[Ask Dr Chiu] Know what to do during a heart attack and seize the critical rescue time!

[Ask Dr Chiu] Know what to do during a heart attack and seize the critical rescue time!

[Ask Dr Chiu] Know what to do during a heart attack and seize the critical rescue time!

Health

2024-07-10

5  Mins Read

Modern life moves at a rapid pace, and people often find themselves under constant stress and pressure. Combined with poor lifestyle habits, this has led to a yearly increase in the incidence of heart attacks worldwide. In Hong Kong, heart attacks are one of the leading causes of death.

A heart attack is an acute and severe heart condition that can cause permanent damage to heart tissue and even lead to death. In this episode, I will walk you through the causes and symptoms of a heart attack, teach you correct countermeasures, and outline preventative measures. Not only increase your survival chances, but also reduce the risk of long-term complications.

What is a heart attack?

A heart attack occurs when part of the heart muscle dies due to a lack of blood supply, usually caused by a blockage in the coronary artery, which is the main blood vessel that supplies blood to the heart. When atheromas accumulates in the coronary artery and rupture, they form blood clots that block the arteries. This blockage cuts off the blood supply, leading to oxygen deprivation and death of the heart muscle, resulting in a heart attack. 

  

Causes of a heart attack

  • Natural factors: Hereditary genes, race, and aging.
  • Nurture factors: Poor lifestyle are the main causes of heart attack, such as high-fat and high-salt eating habits, sedentary lifestyles, smoking and drinking, high stress, and emotional instability. These factors may cause increases in cholesterol, blood pressure, triglycerides, and weight, leading to a higher risk of coronary artery atherosclerosis and heart attack.

Symptoms of a heart attack

1. Chest pain and tightness

The most typical symptom is chest pain and tightness. Patients usually feel a pressing or squeezing sensation behind the breastbone, which can radiate to the left shoulder, left arm, back, neck, or jaw. This pain often lasts for several minutes and does not completely subside by rest or nitroglycerin.

2. Shortness of breath

Shortness of breath is another common symptom. Patients may feel breathless or suffocated, especially after physical activity or when lying down. This occurs because the heart attack impairs the heart's pumping function, leading to inadequate blood supply, and breathing difficulties.

3. Angina

Angina is a manifestation of myocardial ischemia, which is similar to heart attack pain but usually shorter in duration. It can be relieved by rest or nitroglycerin. Angina typically occurs during exertion or emotional stress and is an important warning sign of a heart attack.

4. Other symptoms

  • Upper abdominal pain: Some patients may experience upper abdominal pain, often mistaken for digestive problems.
  • Cold sweat: Sudden cold sweat is a key warning sign of a heart attack.
  • Dizziness and weakness: Patients may feel extremely weak, dizzy, or even faint.
  • Nausea and vomiting: Some patients, especially women and the elderly, may experience nausea or vomiting.

Acute heart attacks can cause varying degrees of damage to the heart, leading to myocardial necrosis and functional failure. This can increase the risk of chronic heart failure, arrhythmias, and stroke. Therefore, recognising the warning signs early and seeking medical attention promptly can significantly reduce the long-term damage. 

  

What to do in a heart emergency

When a heart attack occurs, it is just like a race against time. The sooner treatment is received, the less damage caused by blocked blood vessels in the heart. In addition to reducing complications and improving better prognosis, proper treatment can also increase the chance of saving a life. Therefore, knowing the correct countermeasures during a heart attack can help you seize the critical rescue time to minimise damage to the heart.

When you suspect that you are experiencing symptoms of a heart attack, you should stop all activities immediately to avoid worsening the condition. At the same time, immediately notify nearby pedestrians or family members to call the emergency services for an ambulance. It is recommended to sit or remain half-lying to wait for rescue. 

What to avoid in a heart emergency

Understanding the correct countermeasures are crucial during a heart attack. Incorrect actions can worsen the condition and delay treatment. Here are some common mistakes to avoid:

1. Hitting the inner end of the elbow

Some believe that hitting the inner bend of the elbow can stimulate acupoints and relieve symptoms during heat attack. However, this method is lack of scientific basis and delay timely medical intervention.

2. Forceful coughing

It’s believed that forceful coughing can help the heart pump blood by increasing chest pressure. However, this is not a reliable technique in practice and may increase the heart's workload. It may worsen the ischemia and cannot fundamentally solve the problem causing the heart attack.

3. Hitting or massaging the chest

Some think hitting or massaging the chest can relieve symptoms. This can actually cause further harm, increasing pain and causing chest injuries without restoring blood flow.

Preventing heart attack

An international study suggests that 90% of heart attack cases are due to nine modifiable behavioral and biomedical risk factors. Improving lifestyle habits can greatly reduce the risk.

1. Healthy diet

Maintaining a healthy diet is an important step in preventing heart attacks, as it helps control weight, lower blood pressure, and reduce cholesterol levels.

