What would you do if you were having a heart attack?
- What if you were having chest pains and thought you were having a heart attack?
- Would you know what to do?
The best thing to do if you have even a smidgen of an idea that you could be having a heart attack is dial 9-1-1.
Let them rule it out for you rather than chance staying at home and dying from your heart attack as my father almost did. He had chest pains for 3 days before he told me about them, and almost died because of waiting!
The heart is a muscle. It’s main function is to pump blood to the lungs to be oxygenated. Then the heart pumps it back through the heart and out to the rest of the body.
If body cells are without oxygen, they begin to die. So it is crucial to keep the heart and body healthy, in order for all the organs to receive the oxygen they need.
Brain cells left without oxygen die in 4-6 minutes. Once the brain quits the heart also quits, so the rest of the body also quits. Or in other words, the body dies!
Risk Factors for a Heart Attack
Some people are at greater risk for a heart attack than others. Humans have different types of risk factors.
Risk Factors You Cannot Control
- Many people over the age of 65 die of coronary heart disease.
- Advanced age in women makes them more likely than men to die from the heart attack within a few weeks.
Male Sex (Gender)
- Mostly men have a greater risk of heart attack than women do
- Males also tend to have attacks earlier in life
- After menopause women’s death rate from heart disease increases, but it’s still not as great as men’s
Heredity (Including Race)
- Children whose parents have heart disease are more likely to develop it themselves
- African Americans have more severe high blood pressure than Caucasians and therefore a higher risk of heart disease
- Heart disease risk is higher among Mexican Americans, American Indians, native Hawaiians and some Asian Americans
- This is partly due to higher rates of obesity and diabetes
- Most people with a strong family history of heart disease have one or more other risk factors
- Just as you can’t control your age, sex and race, you can’t control your family history
- Therefore, it’s even more important to treat and control any other risk factors you have
Risk Factors You Can Control
- Someone who Smokes has a higher risk of developing coronary heart disease than nonsmokers. Cigarette smoking has a dramatic risk factor for sudden cardiac death in patients who have coronary heart disease
- Smoking also increases the risk for coronary heart disease
- Exposure to other people’s smoke increases the risk of heart disease even for nonsmokers Learn about smoking and cardiovascular disease
- As a person’s cholesterol rises, so does the risk of coronary heart disease
- When other risk factors (such as high blood pressure and smoking) are present, this risk increases even more
- Your cholesterol level is also affected by age, sex, heredity and diet Learn more about managing your cholesterol
High blood pressure
- High blood pressure makes the heart have to work harder which causes the heart muscle to thicken and become stiff
- This stiffening of the heart muscle is not normal, and decreases the heart’s ability to properly pump the blood to all areas of the body
- Which increases your risk of stroke, heart attack, kidney failure and congestive heart failure
- When high blood pressure exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases even more.Learn more about managing your blood pressure
- Take our Blood Pressure Risk Assessment
- Lack of exercise is a risk factor for coronary heart disease
- Regular, moderate-to-vigorous physical activity helps reduce the risk of heart and blood vessel disease
- Even moderate-intensity activities help if done regularly and consistently
- Physical activity can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people Learn more about getting active
Obesity and overweight
- People who carry excess body weight, especially if a lot of it is at the waist, are more likely to develop heart disease and stroke even if they have no other risk factors
- Overweight and obese adults with risk factors for cardiovascular disease such as high blood pressure, high cholesterol, or high blood sugar can make lifestyle changes to lose weight and reduce the changeable risk factors
- Some people may have difficulty losing weight. But weight loss of 3 to 5% of your body weight can create clinically meaningful reductions in some risk factors
- Larger weight losses can benefit blood pressure, cholesterol, and blood glucose Learn more about managing your weight
- Diabetes significantly increases your risk of developing cardiovascular disease
- Even if you keep your glucose levels under control, diabetes increases the risk of heart disease and stroke
- The risks are even greater if blood sugar is not well controlled
- At least 68% of people >65 years of age with diabetes die of some form of heart disease and 16% die of stroke
- If you have diabetes, it’s extremely important to work with your healthcare provider to manage it and control any other risk factors you can
- Persons with diabetes who are obese or overweight should make lifestyle changes (e.g., eat better, get regular physical activity, lose weight ) to help manage blood sugar
What is a Heart Attack?
