Acute Myocardial Infraction Treatment (Heart Attack):
Think of your heart as a pump generated by your body’s constantly charging electrical system. The pump that is your heart operates at peak proficiency when the heart muscle is strong, when the electrical system is constant and uninterrupted; and when all the veins leading to the heart muscle, as well as those inside the heart muscle, allow blood to flow freely. If any part of the cardiac system—the heart muscle, the electrical system, or the veins and arteries are not working properly, you are at risk for a heart attack.
Also know as acute myocardial infarctions, heart attacks occur when blood supply to the coronary artery is blocked. Because the coronary artery is the main vessel bringing blood to the heart muscle, damage occurs when the blood supply is interrupted. The degree of damage often depends on how quickly the heart attack is diagnosed and treatment initiated. Over time cholesterol can narrow the blood vessels in our bodies. These narrowings or blockages are at risk for rupturing and these plaque ruptures are what cause the body to form a blood clot (thrombus) and completely shut down the crucial flow of blood to the heart muscle. Generally the less time that a coronary artery is closed the better the outcome is for the patient.
What are the warning signs of a heart attack?
Some are easily recognizable such as pain or tightness in the chest. Others are more subtle such as a feeling of impending doom. Symptoms of a heart attack can include:
- Uncomfortable pressure.
- Fullness.
- Squeezing or pain in the center of the chest that either lasts more than a few minutes, or goes away and comes back.
- Chest pain spreading to the shoulders, neck, or arms. The pain may vary from mild to intense and feel like pressure, tightness, burning, or heavy weight on your chest.
- Pain in the upper abdomen, neck, jaw, or the inside of your arms or shoulders.
- Chest discomfort along with feeling lightheaded, faint, nauseated, or short of breath.
- Feeling anxious or nervous.
- Sweating, along with cold, clammy skin.
- Pale pallor.
- Fast or irregular heart beat.
- A feeling of impending doom.
- Attention Women!
Women often do not experience chest pain or other “classic” symptoms of a heart attack. Of course, any woman who experiences the above mentioned symptoms should seek immediate medical attention. A woman should also seek care if she has unusual swelling in her arms or legs or feels overwhelmingly tired and anxious.
The American College of Cardiology and the American Heart Association have developed recommendations for treating heart attack patients which all hospitals should be following to reduce the complications of a heart attack and improve long term outcomes for these patients. These recommendations are that all patients who have been diagnosed with an ST-elevation MI should be taken to the Cath Lab within 90-minutes of presentation to the emergency department to have this artery opened.
At LRMC, we have developed a protocol based on these AHA and ACC recommendations called Code “R” (Reperfusion Protocol) which is activated as soon as a patient is diagnosed with a heart attack. The electrocardiogram is used to diagnose a heart attack and can be done immediately in the Emergency Department or on the ambulance and transmitted to the ER before the patient arrives.
Our team of doctors, nurses and invasive cardiovascular specialists strive to reach the 90-minute "door to wire" goal for every heart attack patient. Once the patient is taken to the cath lab, an angioplasty or thrombectomy procedure is immediately performed to remove the clot and restore blood flow to the heart muscle. A heart attack is serious, but the quicker the patient gets to the emergency room and seeks treatment the better the chances are for saving heart muscle and decreasing complications.
For more information, please visit the American Heart Association's website.
There is also a great resource on Facebook by the Society of Chest Pain Centers on early heart attack care.