To Your Health: Minutes matter in heart attack treatment


By Martin Charlat, MD, Scripps Health

When a heart attack strikes, what happens in the next few minutes can make a critical difference in both the immediate and long-term health consequences.

Each year, about 1.2 million people in the United States have heart attacks. A heart attack results when the flow of blood to the heart is suddenly cut off, often due to a build-up of plaque in the arteries caused by coronary heart disease. Left untreated, the plaque eventually becomes so thick that it prevents blood from getting through. Blood carries oxygen to the heart; if blood flow is not quickly restored, the heart is deprived of oxygen and begins to die. If enough of the heart muscle is damaged, the heart attack can be fatal.

That’s why it is vital to get medical attention immediately if you believe you or someone else may be having a heart attack. The sooner you get treatment, the less likely the damage to the heart muscle. Immediate intervention by a medical professional team is critical to getting the blocked artery open with angioplasty and stent placement and restoring blood flow to the heart muscle. Time is crucial: If treatment is received within several hours, long-term damage can often be minimized or avoided. Once up to six hours have passed without treatment, the injury tends to be more severe. After 12 hours, heart damage is likely to be permanent.

The first step to getting the right care for a heart attack is to be able to recognize the symptoms. For men, the typical warning sign is an intense feeling of pressure, pain or squeezing around the chest. The discomfort may radiate down one or both arms or up to the jaw, neck or shoulders. Sudden and profuse sweating may also occur, as well as shortness of breath, a lightheaded feeling, or nausea. However, these symptoms are not always present — some people may have only mild discomfort, or just feel short of breath.

Women often have very different heart attack symptoms than men, and they can be less predictable. Research by the National Institutes of Health (NIH) indicates that women often experience new or different physical symptoms as long as a month or more before experiencing heart attacks. The most commonly reported symptoms included unusual fatigue, sleep disturbances, shortness of breath, indigestion, and anxiety. More than 40 percent reported no chest pain before or during the heart attack.

If you suspect you’re having a heart attack, don’t write it off as indigestion or wait to see if you feel better. Call 911 immediately and tell the operator you are having symptoms of a heart attack. Too often, people wait to seek medical care because they don’t want to “look silly” if it isn’t a heart attack after all. We would much rather you err on the side of caution than not seek care because you aren’t sure if you need it. Delaying care can be deadly.

While you are waiting for the paramedics to arrive, chew and swallow an aspirin (unless your physician has told you otherwise or you are allergic to aspirin). This can help thin your blood and possibly get more blood flowing to your heart. Once the paramedics arrive, they can begin professional medical treatment to get you to the hospital to open the blocked artery and restore blood flow.

Remember, immediate professional medical care can make the difference between life and death or long-term damage. Know the signs of a heart attack, and never hesitate to get help if you suspect you need it.

Martin Charlat, MD, is a cardiologist with Scripps Health. Join Dr. Charlat for a free presentation on heart attack prevention and new treatments and techniques on Wednesday, February 20, 2013, from 6 to 7 p.m. at Magdalena Ecke Family YMCA, 200 Saxony Rd., Encinitas, CA 92024. Please call 1-800-SCRIPPS (727-4777) to register.