.
Other common symptoms of heart attack, especially among men, include:
- Feeling weak, lightheaded, or faint
- Sudden or profuse sweating
- Pain or discomfort in the jaw, neck, back, arms or shoulders
- Shortness of breath during the attack
Symptoms of heart attack in women are often more subtle and may begin a month or more before the heart attack. These include:
- Pain in the upper abdomen or back
- Sleep disturbances
- Shortness of breath
- Nausea or vomiting
- Unusual fatigue
Some heart attack symptoms are vague and can be caused by other conditions, but it is better to err on the side of caution. If someone appears to have symptoms, the first step is to call 911 immediately and tell the operator you or someone else is having a heart attack.
“We don’t recommend driving the person to the emergency room,” says Todd Hitchcock, MD, a cardiologist at Scripps Clinic Carmel Valley. “The sooner treatment begins, the better the chances of reducing the damage to the heart, and paramedics can begin emergency treatment in the ambulance on the way to the hospital.”
If the person goes into cardiac arrest and the heart stops beating, someone who is trained to perform cardiopulmonary resuscitation (CPR) or use an automated external defibrillator (AED) may be able to restore the heartbeat before emergency medical professionals arrive
Once at the hospital, medical professionals can determine if it is indeed a heart attack and begin proper treatment. Depending on the severity and location of the blockage, doctors may use one or more medications to restore blood flow to the damaged area of the heart. These may include:
- Aspirin to reduce blood clotting and help maintain blood flow through the affected artery
- Thrombolytics known as clotbusters to help dissolve a blood clot that's blocking blood flow
- Antiplatelet agents to help control blood clots and prevent new ones from forming
- Blood thinners to reduce the formation of new clots
- Nitroglycerin to widen the blood vessels
- ACE inhibitors to block the action of an enzyme that causes blood vessels to narrow
In addition, the cardiologist may recommend percutaneous coronary intervention (PCI), a minimally invasive procedure that inserts a device such as a balloon (balloon angioplasty) or stent into the blocked artery to open it.
In more severe cases, a patient may need surgery, such as coronary artery bypass graft surgery, also known as CABG or bypass surgery. This procedure places a healthy vessel from another part of the body around the blocked vessel to reroute the blood to the heart.
“The most important thing is to get emergency care started,” says Dr. Hitchcock. “If someone is having heart attack symptoms, don’t wait it out to see if it goes away or lie down and rest. Call 911 right away.”