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    Treatment for Heart Attacks Can Begin in the Ambulance


    Prehospital treatment with clot-busting drugs is "extremely uncommon" today, even in urban areas, according to Pearle. He adds that many hospitals, including his own, have moved beyond this therapy. "Most of the more sophisticated hospitals prefer primary angioplasty," in which doctors use a balloon device to open the blocked blood vessel, Pearle says. "These studies are pretty old and this technique has not caught on."

    Both Morrison and Pearle say heart-attack victims should receive the best treatment possible as quickly as possible, regardless of what that treatment might be. And that means knowing the warning signs.

    "We nip away five or 10 minutes here and there, but the greatest delay is still with the patient, from symptom [beginning] to calling an ambulance or getting to an emergency room," Morrison says.

    Chest pain is the heart-attack symptom that most people misinterpret, she says, adding that it's not always recognizable pain. Any discomfort, feeling of pressure, or tightness should not be chalked up to stomach upset or muscle strain. The sensation can be intense or fairly mild, and it can come and go.

    "People say, 'Oh, I have gastric burning, or my ulcer is acting up,'" she says. "The nature of the pain is not as important as the appreciation that you have some discomfort. We say anything above the belly button up to the jaw" could be indicative of a heart attack and should not be ignored.

    "When you are having a heart attack, time is of the essence for all interventions," she adds. "Even if they don't get thrombolysis, they might be a candidate for something else" that also needs to be administered or undertaken rapidly.

    Adds Pearle, "The central message is to get there as quickly as possible."

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