Recognizing and Acting On the Symptoms

WHEN symptoms of heart attack occur, it is vital to seek medical help immediately, as the risk of death is greatest within the first hour after an attack. Quick treatment can save heart muscle from irreparable damage. The more heart muscle that is spared, the more effectively the heart will pump after the attack.

However, some heart attacks are silent, manifesting no outward symptoms. In these cases the person may be unaware that he has coronary artery disease (CAD). Sadly, for some a massive attack may be the first inkling of heart trouble. When cardiac arrest occurs (the heart stops pumping), there is little chance for survival unless a rescue team is called immediately and bystander cardiopulmonary resuscitation (CPR) is applied right away.

Of the majority who have symptoms of CAD, the Harvard Health Letter reports, about half will put off seeking immediate medical help. Why? “Usually because they don’t recognize what their symptoms signify or don’t take them seriously.”

John,a a heart-attack victim and one of Jehovah’s Witnesses, implores: “When you sense that something is not right, don’t delay in getting medical help out of fear of appearing melodramatic. I almost lost my life because I didn’t react quickly enough.”

What Happened

John explains: “A year and a half before my heart attack, I was warned by a doctor about my high cholesterol, a major risk factor in CAD. But I evaded the issue, as I felt that I was young—under 40—and in good health. I greatly regret that I did not take action then. I had other warning signals—shortness of breath with physical exertion, pains I thought were indigestion and, for several months before the attack, extreme fatigue. Most of these I blamed on too little sleep and too much job stress. Three days before my heart attack, I had what I thought was a muscle spasm in my chest. It was a minor attack prior to the big one three days later.”

Chest pain or pressure, called angina, gives warning to about half of those who suffer a heart attack. Some experience shortness of breath or fatigue and weakness as symptoms, indicating that the heart is not getting enough oxygen because of a coronary blockage. These warning signals should send one to a doctor for a heart evaluation. Dr. Peter Cohn states: “Once angina is treated, there is no guarantee that a heart attack will be prevented, but at least the chances of an imminent attack are reduced.”

The Attack

John continues: “That day we were going to play softball. As I gobbled a hamburger and fried potatoes for lunch, I shrugged off some discomfort, nausea, and upper-body tightness. But when we got to the ballpark and began playing, I could tell something wasn’t right. In the course of the afternoon, I felt progressively worse.

“Several times, I lay on the players’ benches, face up, and tried to stretch my chest muscles, but they kept getting tighter and tighter. While playing, I said to myself, ‘Maybe I’ve got the flu,’ as I felt clammy and weak at times. When I ran, I was noticeably out of breath. I lay down on a bench again. When I sat up, there was no doubt that I was in serious trouble. I yelled to my son James: ‘I need to go to the hospital NOW!’ My chest felt as though it had caved in. The pain was so great that I couldn’t get up. I thought, ‘This can’t be a heart attack, can it? I’m only 38!’”

John’s son, who was 15 years old at the time, relates: “It took only minutes for my dad to lose his strength, so that he had to be carried to the car. My friend drove the car while asking Dad questions to keep up with his condition. Finally, Dad didn’t answer. ‘John!’ my friend shouted. But my father still didn’t respond. Then Dad jerked in his seat, going into convulsions and vomiting. I shouted over and over: ‘Dad! I love you! Please don’t die!’ After his seizure, his whole body fell limp in the seat. I thought he had died.”

At the Hospital

“We ran into the hospital to get help. Two or three minutes had passed since I thought Dad had died, but I hoped he could be revived. To my surprise, about 20 fellow Witnesses of Jehovah who had been at the ballpark were in the waiting room. They made me feel comforted and loved, which was a great help at such a miserable time. About 15 minutes later, a doctor came and explained: ‘We were able to revive your dad, but he has had a massive heart attack. We aren’t sure he’ll live.’

“He then allowed me to see Dad briefly. Dad’s expressions of love for our family overwhelmed me. In great pain, he said: ‘Son, I love you. Always remember that Jehovah is the most important person in our lives. Never stop serving him, and help your mother and brothers never to stop serving him. We have a solid hope in the resurrection, and if I die, I want to see all of you when I come back.’ We were both crying tears of love, fear, and hope.”

John’s wife, Mary, arrived an hour later. “When I walked into the emergency room, the doctor said: ‘Your husband has had a massive heart attack.’ I was stunned. He explained that John’s heart had been defibrillated eight times. This emergency measure involves the use of electrical voltage to stop the heart’s chaotic beat and restore normal rhythm. Together with CPR, oxygen delivery, and intravenous drugs, defibrillation is an advanced lifesaving method.

