How Does One Treat a Heart Attack?

Factual Questions
1

I think I might have had a mild heart attack in church Sunday morning (I’m feeling much better now). At some point during the sermon I started sweating profusely; I was dizzy and short of breath; my left arm was tingly; and I felt this overwhelming urge to get out of there right now. Of course, the sermon was boring, the A/C wasn’t turned on, and I’d tossed and turned all night the previous night and had probably stretched my muscles un-naturally. But I digress…

Anyhoo, I didn’t go to the hospital. And even if I had gone, I wonder what the treatment would have been. I imagine it would look something like this:

DOCTOR LOOKS AT EKG
DOCTOR: Well I’ll be damned. You did have a mild heart attack. Go home and lose some weight.
DOCTOR LEAVES

Seriously, what can the do for ya once you’ve had a heart attack? I understand the importance of being there during a heart attack, so they can give you oxygen and defibrilate you if you totally start to conk out. But other than that, what can they do but tell you to go home and lose some weight?

TIA

2

There are many, many things that can, and should be done during and after a heart attack. I think you should go to a doctor or hospital as soon as possible.

In addition to EKG’s, there are blood tests that can be done now, even 36 hours later, that may prove you had a heart attack at church. If they are positive, a number of things can be offered with respect to treatment and prognosis. Even if the tests are negative, there may be things that might need to be done.

Again, I think you should get yourself some medical attention. Pronto.

[sub]I will qualify my answer and say that my advice holds especially if you are a man over aged 35 (which I think I remember you as being).[/sub]

3

By all means seek medical care as soon as possible. You, my friend, are playing with fire. Denial is all too common and deadly. Don’t be fooled into thinking everything’s OK because you feel better today.

A work up may include ECGs, blood tests, and X-rays. If those are suspicious, you’re looking at a stress test (treadmill and/or nuclear scans), and inpatient observation. They’ll need to rule out any pulmonary or neurological causes of your symptoms. More invasive tests will follow as needed.

Then your doctor will know the degree, if any, of your heart disease and the best course of treatment. Then you can enjoy a long, happy life.

4

As one who recently went into the ER in a panic over some chest pains, I can speak with a little authority here.

First, the previous posters are right. If only for your own peace of mind, call your doctor and arrange for a checkup.

The AMA has a Web site giving the symptoms for a heart attack, some of which fit your profile. What I didn’t see from you was any mention of chest pain. I had chest pains, but they were small (needle-pricks) and lasted for 10-15 seconds at a time. My doctor in the ER said that chest pains indicative of a heart attack last at least 5 minutes.

I’ve also heard that the pain is supposed to feel like you had an elephant step on your chest.

What they did in the ER was give me an EKG and a blood test, both of which did not show any indication that I had a heart problem. The doctor recommended asking my doctor to arrange a stress test.

I now realize that I had been going through a particularly stressful time of my life (the details of which I’ll keep to myself), and that expressed itself in the aforesaid chest pains. As I was away from home at the time, my panic over the thought of me keeling over suddenly did the rest.

5

Here’s my two cents worth as a paramedic.

The symptoms of a heart attack vary from person to person, although generally there are some common ones. Certainly, the symptoms as described in the OP do not rule out a heart attack. Unfortunately, in some people, relatively minor symptoms and high pain tolerances skew the perception of what is serious and what isn’t.

All severe chest pain that comes on suddenly for no apparent reason should be checked out within an hour of onset, because if a heart attack is occurring, there are thrombolytic drugs available that can dissolve a forming clot. But they only have a limited window of ooportunity - the best efect is achieved if given in the hour or so immediately following the onset of pain. After three or four hours the oportunity to reverse any damage is lost forever.

In South Australia, all patients transported by the Ambulance Service with chest pain that could be of cardiac origin are treated with 100% oxygen, oral aspirin (if no allergy), ECG monitoring, and nitroglycerin to reduce cardiac workload and pain. If an intensive care paramedic attends the patient, the care may extend to use of drugs such as lignocaine and atropine, or cardioversion, depending on the what the ECG has recorded.

The only way to truly confirm whether damage has been sustained by the heart muscle is via blood pathology tests, where unique enzymes can be tested for. This is routinely done in conjunction to taking a 12 lead ECG to establish any electrical changes that may also indicate myocardial damage.

