Early Heart
Attack Care
(EHAC)
Heart attacks have
beginnings
Course Outline
1.
Anatomy and Physiology 101: Your Heart
2.
A Heart Attack in Progress
3.
Concepts of Early Heart Attack Care
4.
Recognition and Intervention
5.
Delay and Denial
6.
You: The Early Heart Attack Care Giver
Part 1
Anatomy and
Physiology 101:
Your Heart
The Human Heart
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The primary function of the heart is to
pump oxygen-rich blood throughout
the body. The oxygen is used by the
body's tissues to perform their normal
work.
Your heart is approximately the same
size as your fist. Inside, the heart is
divided into right and left sides by a
thick muscular wall called a septum.
The right and left sides are divided into
upper chambers called the atria and
lower chambers called the ventricles.
The heart's right side (consisting of an
atrium and a ventricle) receives blood
from the body and sends the blood to
the lungs where it is replenished with
oxygen.
After leaving the lungs, the blood
travels into the left atrium and then
through the left ventricle where it is
pumped out to the rest of the body.
A healthy heart will beat approximately
100,000 times each day and pump over
1,800 gallons of blood throughout the
body's circulatory system.
The Human Heart Electric Pump
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SA Node
AV Node
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The heart has its own built-in electrical
system which causes the heart to beat.
In a healthy heart, each heartbeat
begins in the sinoatrial node or SA node
(the heart's natural pacemaker), which
is located in the top right chamber of
the heart (right atrium).
The electrical signal starts a reaction
that spreads out across both of the top
chambers of the heart causing them to
contract and pump blood into the lower
heart chambers.
The electrical impulse then spreads to
the atrivoventricual node (AV Node)
which is located between the atria and
ventricles. The AV node slows the
impulse allowing the atrium to finish
contracting.
From the AV Node the impulse travels to
the left and right sides of the ventricles
stimulating them to contract causing
blood to be pumped from the R ventricle
to the lungs and from the L ventricle to
the rest of the body.
The Human Heart and Coronary
Arteries
Part 2
A Heart Attack in
Progress
Coronary Artery Disease
Coronary artery disease (CAD)
is a condition in which plaque
builds up inside the coronary
arteries. CAD is the most
common form of heart disease.
CAD can lead to serious health
issues such as angina and heart
attack.
Ischemia & Angina Pectoris
When your coronary arteries
are narrowed or blocked,
oxygen-rich blood can't reach
your heart muscle. This can
cause ischemia, angina or a
heart attack. Ischemia is simply
an inadequate blood supply to
an area. Angina is chest pain or
discomfort that occurs when
not enough oxygen-rich blood
is flowing to an area of your
heart muscle. Angina may feel
like pressure or squeezing in
your chest.
What is a Heart Attack?
A heart attack also know as an
acute myocardial infarct (AMI)
occurs when blood flow to a
section of heart muscle
becomes blocked. If the flow of
blood isn’t restored quickly, the
section of heart muscle
becomes damaged from lack of
oxygen and begins to die. This
blockage may be caused by a
blood clot that gets stuck in an
artery or by a thickening inside
the wall of an artery that
restricts the flow of blood
enough to cause pain and
damage.
Heart Attack Facts
• Heart Attack is the #1 Killer of adults
• 4,100 Heart attacks occur every day
• 600,000 Heart attack deaths occur each year
• Hundreds of thousands survive heart attacks but are
left with a damaged heart
Presentations of a Heart Attack
• Sudden, severe pain that stops you in your tracks
• Gradual increasing pain with damage occurring over
a period of hours
• Very early presentation with mild symptoms over
hours or days
Part 3
Concepts of Early
Heart Attack Care
(EHAC)
Are All Heart Attacks Created Equal?
Heart Attack Treatment
• Thrombolytic Therapy (Clot Busters)
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Thrombolytic Therapy is the use of drugs to dissolve clots which are
blocking blood vessels.
• Angioplasty
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Angioplasty is a procedure that is intended to improve blood flow to your
heart muscle. During angioplasty, a catheter with a balloon at the tip is
placed into the narrowed blood vessel. The balloon is used to open the
narrowed blood vessel and increase the blood flow to your heart muscle.
• Pre-hospital Cardiac Care
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Pre-hospital Cardiac Care involves providing EMT’s and Paramedics with
specific treatment guidelines for potential heart attack patients prior to
their arrival to the hospital.
A decrease in hospital time to treatment means
saved heart muscle
improvement in quality of life.
Too Little Progress: Heart Attack
Recognition
Most heart attack patients do not benefit from
optimal medical advances………………………Why?
Delay
Answer: A delay in recognizing and responding to the
early warning signs of a heart attack.
Why Early Heart Attack Care?
• Early Care: Recognize & Respond
– Often mild symptoms, usually normal activity
• Late Care: Obvious Emergency & Respond
– Incapacitating pain, diminished activity
• Too Late Care: Critical Emergency & Respond
– Unconscious, CPR, defibrillation, probable death
• 85% of the heart damage takes place within the
first two hours
Part 4
Recognition and
Intervention
Early Symptoms of a Heart Attack
Non-Specific Heart Attack
Symptoms
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Weakness/Fatigue
Clammy/Sweating
Nausea/Indigestion
Dizziness/Nervousness
Shortness of Breath
Neck/Back/Jaw Pain
Feeling of Doom
Elbow Pain
Specific Heart Attack
Symptoms
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Chest
Chest
Chest
Chest
Chest
Discomfort
Pressure
Ache
Burn
Fullness
Early Signs of Heart Attack
• Early warning signs are present in up to half of heart attacks
• Signs suddenly accelerate or worsen preceding the heart attack
• Usually appear within 24 hours before the acute attack but can
begin two to three weeks before
• The duration varies from a few minutes to several hours
• Usually intermittent with a pain free period before the onset of
acute occlusion (blockage)
Part 5
Delay and Denial
Why Do We Delay?
It’s nothing really serious (I’ll just rest a bit)
I’m too busy right now (I don’t have time to be sick)
I don’t want to be a problem (If it turns out to be nothing, I’ll be
embarrassed by the fuss made)
Paramedics Beware (First responders can easily be swayed by
patient rationalizations and denials)
It’s probably heart burn or indigestion (I’ll take something for it)
I’m strong (Just walk it off, grin and bear it)
I’m healthy (I have no serious medical problems… I exercise)
I’ll just wait it out (Everything will be okay)
Denial and Procrastination = Our Heart’s Enemy
Part 6
You: The Early Heart
Attack Care Giver
What To Ask and Look For
• Do you have any chest discomfort?
• Is it tightness, pressure, pain in the center of your
chest?
• Is the discomfort also in your arms or jaw or neck or
throat or back?
• Are you sick to your stomach?
• Is the person sweaty or clammy?
• What were you doing when the symptoms started?
• Do the symptoms go away with rest?
• Are you having any shortness of breath?
Listen to Your Heart and Be A
Winner!
• Be aware of pressure, not necessarily pain, in your chest
• Be aware if it increases with activity and subsides with
rest
• Don’t try to rationalize it away; be honest with yourself
and others
• Call 911 or have someone drive you to the nearest
emergency room
• Don’t go to your doctor’s office or wait for an
appointment
• EHAC is knowing the subtle danger signs and acting on
them before damage occurs
Any questions?
If you have further questions please
contact Heart and Vascular Services.
www.somc.org
Safety  Quality  Service  Relationships  Performance