people who have had a recent heart attack are worried about what
might happen to them in the future.
Some worry a little and others far too much.
Some have questions they are “afraid to ask”.
Now is the time to think about and discuss these issues.
In most cases the future is a lot brighter than you think.
have already improved your chances of good health by taking part in this
programme. Your physical fitness is
improving and equally important, you are now better informed than you were
before about your heart and heart disease.
purpose of this module is to provide you with background information to help you
assess your own symptoms and to determine what you should do, to enable you to
give instructions to bystanders if you do have an emergency situation, and to
provide you with some basic information that will enable you to help others if
the need arises. It is no secret
that you are “in the age group” for heart disease and so are your friends. If a situation arises at home, on the golf course, or on the
street, you will be better prepared after this module.
Remember the same rules that apply to you with respect to emergencies
will also apply to others.
of what we need to discuss can usefully be divided in to three broad categories:
PAIN RHYTHM PUMP
Most of you will have experienced
chest pain or discomfort as part of your initial experience of the heart attack
or angina. People perceive pain
differently and it is not surprising that some of your symptoms may differ from
another individual. We will discuss
common symptoms that people may experience with heart disease
recognizing that each individual is different.
If it seems similar but less severe, the discomfort is probably angina.
If the feeling occurs only on extremes of exertion is promptly relieved
by rest, you can avoid it exerting to a lower level, not exerting after meal, or
by using nitro in advance. In any
event, report this to you doctor without delay.
If the discomfort is similar and is beginning to come on with less effort
or particularly if it is coming on at rest, this is unstable angina and must
be evaluated by a doctor, preferably the same day.
Pain of very brief duration,
lasting just a few seconds, often “stabs and jabs” is common.
It is not a heart symptom that needs any attention.
In general any predictable discomfort that comes on with exercise and is
relieved by rest could be angina. It may occur anywhere between the “nose and navel” and
can be isolated to areas like the jaw, neck, or between the should blades.
These symptoms should be reported to your doctor.
If you become aware of pauses in your rhythm that are associated with
weakness or last longer than 2 seconds, see your doctor, preferably today.
If you become aware of sustained fast beats, especially if the rate is
over 100 beats per minute without any good reason, you must
go to emergency or see your doctor the
If you notice intermittent skips in your heart beat, not accompanied by
any other symptoms, they should be reported to your doctor and you likely should
have a Holter monitor placed promptly. This
is particularly important if these symptoms are noted within the first month or
two after the heart attack.
purpose of your heart is to pump the blood with oxygen to all parts of your
body. By definition, since you have
had a heart attack there is at least some damage to the pump.
Pump problems can be experienced as shortness of breath, weight gain,
ankle swelling, fatigue and sometimes much more subtle symptoms.
If you experience a slow increase in shortness of breath over a few days
especially if accompanied by a sensation that you can’t catch you breath when
you lie down or you waken from sleep with shortness of breath, see you doctor the same day.
If you notice increasing ankle swelling +/- shortness of breath, and
especially if associated with swelling of the abdomen see
your doctor, preferably the same day.
If you are becoming increasingly fatigued even in the absence of
shortness of breath, and especially if this is accompanied by lightheadedness
when you stand, this may mean the pump is not working well.
Notify your doctor without delay.
WHAT ABOUT CARDIAC ARREST?
is the most sudden and serious complication of heart disease.
If not treated properly it will lead to sudden death within a few
minutes. Your risks of this
complication are very small and further minimized by your increasing fitness,
good diet, medications designed to prevent this complication and most
importantly, your ability to recognize the emergencies described above.
may one day find yourself in a situation where another individual appears
to have suffered a cardiac arrest. Take
the following steps and use the opportunity to practice CPR with your nurse
If there is no breathing, extend the person’s neck to open the airway.
Remove any obvious foreign matter from the mouth.
Quickly make a seal over their mouth with your own, pinch their nose to
prevent the escape of air and give four quick breaths.
Feel for a pulse.
If no pulse, begin chest compressions with your hands one on top of the
other in the middle of the chest. Press firmly between 60 and 80 times per
minute. After every 8 to 12
compressions give two more breaths.
Make sure you dispatch
someone to call 911 and notify emergency services that there is a cardiac arrest.
Tell the person to come back to the scene to confirm they have placed the
call and to help you.