Every cell in your body needs oxygen to survive, and your heart is no exception. A heart attack is when a portion of the heart loses it’s blood flow, when this happens that portion of the heart dies.
The medical term for heart attack is Acute Myocardial Infarction.
- Acute means sudden onset
- Myo means muscle
- Cardiac means heart
- Infarction means death of
Heart Attack = Sudden death of part or all of the heart muscle
Signs and Symptoms of a Heart Attack
- Not all heart attacks present the same, but most are similar in nature
- Chest pains that last for more than a few minutes, or that come and go
- Many people say it doesn’t really feel like a pain in the chest, it feels uncomfortable, like a pressure or heaviness to the chest
- Sometimes they even say it feels like an elephant sitting on my chest
- Difficulty breathing with or without chest discomfort
- Upper body pain pain or discomfort in one or both arms, the back, neck, jaw or stomach
- Many times you will see the patient rubbing their little finger and ring finger
- Nausea/Vomiting, Indigestion, Cold Sweat, or Lightheadedness
- Women sometimes experience other signs particularly shortness of breath, nausea/vomiting, and back or jaw pain rather than chest pain
- While some people never feel any pain at all
Know the signs and symptoms, but if there is ANY question at all, it is best to call 9-1-1 immediately and get help on the way.
Time is not your friend in a cardiac (heart) emergency.
My Father’s Heart Attack
On New Years Day (Sunday, Jan 1, 2017) my father had a heart attack.
He called me to come over saying, “I have a little problem. Are you home? What are you doing now? Can you come over after while and take my vital signs?”
Sensing there was more to the story, and getting strange vibes from the sound of his voice,” I ask 3 times, what is wrong? No intelligible answer.
I quickly struggle to figure out medically what could be going on as I say, ” “I’ll be right there.”Three minutes later I arrive at my parents house.
Assessing my father for a heart attack
“I’m ok,” he tells me as I arrive. Here he is trying to reassure me that he isn’t having a serious problem while I am thinking I will
have a struggle to get him to go to the ER.”What’s the problem?”
“I’m just having a little pain in my should and maybe my upper chest.”
“Point with one finger, where is the pain?” I query him. Now the Paramedic in me takes over.
“Here in my shoulders and upper chest,” he says, pointing directly at his sternum (The breastbone in the center of the chest).
Checking Vital Signs
As I check his pulse, blood pressure, and breathing status, I start preparing him to head to the ER. Dad balks at the idea.
He and Mom have both made several trips to the ER in the past few years, and all he can think of is the process he will have to go through when he gets there. Sitting around for awhile until he can see the doctor. Then blood drawn and IV’s started. Constant interruptions of his television programs (usually golf, football, or basketball).
I try again, being a bit more insistent and persuasive. The more I insist the more he balks. He has a seriously scared look on his face!
Believe me, as a Paramedic the more a patient tells me they aren’t having a heart attack the more I know they are. You can just tell by that denial and the scared look on their face!
My Dad’s having a heart attack and doesn’t want to go to the hospital
My brother in law says, “Why don’t you just go ahead and call an ambulance, he won’t give you as much trouble as the ambulance crew. A t least he won’t have to stop at triage on the way in.”
I think to myself, he’s already on O2 and had an aspirin, we’re checking vital signs and O2 sat, other than an ECG monitor we are doing the same things as the ambulance crew will do.
If I take him out in a wheelchair we can be there quicker than the ambulance can get here. Because my parents house is virtually across the street from the hospital. But I relent and dial 9-1-1.
I tell the 9-1-1 Call Taker, “We have an 89 y.o. male c/o chest pains and difficulty breathing, he’s caox3. We need an ambulance.
