Transcript Early Heart Attack Care” EHAC

Early Heart Attack Care
Heart Attacks Have Beginnings
Heart Attack:
A Community Problem
With A
Community Solution
Course Outline
1. Anatomy and Physiology 101: Your Heart
2. A Heart Attack in Progress
3. Concepts of Early Heart Attack Care
4. Recognition and Intervention
5. Delay and Denial
6. You: The Early Heart Attack Care Giver
Part 1
Anatomy and Physiology 101:
Your Heart
The Human Heart
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Location:
Size:
Purpose:
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Weight:
Capacity:
Middle of the chest
That of a fist
Pumps blood throughout the
body
7 - 12 ounces
Pumps 1,800 gallons of blood &
beats over 100,000 times daily
The Human Heart
and Coronary Arteries
SUPERIOR VENA CAVAL
BRANCH (NODAL ARTERY)
ANTERIOR R.
ATRIAL BRANCH
OF R. CORONARY
ARTERY
RIGHT
CORONARY
ARTERY
ANTERIOR
CARDIAC
VEINS
SMALL
CARDIAC VEIN
L. CORONARY ARTERY
CIRCUMFLEX BRANCH OF
L. CORONARY ARTERY
GREAT CARDIAC VEIN
ANTERIOR
INTERVENTRICULAR
(ANTERIOR DESCENDING)
BRANCH OF L. CORONARY
ARTERY
The Human Heart
and Coronary Arteries
OBLIQUE VEIN OF L.
ATRIUM
GREAT CARDIAC VEIN
CIRCUMFLEX BRANCH OF L.
CORONARY ARTERY
CORONARY SINUS
POSTERIOR VEIN
OF L. VENTRICLE
MIDDLE
CARDIAC VEIN
SUPERIOR VENA CAVAL
BRANCH (NODAL ARTERY)
SINOATRIAL (SA) NODE
SMALL
CARDIAC
VEIN
R. CORONARY
ARTERY
POSTERIOR
INTERVENTRICULAR
(POSTERIOR DESCENDING)
BRANCH OF R.
CORONARY ARTERY
The Human Heart
Electric Pump
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.
Part 4
Recognition and Intervention
Early Symptoms
of a Heart Attack
• Non-Specific Symptoms:
– weakness/fatigue
– clammy/sweating
– nausea/indigestion
– dizziness/nervousness
• Specific Symptoms
– chest discomfort
– chest pressure
– chest ache
– shortness of breath
– chest burning
– neck/back/jaw pain
– chest fullness
– feeling of doom
– elbow pain
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
Why Do We Delay?
Denial and Procrastination
= Our Heart’s Enemy!
1. It’s Nothing
Really Serious
I’ll just rest a bit
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
6. I’m Strong
Just walk it off, grin and bear it
7. I’m Healthy
I have no serious medical problems..
I exercise
8. I’ll Just
Wait It Out
Everything will be OK
Part 6
You: The Early Heart Attack
Care Giver
The EHAC
Caregiver
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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.
ACT WISELY
A
C
T
Acknowledge the problem
Be Calm
Be Tenacious and do not give in.
W
I
S
E
L
Y
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.