Heart Attack
A heart attack may come as a surprise, or the victim may have known he had heart disease or high blood pressure. Symptoms vary, but often include extreme pain and temporary unconsciousness. With good care, many victims of heart attack recover completely. In a few cases death occurs soon after the attack strikes. There are three principal causes of heart attack:
A. Angina Pectoris. The attack in this case is brought on by a reduction in blood supply to the muscular wall of the heart, possibly resulting from a narrowing or a spasm of the coronary arteries that supply the heart. Blood still reaches the heart muscle but in reduced quantity.
The attack is precipitated by exertion, physical or emotional, or exposure to cold. It often follows the eating of a hearty evening meal, particularly if the meal included much fat. The principal symptom is extreme pain in the chest which may extend into the neck and even down the left arm to the wrist. The victim's face appears pale and gray. Usually he does not lose consciousness but clutches his chest, becomes very anxious, and refuses to move. Sometimes
there is difficulty in breathing. In
most cases the pain gradually disappears
after a few minutes of rest or after
medication.
WHAT TO DO
1. Lay the victim on the floor or on a bed. Elevate his head and shoulders on a pillow or folded blanket.
2. Keep him absolutely quiet and protect him from the gaze of onlookers or from other circumstances that might make him apprehensive.
3. Do not move the victim until the pain has eased. Meanwhile cover him as necessary to keep him warm.
4. If the person has had previous similar attacks, he may be carrying nitroglycerin tablets. If so, one of these should be placed under his tongue (not swallowed). This will usually terminate the attack promptly. This medication is best administered with the patient lying down, as it may cause fainting.
5. Arrange for him to see his doctor as soon as possible.
B. Coronary Obstruction, Acute. This type of heart attack is caused by the sudden obstruction of one of the branches of the coronary arteries. Depending upon the size of the branch plugged and on the portion of the heart deprived of its blood supply, the patient may recover completely or may die within the next several hours.
The victim experiences extreme pain in his chest, which he may describe as being squeezed in a vise. The pain may extend through to the back, up into the neck, or down the left arm where it may even involve the fingers (commonly the fourth and fifth) and is not relieved by rest. The victim may become unconscious, and he typically appears very pale. He may go into shock, with profuse perspiration and lowered body temperature. The pulse is usually irregular, and vomiting may occur.
WHAT TO DO
1. Place the victim in a half reclining position with head and shoulders elevated until the fire department's rescue squad or an ambulance arrives, or until seen by a doctor.
2. Insist that he remain absolutely at rest, not even moving a finger.
3. Loosen the victim's clothing where it might constrict the neck or waist.
4. If pure oxygen is available, playa stream of the oxygen in front of his face so that he can breathe this along with the air. Otherwise, allow him to breathe fresh air.
5. If nitroglycerin tablets are available, place one of these under the victim's tongue, allowing it to be dissolved there.
6. Even with a favorable turn of events, the victim should be kept at absolute rest under a doctor's care for
gradual recovery.
C. Heart Failure, Acute. Heart failure occurs as a climax to long-standing heart disease. The acute episode is caused by the inability of the heart to circulate a sufficient quantity of blood throughout the body. The blood now begins to stagnate in the lungs and other tissues.
The principal symptoms are shortness of breath and coughing. Instead of being pale, the patient's skin appears dusky. The difficulty in breathing is most severe when the patient lies down. He will insist that he should sit up at least partway.
WHAT TO DO
1. Keep the victim propped up in bed in a near sitting position.
2. Give oxygen if available.
3. Preferably, the victim should be attended by a physician before he is moved. The physician can administer
drugs which will improve the heart's action. Otherwise prompt treatment can be secured at the hospital emergency
room.
