Call 911 At First Sign of Heart Attack

From the WebMD Archives

Sept. 10, 2001 -- Modern treatments for heart attack can prevent permanent damage to your heart and even save your life. However, only 1 in 5 people having a heart attack get to the emergency room fast enough to get the greatest benefit from these treatments.

The American Heart Association and the National Heart, Lung, and Blood Institute (NHLBI) has launched a new education campaign urging Americans to learn the warning signs of heart attack and call for emergency medial help at the first signs of trouble. For most people, that means dialing 911, but be sure you know how to call for help where you live.

"If you experience symptoms of a heart attack, call 911 immediately. Don't wait for 15 or 20 minutes. The average person waits over two hours," says James M. Atkins, MD. He points to a study that found if people called within 30 minutes and are treated within the first hour from the time symptoms started, eight in 10 patients wouldn't lose any significant amount of heart muscle to the heart attack. And statistically, not even one person in 100 would be expected to die. But people who waited 2 hours lost about 20% of their heart muscle, and the death rate rose to 6% to 8%, he says.

Atkins is medical director of emergency medicine education at the University of Texas Southwestern Medical Center in Dallas. He also is the chairman of the executive committee of the National Heart Attack Alert program of the NHLBI.

If you have signs of a heart attack, you should never drive yourself to the hospital, adds David Faxon, MD, president of the American Heart Association (AHA). "Life-threatening complications, such as serious heart rhythm disturbances, can occur early in a heart attack. If you're driving yourself, you could pass out and die. In an ambulance, paramedics can administer life-saving treatment." In addition, he says, paramedics do tests and call ahead to alert the emergency room, so someone who arrives in an ambulance will be treated faster than someone who arrives on their own. "They sit in the waiting room and there's a delay, because no one's aware they're having a heart attack."

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Heart attacks are caused when a blood clot closes off a heart artery, cutting off the organ's blood supply and causing heart muscle to begin to die. When someone with a heart attack gets to an emergency room, doctors can use medications to dissolve the clot. Or, sometimes, they inflate a tiny balloon inside the artery to open the vessel and get the circulation flowing again. "The sooner this is done, the greater the benefit," says Faxon. "It can still be done up to six hours after the heart attack started, but meanwhile, some heart muscle has died."

Women tend to delay calling 911 more than men do. Part of the problem could be that during a heart attack, women are more likely to experience vague symptoms that may be different than the classic chest pain that's easier for more people to recognize.

"Unfortunately the signs of a heart attack are hard to define precisely," Atkins says. Take sweating as an example, he says. It can signal a heart problem is present, but people may be sweating for many different reasons. "But if there's no explanation for your sweating, or if it's combined with discomfort and shortness of breath, that really is a sign you should come in and be checked."

In addition to chest pain and sweating, people should realize these other symptoms could be warning signs of a heart attack and seek help at once:

  • Discomfort in one or both arms, back, neck, or stomach;
  • Shortness of breath, nausea, or lightheadedness.

Women often don't realize that heart disease is their No. 1 cause of death, not breast cancer, Faxon says. "Heart attacks can happen even in young women, but women in their 50s are equally likely to die from a heart attack or from other causes such as cancer. Once a woman reaches 65, she is more likely to die from heart disease than from all other causes."

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