“When I saw John, my heart ached. He was very pale, and there were many tubes and wires connecting his body to monitors. Silently, I prayed to Jehovah to give me the strength to endure this trial for the sake of our three sons, and I prayed for guidance to make wise decisions about what might lie ahead. As I approached John’s bed, I thought, ‘What do you say to your loved one at a time like this? Are we really prepared for such a life-threatening situation?’

“‘Honey,’ John said, ‘you know I may not make it through this. But it’s important that you and the boys remain faithful to Jehovah because soon this system will end and there will be no more sickness and death. I want to wake up in that new system and see you and our boys there.’ Tears streamed down our faces.”

The Doctor Explains

“The doctor later called me aside and explained that investigation showed that John’s heart attack was due to a 100-percent blockage in the left anterior descending artery. He also had blockage in another artery. The doctor told me that I must make a decision regarding John’s treatment. Two of the available options were drugs and angioplasty. He thought the latter would be better, so we opted for the angioplasty. But the doctors made no promises, as most do not survive this kind of a heart attack.”

Angioplasty is a surgical technique in which a balloon-tipped catheter is inserted into a coronary artery and then inflated to open the blockage. The procedure has a high rate of success in restoring blood flow. When several arteries are seriously blocked, bypass surgery is usually recommended.

Grim Prognosis

After the angioplasty, John’s life continued to hang in the balance for another 72 hours. Finally, his heart began to recover from the trauma. But John’s heart was pumping at only half of its former capacity, and a large portion of it had become scar tissue, so the prospect of his being a cardiac cripple was almost inevitable.

In retrospect, John admonishes: “We owe it to our Creator, our families, our spiritual brothers and sisters, and ourselves to heed the warnings and to take care of our health—especially if we are at risk. To a considerable extent, we can be the cause of happiness or grief. It’s up to us.”

John’s case was severe and required immediate attention. But not all with heartburn-type discomfort need to run to a doctor. Still, his experience is a warning, and those who feel that they have symptoms should have a checkup.

What can be done to reduce the risk of heart attack? The next article will discuss this.

[Footnote]

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Symptoms of a Heart Attack

• An uncomfortable feeling of pressure, squeezing, or pain in the chest that lasts more than a few minutes. Could be mistaken for severe heartburn

• Pain that may spread to—or be present in only—the jaw, the neck, the shoulders, the arms, the elbows, or the left hand

• Prolonged pain in the upper abdomen

• Shortness of breath, dizziness, fainting, sweating, or feeling clammy to the touch

• Exhaustion—may be experienced weeks before the attack

• Nausea or vomiting

• Frequent angina attacks not caused by exertion

Symptoms may vary from mild to strong and do not all occur in every heart attack. But if any combination of these takes place, get help fast. However, in some cases there are no symptoms; these are referred to as silent heart attacks.

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Actions for Survival

If you or someone you know shows symptoms of heart attack:

• Recognize the symptoms.

• Stop whatever you are doing and sit down or lie down.

• If symptoms last more than a few minutes, call a local emergency telephone number. Tell the dispatcher that you suspect heart attack, and give him the information needed to locate you.

• If you can get the victim to a hospital emergency room more quickly by driving there yourself, do so. If you think you are having a heart attack, ask someone to drive you there.

If you wait for an emergency medical crew:

• Loosen tight clothing, including a belt or a necktie. Help the victim to get comfortable, propping him with pillows if necessary.

• Stay calm, whether you are the victim or the helper. Excitement may increase the likelihood of life-threatening arrhythmia. Prayer can be a strengthening aid in remaining calm.

If the victim seems to stop breathing:

• In a loud voice ask, “Can you hear me?” If there is no response, if there is no pulse, and if the victim is not breathing, begin cardiopulmonary resuscitation (CPR).

• Remember the three basic steps of CPR:

1. Lift the victim’s chin up, in order to open the airway.

2. With airway open, while pinching the victim’s nostrils closed, blow slowly twice into the mouth until the chest rises.

3. Press 10 to 15 times on the middle of the chest between the nipples to push blood out of the heart and the chest. Every 15 seconds, cycle two breaths followed by 15 compressions until pulse and breathing are regained or the emergency team arrives.

CPR should be performed by someone trained to do it. But when no one trained is available, “any CPR is better than none,” says Dr. R. Cummins, a director of emergency cardiac care. Unless someone initiates these steps, chances of survival are very poor. CPR buys time until help arrives.

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Quick treatment after a heart attack may save a life and reduce heart damage