Emergency Medical Dispatch
Knowing that I am an EMD & EMT Instructor and Paramedic, the Call Taker proceeds to go straight through the EMD protocols, following them exactly, I might add. ” It’s ok, you don’t have to go all the way through the whole protocol, I have already given you the information you need to make a proper SEND decision.” So she stops and sends a response exactly as she should have.
“I was afraid not to, since you are an instructor,” but I reassure her again, that it is unnecessary in this situation, so she stops after the Post Dispatch Instructions.
We hang up at that point, since we don’t need any further instructions, I know the PAI’s like the back of my hand. She has followed the Priority Dispatch protocols to the letter, and made an appropriate dispatch decision based on those protocols and the information I gave her.
Waiting for the Ambulance to arrive
While waiting for the responders my father suddenly burps loudly. For those of you who don’t know him, he is obsessive about manners and would never burp out loud.
So I ask, “Dad are you having indigestion?”
He nods “yes” and says, “And Nausea too.”
Oh Lord, I am about in panic city by now!
The fire department arrives about this time. They were followed by the ambulance within a minute or so.
Heart Attack Treatment in the Ambulance on the way to the Hospital
The ambulance Paramedic, continues the Oxygen, gives 2 more baby aspirin and Dad is placed on the ECG Monitor, immediately we see ST segment elevation and rabbit ears, on a patient who has never had any heart or blood pressure problems, but remember he has had lung problems! Lung problems also put significant stress on the heart.
This is indicative of a pretty serious heart attack! I now know for sure, it isn’t just a gut feeling anymore, this is serious, but I am wrestling with my own feelings, as I try to keep from letting Dad, Mom and my sister know how bad it is.
All the while, I’m freaking out looking at the damn ECG Monitor reading! My Dad who has lung problems and prostate cancer, but absolutely no history of cardiac problems is having a heart attack!
Starting the IV
It takes the EMT a couple of tries to get the IV started, and of course Dad gives them “what for” as the driver tries to start the IV. He makes everyone who tries to stick him nervous, because he hates IV’s. He is a difficult stick at best. But the EMT goes through the process and finally gets it on the second try.
The Paramedic then gives 2 Sub Lingual (under the tongue) nitroglycerin, following appropriate cardiac protocols. He notifies the hospital of a STEMI enroute, and they proceed to take him to the hospital. They arrive in 2 minutes or less. It is now approximately 12:00 hours.
Arrival at the hospital
At Rockdale Health Care, Dr. Kalynych is on duty, she is an amazing cardiac specialist from Piedmont Atlanta! The ambulance arrived and moved him into a room, she did a rapid triage, immediately ordered a cardiac cath, and called in the appropriate staff to assist.
The Cardiac Catheterization Is Complete
Before 14:00 hours the cardiac cath is complete.
Dad had a complete blockage of one of his coronary arteries at the back of the heart. It was a difficult case, due to an unbeknownst (to us), congenital defect, so strange that less than 5% of the population have this.
Many doctors may have missed diagnosed it, but Dr. Kalynych was right on the money!
Transport to Piedmont Hospital in downtown Atlanta
Since Rockdale Health Care doesn’t have the same cardiac capabilities as Piedmont, she has already called for another ambulance to transfer him downtown.
She notifies Dr. Klein that she is transferring him, and lets us know that Dr. Klein will see Dad downtown at the hospital.
He will be a direct admit to the Coronary Care Unit.
I walk in the CCU and head to his room then spot my husband’s niece in another room with a patient.
We both do a double take and then stop to exchange niceties. I know she is a Coronary Care RN at Piedmont, although I had no idea she was on duty at this time!
She is not my Dad’s nurse, but she had seen him come in and saw his name on the board so she was expecting us.
Piedmont Hospital Coronary Care Unit
If you have never been in the CCU at a large urban hospital like Piedmont, it is incredible.
I have never seen such a proficient, attentive and positive group of nurses anywhere before! You ask them to do anything, and it happens immediately. There is exceptional communication between the Nurses and their Techs, the Doctors, and the Patients, it all works seamlessly, exactly as it is designed to work. Which isn’t always the case in some other hospitals.
