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Saturday, May 7, 2011

What are the signs of a heart attack and what should you do?

Most heart attacks are sudden and intense. But sometimes a heart attack starts slowly, with mild pain or discomfort. People often aren’t sure what is wrong, and wait too long before getting help. A severe heart attack can stop the heart, causing sudden death.


Major heart attack:
A major heart attack is called a myocardial infarction. It usually starts with pain or discomfort in the centre of the chest, which lasts for more than a few minutes or keeps coming back. The discomfort can feel like pressure, squeezing, or fullness. Pain or discomfort may also be felt in the arms, the left shoulder, elbows, jaw, or back. Other symptoms include:

• diffi culty breathing or shortness of breath;
• feeling sick or vomiting;
• feeling light-headed or faint;
• breaking into a cold sweat;
• becoming pale.

Women are more likely to have shortness of breath, nausea, vomiting, and back or jaw pain. People who have had diabetes for a long time may not feel the chest pain as much, because diabetes can damage the nerves.

What to do if you are having a heart attack
Many patients who have a heart attack die before reaching hospital. So act fast. Every second counts.
There are treatments that can dissolve the blood clot and restore blood fl ow to the heart. The treatment works best if it is given within an hour of the attack. If treatment is started quickly, there will be less damage to the heart muscle.

If there is a hospital nearby, have someone call an ambulance or take you to the emergency room right away. If there is no hospital or health care centre nearby, call a doctor immediately.


Angina:
If the heart blood vessels are blocked only partially and the blood fl ow to the heart is decreased but not stopped, it can cause chest pain called angina or angina pectoris. The person may have pain or discomfort in the centre of the chest that lasts for a few minutes. Often it is triggered by physical activity and relieved by rest. It may also be brought on by strong emotions, stress, or extreme heat or cold. The pain may spread to the arms, back, jaw, neck and stomach. People who have angina are at high risk of having a major heart attack. People with angina should monitor their chest pain. The angina may be getting worse if the chest pain:
• occurs more often;
• lasts longer than usual;
• is combined with shortness of breath or a fast or irregular heart beat;
• occurs with smaller amounts of exercise or stress.

What to do if you are having an angina attack?
Stop what you are doing and rest until the pain has passed. Your doctor may have prescribed a tablet for you to keep under your tongue or a spray that helps relieve the discomfort. Follow your doctor’s instructions. If these things do not help, call an ambulance to take you to the emergency room of the nearest hospital. If there is no hospital or health care centre nearby, call your doctor immediately.

Treating a heart attack:
The level of medical care you will receive can vary from place to place. The amount of care you will need depends on how severe the attack was.

If you go to the emergency department of your nearest hospital, the doctor there may give you a thrombolytic medicine right away, to dissolve any blood clots in your arteries.

You will probably have a number of tests, such as blood tests, an electrocardiogram, and a coronary arteriogram.

The doctor will probably prescribe medicines to help you manage your heart condition, and give you advice on changing your lifestyle to lower your risk of having another heart attack. If you take this advice, you will get the best possible results. Listen carefully to your doctor’s instructions and ask questions
if you need to.

There are special procedures that can improve the blood supply to the heart, such as angioplasty or coronary artery bypass surgery. Those procedures will be applied to patients depending on the individual condition.

After you go home:
Many patients will be offered cardiac rehabilitation. This is a medically supervised programme for patients who have suffered heart attacks and angina. It helps you adapt to daily life, and helps prevent repeat attacks. The programme usually includes:

• physical activity prescribed by doctors;
• help with taking medicines and going through medical treatment;
• support for lifestyle changes, like quitting smoking;
• health education and counselling tailored to your needs and risk factors;
• help with regaining strength and independence and improving your quality
of life;
• support for going back to work.


Medicines used to treat heart attack and angina
Medicines often used to treat heart attacks and angina include:
• antiplatelet agents, such as aspirin;
• nitrates and other medicines to relax blood vessels;
• medicines to control blood pressure, such as calcium-channel blockers, and angiotensin converting enzyme inhibitors;
• diuretics to help get rid of excess water;
• medicines to lower blood-fats.
These medicines must be used under a doctor’s supervision. You can read more about heart medicines and their side effects in Annex.

Vitamins and heart attacks:
There is no evidence that taking extra vitamin supplements, such as vitamins A, C, and E, prevents heart attacks. The important thing is to eat a healthy, balanced diet.


Can the heart recover from a heart attack?
Yes, but the degree of recovery depends on how much damage was done to the heart muscle. You should get treatment as soon as you feel the symptoms of a heart attack. The sooner you get treatment, the more muscle doctors may be able to save. That’s why they say, “Time is muscle.”


How can I avoid having another heart attack?
Someone who has had a heart attack has a high risk of having another one that could be even more serious and of having complications like acute heart failure. In order to decrease the chance of a future attack, you must:

• follow your doctor’s advice and adopt a healthy lifestyle;
• work hard at the rehabilitation programme prescribed by your doctor;
• take your medicines regularly and according to the instructions. Most patients need to continue taking medicines on a long-term basis.

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