Early Heart Attack Care Heart Attacks Have Beginnings

Heart Attack: A Community Problem With A Community Solution

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

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

The Human Heart Location: Middle of the chest Size: That of a fist Purpose: Pumps blood throughout the body Weight: 7 - 12 ounces Capacity: Pumps 1,800 gallons of blood & beats over 100,000 times daily

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

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

The Human Heart Electric Pump

A Heart Attack in Progress Part 2 A Heart Attack in Progress

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

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.

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

Coronary Artery Disease

Complete Obstruction: AMI Area of Infarct

Part 3 Concepts of EHAC

Are All Heart Attacks Created Equal?

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

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?

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

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.

Recognition and Intervention Part 4 Recognition and Intervention

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

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.

Part 5 Delay and Denial

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

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

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

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

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

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

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

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

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

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

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

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?

Overcoming Reluctance Suggest he or she check out early symptoms, better safe than sorry. Call 9-1-1. 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.

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

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 9-1-1 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.