The Physician’s Assistant and the Doctor
The Physician’s Assistant, Mike comes in and talks to us, to get the history and answer any questions we might have. He tells us Dr. Klein, another of the Cardiology Docs is in the hospital and will be by to see us soon. Then he relays the appropriate information to Dr. Klein.
Sure enough in a short period of time, here comes Dr. Klein.
The Doctor spends a fair amount of time talking with us, getting even more history and we talk with him about Dad’s stem cell transplant for the pulmonary fibrosis (lung problems). Dr. Klein is interested in the excellent results Dad had, and shares with us about the extensive studies and papers he has written on stem cell treatment for cardiac patients. He is interesting and educational at the same time.
This is the way Doctors should always operate. It reminds me of Dr. Corey Slovis (who is now at Vanderbilt) and so many of our other Medical Directors at Grady EMS . I get somewhat nostalgic as I ponder the pleasant memories.
Coronary Step Down Unit
Tuesday, comes and he is moved to the Cardiac Stepdown unit, which at Piedmont is a whole wing! The staff is so talented, positive, and attentive, I am totally impressed with all of them.
Wednesday we see PA, Patti Atkinson, she is exactly like the others, right at the top of her game. She interviews my Dad, and is slightly hesitant to release him because he is having trouble maintaining his O2 sat. We assure her he has an oxygen concentrator at home and we monitor his O2 sat regularly.
She agrees to ask Dr. Arnold (the on duty doctor) if he can be released with the stipulation that the O2 concentrator is brought to the hospital in order to use it during his transport home, and he must continue his O2 at home (which he does anyway for his breathing problems).
Finally Dr. Arnold comes around and talks to Dad about the importance of maintaining his O2 saturation levels and releases him to go home.
Waiting to be discharged
Sitting in Dad’s room at Piedmont, waiting now for all the appropriate people to process his paperwork so we can leave.
His room overlooks the ambulance entrance to the ER. As I watch the Grady Ambulances come in and out, I am feeling a bit wistful and nostalgic. I sure do miss being an EMS crew member.
Now it almost makes me wish I had never gone into EMS management! So I could have stayed on the ambulance. I miss patient contact and care.
We had so much fun, and were such great teams “back in the day!” I have seriously missed having Theresa Little, Frank Bader, and especially our Director Ray Hawkins who constantly kept sending positive messages to us. He kept everyone motivated to do their jobs without having to be told.
We were a team, we covered for each other for meal breaks, helped each other on difficult calls, it was truly more of a family and I miss them.
Missing my EMS Family
There was Supervisor Sam Shartar, showing up on your scene when you least expected it, sometimes to help, sometimes just to watch.
There is a story about Maeretha Smith who would show up at the South County Base Station without notice and catch somebody sleeping when they weren’t supposed to. Even though (he) who shall remain nameless (ahemmm Junie Harris) was trying hard to appear as if he wasn’t sleeping. He allegedly heard her come in and he jumped up and out of the back of the ambulance in his (long insulated) underwear. Rubbing his eyes and asking her WTF she was doing there?
For the record, he had removed his uniform to keep from getting it wrinkled. (I don’t even remember who his partner was at the time, so I can’t tell you what really was going on there, but usually one person stayed in the ambulance and one person stayed in the crew room listening for the dispatcher to call.)
Grady EMS Medics
Grady Medics used to compete in all sorts of competitions and win them to the point where most other services didn’t even want to compete against them anymore! I was proud to put on my uniform and go to work everyday. Each day brought on new challenges and new opportunities for learning.
Those were the days
Such “were the days, my friend, we thought they’d never end…” but they have, some of us have passed away, some have retired due to “old” age, and some have been forced to retire due to injuries, but they really were the good ol’ days!
We all were a family who helped each other and we always got the job done, no matter how huge it was. Life was good and fun, even though we worked hard and saved a lot of lives.
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Sassy “Mimi” Sandy Sue Says,
Thanks for joining us today. Hope you were pleasantly surprised to learn about heart attacks and how to contact 9-1-1 in the case of emergencies. If you have any questions, please contact us and we will answer them as quickly as possible.[contact-form-7 404 "Not Found"]