Myocardial infarction first aid + Does chest pain mean a heart attack?

What is the first aid for a heart attack?

Cardiovascular disease is the most common cause of hospitalization and death worldwide.

Nowadays, early diagnosis and treatment minimize the negative consequences for the patient's overall health or reduce the risk of death. However, cardiovascular diseases still pose a threat. In addition to the at-risk group, they are increasingly common in younger people, probably due to increased stress levels and poor lifestyle.

What are cardiovascular diseases?

They are diseases of the heart and blood vessels of the body. This statement is too general. A narrower group of diseases include coronary heart disease, lower limb disease and ischaemic stroke. They have common risk factors.

1. high blood pressure
2. elevated cholesterol levels
3. obesity
4. reduced consumption of vegetables and fruit
5. smoking
6. alcohol
7. little physical activity

Risk factors can be divided into two groups depending on how we can influence them.

• The group of uncontrollable risk factors (age, gender, family and personal history, heredity, race)
• a group of controllable risk factors (elevated cholesterol, high blood pressure, smoking, alcohol, diabetes, obesity, lack of physical activity, poor diet, stress and hormonal influences)

Cardiovascular diseases are more prevalent in men and at a younger age. In women, the risk period is after menopause.

Ischaemic heart disease

Ischaemic heart disease is a disease of civilisation. It is caused by insufficient blood supply to the heart muscle (myocardium), thereby reducing the level of oxygen to the myocardial cells relative to the need. The cause is narrowing to closure of the heart arteries (coronary, coronary). Narrowing of the vessels to more than 50% is functionally significant.

When the narrowing exceeds 50 %, exertional chest pain (angina pectoris) - stable angina pectoris (AP, from the Greek angeru, a constricting pain in the chest) - occurs. It is termed exertional because it occurs during physical or mental exertion. It usually subsides within 15 minutes after the cessation of physical activity, after calming down.

If the narrowing of the coronary vessels is more than 70 %, unstable angina pectoris develops. If the narrowing is more than 95 %, myocardial infarction occurs.

Acute coronary syndrome

You may have picked up on this term and not quite know what it means. It is a collective term for unstable angina, myocardial infarction and sudden death resulting from coronary artery occlusion.

Acute coronary syndrome is further subdivided according to ECG changes into STEMI and NON STEMI (NSTEMI). Peripherally, it means whether ST segment elevation is present on the ECG. In the case of STEMI (occlusion of a coronary vessel) it is present. In the case of NONSTEMI it is not present on the ECG (at least partial blood supply is preserved).

A patient with STEMI is indicated for primary reperfusion treatment (angioplasty) at the cardiac centre within 12 hours of the onset of the problem. Further management of the patient by the emergency service is ideally to transport the patient from the detection of the presence of ST elevation on the ECG (STEMI diagnosis). The arrival time at the cardiac centre should be no longer than 90 minutes (90 + 30 minutes = 120 minutes from the detection of STEMI to admission at the cardiac centre).

• Unstable angina is ischaemia (non-blooding) of the heart muscle that can occur at rest, without exertion or any other factor.
• A myocardial infarction is the death of heart muscle that occurs in as little as 15 minutes of non-bloody heart muscle. Final death of heart muscle cells occurs within 10-12 hours of closure.
• Sudden death is defined as death that occurs within one hour of the onset of the problem. Up to 70% of these deaths have a cause in coronary artery disease. And the bad news is that it can be the first manifestation of the disease.

Acute coronary syndrome is well managed nowadays, but the process before a patient is admitted to a healthcare facility is important. That's why it's important to contact the emergency medical services when symptoms appear.

Cardiac muscle cell death occurs after 15 minutes. Any delay in time is detrimental to health and life threatening!

What should you know about first aid for myocardial infarction?

Before a person with symptoms gets into the hands of professionals, it is important to ensure a few simple actions:

• If there is no bed, chair, or sofa at hand, then sit the person on the floor. At that point, it is important to stop any physical or mental exertion or strain. The surroundings should also remain calm. Any agitation is inappropriate.
• Loosen the clothing around the neck and waist. If it is a person in a suit, tie off.
• Open a window, ventilate the room.
• Call emergency medical services.
• If the person is being treated for coronary artery disease and has a doctor's prescription for medication, give it. Nitroglycerin under the tongue (NTG or other nitrates, spray under the tongue) and anopyrine (acetylsalicylic acid). NTG is for chest pain and not to be given for any nausea. The current blood pressure reading is also important and should be above 100 systolic blood pressure if NTG is given.
• In the event of respiratory and circulatory arrest, the most important thing is to start performing cardiopulmonary resuscitation. This is the familiar chest compressions, which you know from first aid courses (in driving school), among other things. If you do not happen to remember the exact procedure, when you call the emergency line, the emergency medical services operator will be happy to help you and guide you to the correct procedure. Cooperation with the line is important.

When the blood circulation stops, brain cells die after just five minutes. And for a life-saving operation, all we need are hands and a willingness to help. And, of course, it's vital not to be afraid to lend a hand.

Recommendations for the public include calling the emergency medical services after determining the typical symptoms of a myocardial infarction. The emergency medical services will determine whether it is a myocardial infarction based on the patient's information (medical history) and tests (ECG, blood pressure, pulse). If so, it is important to get the affected person to hospital as soon as possible.

Treatment is chosen on the basis of comprehensive information. Nowadays, acute coronary syndrome is well manageable, thanks to coronary angioplasty. You may have heard it popularly called balloon blood vessels. A medical facility with this treatment option is called a cardiac centre.

Not every chest or chest pain means a myocardial infarction!

If a person is being treated for coronary artery disease or has had a myocardial infarction in the past, he or she will recognize whether the chest pain is of cardiac origin or not. It is important to remember that not every chest, chest or chest pain means a myocardial infarction. It can be equally serious, less serious, but also not serious problems or diseases and its symptoms.

• anxiety that is induced psychologically
• muscle spasms (cramps), chest injuries, rib fractures, sternum fractures
• airway inflammation, pneumothorax (air in the pleural cavity), pulmonary hypertension, pulmonary embolism, pulmonary emphysema
• pericarditis, aortic aneurysm
• GERD (gastroesophageal reflux disease), heartburn, hiatal hernia, gastric and duodenal ulcers, gallstones, colicaneuralgia, e.g. in herpes zoster, spinal pain (in disc herniation) and other spinal disorders

Any deterioration in your health can be discussed with your GP. Chest pain can recur, take many forms and have even more causes.

Not every twinge in the chest, chest or breast is a heart attack.

Sometimes it can be asymptomatic (without symptoms).

Each person is different. Some people have a milder course, others have the opposite. The pain threshold is also different for each person. People being treated for diabetes may not experience pain at all. The heart muscle is supplied by several coronary vessels, and the occlusion of a vessel can occur at any location.