6

I had a heart attack almost 4 years ago, and I remember pretty much everything. I drove myself to the hospital, because I was sure my daughter had broken one of my ribs earlier that evening when she kicked me while we played. I couldn’t sleep, couldn’t lay down, or sit . . . chest pain, sweating, etc.

I got to the hospital around 3 a.m. on Wednesday, and had a cath on Thursday. My arteries were pretty blocked up, too much for an angioplasty. I met the surgeon on Friday, and had 4 bypasses on Monday (and went home the following Friday).

The docs may give you medicine to lower your cholesterol. They will give you little pills to carry with you, in case you have chest pain. They will give you a stress test, and maybe a cath. But at least you will know what’s going on, and you can get the problem diagnosed and fixed.

Don’t think you’re too young - I was 35 when I had my attack, and I lowered the average age of the cardiac unit about 30 years.

7

Firstly, allow me to tell you this: GET TO THE DAMN DOCTOR NOW!!

I’m no medical expert, but I have been around heart attack victims and you sound like you have had a small one. If you have, the fact that you are still walking around means it was small, but, there is an 80% chance that the next one will be quite worse unless you start treatment.

All of your symptoms match basic heart attacks, sweating, anxiety, arm pain, and shortness of breath for a time. You might have felt a tightness or ‘pressure’ in the chest.

Now, look, in the 1970s my father died of a heart attack, what is known as a coronary thrombosis – blood clot in an artery of the heart. It was his second and biggest one. Back then, all they could do was treat him, and hope he would survive 24 hours to get well enough to be taken via ambulance to a big hospital 100 miles away, where the new arterial grafts were being done.

He didn’t make it.

Today, with what we have, he would still be alive and doing well, of that, I have no doubt.

In the tests they give you, they check the electric function of your heart, because some attacks throw it off some and act like a fingerprint. Then in blood tests they look for the injury toxins a damaged heart gives off shortly after an attack. They don’t show up at any other time. A scan will give them a real time view of the functioning heart, to not only spot the damaged area, but to determine how bad it is by giving you a dye via intravenous catheter.

Your actual damage can be only as big as a dime, but that is the heart and sometimes even minor damage can spread.

Today, they have many options, from giving you medications to open the clogged vessel, medications to stimulate your heart if you start to have problems, medications to thin your blood. One of the BEST THINGS to do after a possible heart attack is to take an ordinary aspirin, because it thins the blood some.

You will probably have to start exercising, if you don’t, and be placed on a low cholesterol diet.

The next step is that they can insert a tube up your arm, under anesthetic, go in, look at the damaged vessel and do one of three things: trickle in a clot busting medication, carefully ream out the block, or ream out the block and insert a stent, which holds the vessel open.

Depending on the injury, they might start you on medication to encourage the new growth of new vessels around the block. (Right after a heart attack, the muscle area affected starts to die. In surgery you can actually see the difference in color on the affected area. The heart starts to grow new vessels around the blockage, but slowly. Medication now increases the speed, which diminishes the amount of area killed.)

The more serious step is to operate and graft vessels around the blocked one to preserve as much of the affected area as possible.

The extreme case only, is a transplant, but you’d not be sitting up at the keyboard if it was that serious.

Heart attacks in the 70s required days in the hospital, slow recovery, strict diets, and various forms of medication. Bypass operations used to require almost a month or so of careful care and a slow progression back to normal.

Now, you’re in, get the surgery and you’re out within days.

From what you have said, chances are you’ll be placed on medication only. At the worst, they’ll want to go in and open the vessel. Either way, any hospital stay will be measured in less than a week. My neighbor has had two cardiac catheterizations, where they open the artery, and spent something like 3 days each time in the hospital. One day to work him up, one day for the procedure and one day to recover and be watched for any complications.

There are so many heart attacks each year that they have it down to a science now.

The thing of it is, though, even though you feel good now, IF you have had a heart attack, it can get worse without treatment. So, go see your doctor, even if you don’t want to know. The treatment is so good these days that the survival rate has soared beyond belief since my father died and it is no longer so complicated and drawn out.

Go! Like, … now.