When President Dwight Eisenhower had a heart attack in 1955, doctors had limited tools for dealing with it. Eisenhower survived with treatment that consisted mainly of morphine to kill the pain and bed rest that continued for nearly a month before he was able to sit in a chair for a few hours each day.
Today, doctors know more about heart disease and have sophisticated technology and established procedures; a patient surviving a heart attack similar to that suffered by Eisenhower can expect to be up and around within a few days. Even so, a heart attack is still a serious event and the number one cause of death for both men and women in all parts of the world.
A heart attack occurs when blood and oxygen flow to part of the heart becomes interrupted because of a blockage in one of the coronary arteries. Lack of oxygen is responsible for the chest pain or pressure, shortness of breath, nausea, palpitations, sweating and other symptoms.
When Americans recognize these symptoms, most know they should dial 911 right away. “Time is muscle,” doctors say, and the goal of treatment is to get blood flowing quickly, preferably within 90 minutes.
The best way of treating a heart attack, of course, is prevention. On the day of his attack, Eisenhower ate what many today might refer to as a heart attack on a plate: sausage, bacon, mush and hot cakes for breakfast; a hamburger for lunch; and roast lamb for dinner. He had previously smoked four packs of cigarettes a day.
At that time there was little knowledge about the role of diet, exercise and smoking. A heart attack was commonly accepted as a sign of an aging, dying heart.
By contrast, most Americans today know what constitutes a heart-healthy lifestyle and have medications available that can reduce their risk by lowering cholesterol and blood pressure. Heart attacks nevertheless occur at a rate of 1.2 million a year, and they occur both to those diagnosed with cardiovascular disease and those who have no idea they are at risk.
Symptoms may come on gradually, and studies show that patients wait an average of three hours before calling for medical help–a serious mistake. As many as half of heart attack fatalities occur in the first hour.
Don’t consider driving to the hospital yourself; it’s dangerous. And don’t have someone else take you unless there’s no other option; you’ll get treated more quickly and efficiently if you dial 911.
Most heart attacks are precipitated by a blood clot in a coronary artery. Unless you are allergic to aspirin, the next thing to do is to take aspirin–162 to 325 milligrams, preferably non-coated. Chew the tablet, dissolve it or place it under the tongue for faster action. The aspirin has an anti-platelet effect that should keep further clots from forming.
Ambulance service varies according to where you live, but good pre-hospital care is crucial, not only for speedy delivery but also to start treatment and gather information that will be valuable for hospital treatment.
The severity of symptoms is not necessarily an indication of the severity of the heart attack, but an ECG (electrocardiogram) and other tests can determine whether a heart attack is taking place and the nature and severity of the attack.
When the blockage is complete or nearly complete, the primary goal is to break up the clot and gets blood flowing. Known as reperfusion, this involves either 1) injecting medications to dissolve the clot (thrombolytic therapy), 2) emergency balloon angioplasty (usually with insertion of a stent) to restore blood flow or 3) emergency coronary artery bypass graft surgery. The latter is usually chosen only if the first two options offer little chance of success.
The preferred treatment in most cases is angioplasty. When performed promptly by an experienced team, studies show that angioplasty restores blood flow in 95 percent of cases. Other studies indicate that the risk of future attacks is lower in patients getting angioplasty than in those treated with clot-dissolving medications.
Not all hospitals have facilities for emergency angioplasty. In such cases, the emergency team must decide whether the patient will be better off getting thrombolytic therapy at the nearest hospital or transported to one that can perform emergency angioplasty or bypass surgery.
When blood flow can be restored promptly, the patient may suffer minimal permanent damage to the heart. The heart attack survivor today is encouraged to begin moving around as quickly as possible and is usually prescribed an outpatient rehabilitation program that includes supervised exercise. Unlike their counterparts in the 1950s, many heart attack patients today return relatively soon to a healthy, active lifestyle.
Two Leaders, One Leading Heart Care Team. The Marshfield Clinic and Ministry Health Care heart care team is a cooperative effort by two leading health care organizations working together as a single leading team. For over 90 years, this has enabled the team to deliver the very highest level of care available in the region. It is the heart care team chosen more often than any other local program, treating more of the most complex cases and conducting more research into leading edge heart care treatments. The team is made up of primary care physicians, cardiologists, cardiovascular surgeons, researchers, and other physicians and staff located at 41 hospitals and clinics. Log on to www.oneheartcareteam.org to learn more.
"I am happy to be able to bring our Heart Care to our patients in their own community," stated Marshfield Clinic Cardiologist Richard Reinhart, MD. "This offers access to the combined expertise of our institutions for our patients in their home towns. If needed, direct access is provided to any additional evaluation or treatment in our heart center at Saint Clare’s Hospital in Weston or Saint Joseph’s Hospital in Marshfield."
For more information about the Heart Care Team in your area, including second opinions, call 800-888-4755.