American Medical Association Family Medical Guide - American Medical Association [326]
CPR Can Save Lives
Cardiopulmonary resuscitation (CPR) is a lifesaving technique that is performed to restart a person’s breathing and heartbeat after they have stopped. The procedure involves keeping the person’s airway open, performing rescue breathing, and doing chest compressions to pump blood through the heart. Because of the potential for serious injury, only people who have been fully trained in CPR should attempt this procedure. Before starting CPR, call 911 or your local emergency number. Once you have started CPR, do not stop until emergency medical personnel have taken over.
Ask your doctor about the availability of CPR classes in your community. Your local hospital or fire department may offer a class. If not, contact the local chapter of the American Red Cross or the American Heart Association. CPR training can mean the difference between life and death.
Other common symptoms of a heart attack include dizziness, shortness of breath, sweating, chills, nausea, restlessness or anxiety, fainting, or weakness. Sometimes the lips, hands, or feet turn slightly blue. Women are more likely than men to have these symptoms in addition to chest pain. In rare cases, a heart attack does not cause symptoms and is detected by chance on an electrocardiogram (ECG; see page 559), a recording of the electrical activity of the heart, performed for another purpose.
Some people may ignore their symptoms or assume they are caused by some other condition, such as indigestion or overexertion. However, because most deaths from a heart attack occur within an hour of the onset of symptoms, it is crucial to be able to recognize the symptoms and act quickly. The sooner treatment begins, the less damage to the heart muscle and the better the long-term prognosis.
Diagnosis
After you arrive at the hospital emergency department, a doctor or nurse will check your temperature, pulse, and blood pressure and ask you to describe your symptoms. Because other conditions—such as indigestion, pneumonia, a blood clot in a lung, or gastroesophageal reflux disease—can imitate the symptoms of a heart attack, the doctor will order an ECG and blood enzyme tests to make a diagnosis. An ECG will often show heart muscle damage caused by a heart attack. However, if several ECGs performed over the course of several hours appear normal, the doctor will probably use the blood enzyme tests to make the diagnosis.
An elevated blood level of heart muscle enzymes called troponins indicates heart muscle damage caused by a heart attack. The level of troponins in the blood increases about 4 to 6 hours after a heart attack, peaks about 10 to 24 hours after the attack, and can be detected in the blood for about a week. Troponin levels are usually measured soon after a person is admitted to the hospital with chest pain and a possible heart attack and at 8-hour intervals over a 24-hour period.
WARNING!
Signs of a Heart Attack
A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number immediately. The sooner treatment begins, the greater your chances of survival, so act quickly, even if you are not sure you are having a heart attack. The most common symptoms of a heart attack include:
• Sudden squeezing pain or a feeling of tightness, pressure, or fullness in the center of the chest that lasts for more than several minutes
• Chest pain that extends to the shoulders, arms, back, neck, or jaw
• Indigestion or persistent pain in the upper abdomen
• Shortness of breath
• Dizziness or fainting
• Weakness or fatigue
• Heavy sweating
• Chills
• Nausea and vomiting
• Backache
• Arm or jaw numbness
• Restlessness or anxiety; sleeplessness
• Paleness
• Blueness of the lips, hands, or feet
While waiting for emergency help to arrive, take an aspirin tablet; aspirin reduces blood clotting and helps limit damage