1. Early Heart Attack Care
Heart Attacks Have Beginnings

2. Heart Attack: A Community Problem With A Community Solution

3. Course Outline Anatomy and Physiology 101: Your Heart
A Heart Attack in Progress
Concepts of Early Heart Attack Care
Recognition and Intervention
Delay and Denial
6. You: The Early Heart Attack Care Giver

4. Anatomy and Physiology 101: Your Heart
Part 1
Anatomy and Physiology 101: Your Heart

5. The Human Heart Location: Middle of the chest Size: That of a fist
Purpose: Pumps blood throughout the body
Weight: ounces
Capacity: Pumps 1,800 gallons of blood & beats over 100,000 times daily

6. The Human Heart and Coronary Arteries
SUPERIOR VENA CAVAL BRANCH (NODAL ARTERY)
L. CORONARY ARTERY
ANTERIOR R. ATRIAL BRANCH OF R. CORONARY ARTERY
CIRCUMFLEX BRANCH OF L. CORONARY ARTERY
RIGHT CORONARY ARTERY
GREAT CARDIAC VEIN
ANTERIOR INTERVENTRICULAR (ANTERIOR DESCENDING) BRANCH OF L. CORONARY ARTERY
ANTERIOR CARDIAC VEINS
SMALL CARDIAC VEIN

7. The Human Heart and Coronary Arteries
SUPERIOR VENA CAVAL BRANCH (NODAL ARTERY)
OBLIQUE VEIN OF L. ATRIUM
GREAT CARDIAC VEIN
SINOATRIAL (S-A) NODE
CIRCUMFLEX BRANCH OF L. CORONARY ARTERY
SMALL CARDIAC VEIN
CORONARY SINUS
POSTERIOR VEIN OF L. VENTRICLE
R. CORONARY ARTERY
MIDDLE CARDIAC VEIN
POSTERIOR INTERVENTRICULAR (POSTERIOR DESCENDING) BRANCH OF R. CORONARY ARTERY

8. The Human Heart Electric Pump

9. A Heart Attack in Progress
Part 2
A Heart Attack in Progress

10. Heart Attack Facts #1 Killer of Adults 4,100 Heart Attacks every day
600,000 Heart Attack deaths each year
Hundreds of thousands survive but are left with a damaged heart

11. Three Presentations of a Heart Attack
Sudden, severe pain that stops you in your tracks.
Gradual increasing pain with damage occurring over a period of hours.
Very early presentation with mild symptoms over hours or days.

12. Ischemia & Angina Pectoris
Partial block producing chest pain
Area of decreased blood supply

13. Coronary Artery Disease

14. Complete Obstruction: AMI
Area of Infarct

15. Part 3
Concepts of EHAC

16. Are All Heart Attacks Created Equal?

17. Progress: Heart Attack Treatment
Thrombolytic Therapy (clot busters)
Angioplasty
Prehospital Cardiac Care
Decrease in hospital time to treatment saved heart muscle improvement in quality of life

18. Too Little Progress: Heart Attack Recognition
Only 25% of heart attack victims receive thrombolytic therapy
Only 10% receive therapy within the first critical hour
Most heart attack patients do not benefit from optimal medical advances
WHY?

19. DELAY
in recognizing and responding to the early warning signs of a heart attack

20. Why EHAC? Early Care: Recognize & Respond
often mild symptoms, usually normal activity
Late Care: Obvious Emergency & Respond
incapacitating pain, diminished activity
Too Late Care: Critical Emergency & Respond
unconscious, CPR, defibrillation, probable death
85% of the heart damage takes place within the first two hours.

21. Recognition and Intervention
Part 4
Recognition and Intervention

22. Early Symptoms of a Heart Attack
Non-Specific Symptoms:
weakness/fatigue
clammy/sweating
nausea/indigestion
dizziness/nervousness
shortness of breath
neck/back/jaw pain
feeling of doom
elbow pain
Specific Symptoms
chest discomfort
chest pressure
chest ache
chest burning
chest fullness

23. Early Signs of a Heart Attack
Present in up to half of heart attacks.
Suddenly accelerate preceding the heart attack.
Usually appear within 24 hours before the acute attack but can begin two to three weeks before.
Duration varies from a few minutes to several hours.
Usually intermittent with a pain free period before the onset of acute occlusion.

24. Part 5
Delay and Denial

25. Denial and Procrastination
Why Do We Delay?
Denial and Procrastination
= Our Heart’s Enemy!

26. 1. It’s Nothing Really Serious
I’ll just rest a bit

27. I don’t have time to be sick
2. I’m Too Busy Right Now
I don’t have time to be sick

28. 3. I Don’t Want to be a Problem
If it turns out to be nothing I’ll be embarrassed by the fuss made.

29. 4. Paramedics Beware!
First responders can easily be swayed by patient rationalizations and denials

30. 5. It’s Probably Heartburn or Indigestion
I’ll take something for it

31. Just walk it off, grin and bear it
6. I’m Strong
Just walk it off, grin and bear it

32. I have no serious medical problems..
7. I’m Healthy
I have no serious medical problems..
I exercise

33. 8. I’ll Just Wait It Out
Everything will be OK

34. You: The Early Heart Attack Care Giver
Part 6
You: The Early Heart Attack Care Giver

35. The EHAC Caregiver Spouse Children Parent Co-worker Friend
Exercise Partner
Anyone who cares about you!

36. What to Ask and Look For Do you have any chest discomfort?
Is it tightness, pressure, pain in the center of your chest?
Is the discomfort also in your arms or jaw or neck or throat or back?
Are you sick to your stomach?
Is the person sweaty or clammy?
What were you doing when the symptoms started?
Do the symptoms go away with rest?
Are you having any shortness of breath?

37. Overcoming Reluctance
Suggest he or she check out early symptoms, better safe than sorry.
Call Paramedics have excellent evaluation tools.
Offer to call spouse or family members if he or she is anxious.
If he or she refuses to seek help, enlist friends or family members to help you convince them.
Be personal and persistent. Sit, talk, try to relieve any tension and don’t go away.
When he or she agrees, congratulate them on their good judgment.
If all else fails, take charge and be aggressive about getting the patient to the hospital.

38. A C T W I S E L Y A C T W I S E L Y Acknowledge the problem Be Calm
Be Tenacious and do not give in.
Be Willing to spend the time
Be Influential
Keep it Simple
Be Empathetic
Link patient w/ early symptoms to medical care
Say Yes - I’ll pay attention

39. Listen to your  and be a Winner!
Be aware of pressure, not necessarily pain, in your chest.
Be aware if it increases with activity and subsides with rest.
Don’t try to rationalize it away. Be honest with yourself and others.
Call or have someone drive you to the nearest emergency room.
Don’t go to your doctors office or wait for an appointment.
EHAC is knowing the subtle danger signs and acting on them before damage occurs.