First Aid in Heart Attack

Overview

A heart attack also called a Myocardial Infarction is a medical emergency condition, in which the blood supply to the heart is suddenly blocked by a blood clot or accumulation of fat or cholesterol in the heart (coronary) arteries. A heart attack if not managed at an early stage, can be life-threatening, it will result in causing damage or death of the heart muscles.

According to the survey, approximately around 1.3 million cardiovascular deaths, 0.9 million coronary heart disease death, and 0.4 million stroke death occurred in people aged between 30-69 years of age

Causes of heart attack

The main cause of a heart attack is coronary artery disease (CAD). During this condition, one or more arteries of the heart (coronary) are blocked. These coronary artery blockages are often caused due to plaque deposits (cholesterol-containing deposits).  These plaque deposits can narrow the arteries, which will result in causing decreased blood flow to the heart 

Some of the other causes of heart attack are coronary artery spasm (it is a condition where there is a severe squeezing of a blood vessel), certain infections such as Covid-19 and other viral infections that may cause damage to the heart muscle, spontaneous coronary artery dissection (a condition where there is a tear inside a heart artery) 

Risk factors  

The risk factors causing heart attack are listed below:

• Age- the incidence is higher in men who are 45 years and above and women who are 55 years and above, although heart attacks can occur in men and women at any age.
• Smoking
• Obesity
• High blood pressure (high BP)
• High cholesterol levels (triglycerides) in the body
• Hereditary (family history of having a heart attack)
• Metabolic syndrome- it is a condition where there is a combination of at least three of the below-mentioned things. They are listed below

a) Central obesity (enlarged waist)

b) High triglyceride levels (bad cholesterol) and low good cholesterol

c) High blood sugar levels

d) High blood pressure

• Lack of exercise and maintaining an unhealthy lifestyle
• Stress
• Drug abuse
• Autoimmune conditions
• History of preeclampsia- a condition in which a female is diagnosed with high blood pressure during pregnancy 

 Types of heart attack

Types of heart attacks are listed below:

• Type 1: During this condition, the coronary artery which supplies blood to the heart is completely blocked. This condition is also called STEMI. Blockage of the coronary artery is often caused due to accumulation of cholesterol or other substances in the bloodstream.
• Type 2: During this condition, the heart does not receive enough oxygen-rich blood, which can result in causing a heart attack. However, there is no complete blockage in the artery. This condition is also called NSTEMI 
• MINOCA- It is a condition, where there is no blockage in the coronary artery seen. MINOCA stands for myocardial infarction with non-obstructive coronary arteries 

Symptoms for heart attack

The symptoms of heart attack vary from person to person. Some of the symptoms are listed below:

• Chest pain that may feel like tightness, heaviness, squeezing or aching pain, pressure
• Discomfort or pain often spreads to the left arm, shoulder, back, neck, jaw, and teeth, and in a few cases, the pain can radiate to the upper abdomen.
• Sweating
• Nausea (feel like vomiting)
• Fatigue
• Dizziness (giddiness), anxiety
• Shortness of breath (difficulty to breath)
• Palpitations (uneven heartbeat, or rapid heartbeat) 
• Indigestion

Diagnosis of heart attack

Heart attack is a critical life-threatening condition that must be treated immediately. Whenever the patient notices any kind of abnormal signs and symptoms which are mentioned above, the patient should be taken to the hospital immediately. The doctor will confirm the condition by doing the following tests which are listed below:

• Physical Examination- During the physical examination, the doctor will auscultate the heart of the patient using the stethoscope, to listen for abnormalities in heartbeat or heart rate. The doctor will advise a couple of tests to diagnose the condition.
• Electrocardiogram (ECG)- This is the initial assessment test, for all patients who are having cardiac abnormalities. ECG helps us to record the electrical activity of the heart.
• Blood Tests- A heart attack can cause damage to the heart, which will result in causing protein leaking into the bloodstream. During a blood test, a sample of blood is taken to test for a few proteins called cardiac markers. The most common cardiac marker suggested is cardiac troponin.
• Chest X-ray
• Coronary Angiography- coronary angiography will help us to evaluate whether there is any kind of blockage in the coronary artery or narrowing of the artery, and its location. During this test, a thin tube (catheter) is passed into one of the blood vessels of the groin or arm and is passed into the coronary artery using X-rays. A special fluid called dye is injected through the catheter into the coronary arteries to look for the location of the blockage or narrowing of the artery.
• Cardiac CT or MRI scan 

First Aid in Heart Attack:

The steps which must be followed during first aid in a heart attack are mentioned below:

• Call emergency number 108: Whenever someone experiences a heart attack, the attendee of the patient first should call the emergency services immediately and one must follow the instructions given by them correctly.
• Aspirin for Heart Attack: If the patient is awake and responsive, then one must give a small dose of aspirin to the patient
• Sit or lie down: Avoid giving food or water to the patient in this condition, Place the patient in a comfortable position, and look for their medication list, in case the patient is on any medications. 
• In conditions where the patient becomes unresponsive, but is breathing properly, in such situations, lower the patient to the ground and keep his/her head relaxed in an erect position. Doing this will prevent the choking of the patient, by letting the saliva drain from the mouth.
• CPR (cardiopulmonary resuscitation): In Conditions where the patient becomes unresponsive and not breathing properly, then the person who is next to the patient should perform CPR (cardiopulmonary resuscitation) immediately. CPR plays a very important role in saving the life of the patient. According to the “American Heart Association”, CPR is called as a “CHAIN OF SURVIVAL”. Studies have shown that performing CPR procedures at the right time has a survival rate of 12% . The steps followed while performing CPR are mentioned below:

A) Place the patient in the supine position, followed by placing one hand over the other hand on the center of the chest near the nipple area.

B) Using the entire body, not just arm pressure, push the hand down hard and fast- at least two inches deep.

C) By giving manual chest compression in combination with artificial breathing (mouth-to-mouth respiration) will result in a good outcome for the patient. However, CPR alone can also be very effective.

D) Continue chest compressions of at least 100-120 compression per minute until the emergency service people arrive or till the person regains consciousness.

E) In Conditions where there are more than 2 people in that place, CPR can be done by switching off every two minutes in order to preserve the quality of compression.

E) In addition to CPR, one can use AED (automated external defibrillator) in cases where the patient becomes unconscious and unresponsive. AED is a portable electronic device used to give a shock to the heart during cardiac arrest, in order to help regain the heart’s normal rhythm.

• The most essential and important step one should keep in mind is to stay calm and follow the protocol or instructions provided by the emergency services and try to act quickly, since every minute matters in saving the life of the patient.

Complications of heart attack

The complications associated with heart attack are listed below:

• Arrhythmias (irregular or abnormal heart rate)
• Cardiogenic shock- a condition where the heart suddenly stops or abruptly fails to pump blood.
• Cardiac arrest
• Heart failure- a condition where the heart muscles are damaged completely resulting in failure to pump blood.  
• Pericarditis- a condition where there is inflammation (infection) to the sac-like structure surrounding the heart.

Prevention of heart attack

The steps followed in order to prevent a heart attack are mentioned below:

• Follow a healthy lifestyle
• Maintain a healthy weight, and avoid being obese
• Avoid fatty food
• Quit drinking and smoking
• Exercise regularly
• Eat a healthy diet
• Control stress
• Have regular follow-ups with the doctor, in case the condition is hereditary.