  • Low-fat, Low-salt eating habit: Choose low-fat, high-fibre foods and avoid excessive saturated or trans fats. Limit salt intake to no more than 6 grams per day, and drink at least 2,000 ml of water daily to maintain normal blood pressure.
  • Consume more fruits and vegetables: A 2018-2019 Health Behaviour Survey by the Department of Health found that 95.6% of people aged 15 and above do not eat enough fruits and vegetables. Adults should eat at least two servings of fruit and three servings of vegetables daily to get enough vitamins, minerals, and antioxidants for heart protection.

2. Regular exercise

Regular exercise is crucial for heart health. Aim for at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise weekly such as brisk walking, jogging, or swimming. Exercise helps control weight, improves cardiovascular function and lowers blood pressure and cholesterol levels.

3. Quit smoking and limit alcohol intake

Smoking is a major risk factor for heart attack. Quitting smoking can significantly reduce the risk of cardiovascular diseases. Additionally, alcohol intake should be kept within appropriate limits, as excessive drinking can raise blood pressure and harm heart health.

4. Regular health checks

Regular health checks are essential for heart attack prevention. They help detect and manage high blood pressure, high cholesterol, diabetes, and other risk factors early. Annual comprehensive health checks are recommended, especially for those with a family history of cardiovascular diseases, using ECGs, stress tests, and echocardiograms for early diagnosis and treatment.

Combine immediate treatment with prevention to avoid heart attacks

Each heart attack damages heart function, causing irreversible harm and serious consequences, even death. Heart attacks are emergencies, and the sooner you recognise the symptoms and seek medical help, the better the chances of a positive outcome. In addition to the correct countermeasures, preventing heart attack is equally important. Adopting a healthy lifestyle can significantly lower the risk of heart attacks, including a balanced diet, regular exercise, quitting smoking, and limiting alcohol, along with regular health checks.

Currently, there are critical illness insurance plans available that cover not only major illnesses and minor illnesses, but also early risk conditions. This allows you to take advantage of critical treatment opportunities in the early stages. After reading this article, I hope we can all take steps to stay away from the threats of heart attacks and enjoy healthy and happy lives.

1. Amsterdam, E. A., Wenger, N. K., Brindis, R. G., Casey, D. E., Ganiats, T. G., Holmes Jr, D. R., ... & Goff Jr, D. C. (2014). 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 64(24), e139-e228.
2. Benjamin, E. J., Blaha, M. J., Chiuve, S. E., Cushman, M., Das, S. R., Deo, R., ... & Jimenez, M. C. (2017). Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation, 135(10), e146-e603.
3. Dagenais, G. R., Leong, D. P., Rangarajan, S., Lanas, F., Lopez-Jaramillo, P., Gupta, R., ... & Krishnapillai, V. (2020). Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents (PURE): a prospective cohort study. The Lancet, 395(10226), 785-794.
4. GBD 2019 Diseases and Injuries Collaborators. (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 396(10258), 1204-1222.
5. Ibanez, B., James, S., Agewall, S., Antunes, M. J., Bucciarelli-Ducci, C., Bueno, H., ... & Yellon, D. M. (2017). 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal, 39(2), 119-177.
6. O'Gara, P. T., Kushner, F. G., Ascheim, D. D., Casey Jr, D. E., Chung, M. K., de Lemos, J. A., ... & Jacobs, A. K. (2013). 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 61(4), e78-e140.
7. Roffi, M., Patrono, C., Collet, J. P., Mueller, C., Valgimigli, M., Andreotti, F., ... & Levine, G. N. (2016). 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). European heart journal, 37(3), 267-315.
8. Thygesen, K., Alpert, J. S., Jaffe, A. S., Chaitman, B. R., Bax, J. J., Morrow, D. A., ... & Goodacre, S. (2018). Fourth universal definition of myocardial infarction (2018). European heart journal, 40(3), 237-269.
9. Wang, H., Naghavi, M., Allen, C., Barber, R. M., Bhutta, Z. A., Carter, A., ... & Dandona, L. (2016). Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. The lancet, 388(10053), 1459-1544.
10. Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., ... & Lisheng, L. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. The Lancet, 364(9438), 937-952.

The above content is reviewed by Dr Alexander Chiu - Chief Medical Officer of AXA Hong Kong and Macau.

Information and materials provided is general in nature and does not constitute medical or health advice from AXA Hong Kong and is on an “as is” and “as-available” basis without representation and/or warranty of any kind, either express or implied.  While AXA Hong Kong has taken reasonable care in providing such information and materials, they are not specific to your investment objective, financial situation, health or medical conditions or particular needs.  No warranty or responsibility is assumed by AXA Hong Kong and our related or holding companies regarding non-infringement, security, accuracy, completeness, adequacy, reasonableness, fitness for a purpose or free from computer viruses in connection with the information and materials provided.  AXA Hong Kong and our related companies and holding companies do not accept any liability for any loss, damage, cost or other expense, whether wholly or partially, directly or indirectly, arising from any error, inaccuracy or omission of the information and materials to the extent that such liability is not excluded by law.

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