NEW APPROACH TO HEART ATTACKS CALL 911 PARAMEDICS WHEN IT COMES TO A POSSIBLE HEART ATTACK TIME IS PRECIOUS DONT WAIT FOR COUSIN SHIRLEY TO DRIVE YOU

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A Study Says People With Possible Heart Attacks DO Better When They Call Emergency Paramedics

How can you tell if you are having a heart attack? You can't. Chest pain, sweating, weakness are all signs of a heart attack but they may or may not be present.Some people especially those with diabetes may have blunted symptoms even if they have a heart attack. It is always better to get immediate medical care with chest pain. Do not wait. Research by Dr. Ivan C. Rokos, assistant clinical professor of emergency medicine at UCLA Medical Center, shows that heart attack victims have a better chance of survival if they call paramedics than if they are transported to medical facility by an acquaintance or family member.




"If you live in Los Angeles, Ventura, Orange or San Diego county and think you are having a heart attack, call 911 rather than have a friend or family member drive you to the hospital. It could mean the difference between life and death. Currently,only about half of all heart attack victims arrive at hospitals by ambulance. When patients walk into emergency rooms on their own, long waits can delay diagnosis and treatment, health officials say".






"By outfitting ambulances with devices that allow paramedics to more quickly diagnose serious heart attacks and call ahead to hospitals equipped to perform a specialized procedure, the protocol has sharply reduced the time it takes for patients to receive life-saving treatment, officials said".



"Before Orange County implemented the protocol, patients often waited two hours or more for treatment, said Dr. Samuel Stratton, medical director of Orange County's Emergency Medical Services. Now,all ambulances have been equipped with upgraded electrocardiogram machines and patients in need of the procedure are taken only to hospitals staffed to perform it 24 hours a day".



"Results are promising. Stratton said he is convinced that mortality rates have dropped in Orange County since the protocol was implemented in 2005, but didn't have comparative statistics. Also, many patients in Orange County are now sent home within three to five days, rather than seven to 10 days, Stratton said.The largest hurdle counties now face, Rokos said, is educating the public to call 911 when a heart attack is suspected."The paramedics can provide you with one-on-one concierge service," Rokos said. "If you go into the emergency department, you're fighting off the masses.""

911 is best call to make if heart attack strikes

VIDEO HANDS ONLY CPR HEART ASSOCIATION SAYS IF BYSTANDER NOT TRAINED OR NOT CONFIDENT USE HANDS ONLY CPR FOR CARDIAC ARREST SOME EXCEPTIONS

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The Heart Association say that "even people without CPR training can save the life of an adult whose heart stops,(cardiac arrest) and the American Heart Association has issued an advisory" called Hands-Only (Compression-Only) Cardiopulmonary Resuscitation, "urging everyone,trained or not, to act immediately in such an emergency" when the heart stops . The procedure is simple: if you see an adult collapse after having a heart attack, immediately call 911 and then push hard and fast in the middle of the chest continuously, until emergency medical personnel arrive or an external defibrillator can be used". You should read the Heart Association guidelines.





Let's face it many people faced with an adult who collapses from a heart problem and has no pulse (cardiac arrest) are gripped by sheer panic. What to do? Time is critical. If the heart doesn't circulate the blood damage results. Many airports and public places have external automatic defibrillators which anyone trained or not can use to restart the heart with an electric shock but what if one is not available? Time is crucial. You call 911 and then what? CPR cardiopulmonary resuscitation is recommended to get the blood circulating. But most people either don't know CPR or find it too hard to understand. How fast do you push on the chest? When do you breathe in the mouth. Plus many people don't like the idea of breathing in a stranger's mouth.




Heart Association Advertisement About Hands Only CPR Click the Arrow to Start





"Dr. Michael R. Sayre, the lead author of the recommendations, said in a telephone interview that the ideal would be 100 pushes a minute with enough force to make the chest go down two inches, but, he added, “there is no need to use a metronome and a ruler.” Dr. Sayre is an associate professor of emergency medicine at Ohio State University. CPR, or cardiopulmonary resuscitation, can more than double the survival rate in cardiac arrest, but only about a third of people who collapse get CPR from bystanders. The advice does not apply to cardiac arrest in children, or that due to drowning or drug overdose, which usually require rescue breathing. Nor does it apply when the bystander does not see the collapse, since it might not have been cardiac arrest.









But the exceptions, Dr. Sayre said, are only about a quarter of all cardiac arrests. “We want people to act no matter what,” he said, “and one of the reasons it’s important to take a CPR class is because of this other 25 percent. “But doing chest compressions alone in these situations is better than doing nothing,” he said. “Even for children, the procedure would be the same.”

Hands Only CPR Consumer Website from Heart Association (Find the video here)

CPR Can Help, Even With No Training



The Heart Association report is called Hands-Only (Compression-Only) Cardiopulmonary
Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest: A Science Advisory for the Public From the American Heart Association. Here is part of what they say:




All victims of cardiac arrest should receive, at a minimum,
high-quality chest compressions (ie, chest compressions of
adequate rate and depth with minimal interruptions). To
support that goal and save more lives, the AHA ECC
Committee recommends the following.
When an adult suddenly collapses, trained or untrained
bystanders should—at a minimum—activate their community
emergency medical response system (eg, call 911) and
provide high-quality chest compressions by pushing hard and
fast in the center of the chest, minimizing interruptions (Class I).


● If a bystander is not trained in CPR, then the bystander
should provide hands-only CPR (Class IIa). The rescuer
should continue hands-only CPR until an automated external
defibrillator arrives and is ready for use or EMS
providers take over care of the victim.


● If a bystander was previously trained in CPR and is
confident in his or her ability to provide rescue breaths
with minimal interruptions in chest compressions, then the
bystander should provide either conventional CPR using a
30:2 compression-to-ventilation ratio (Class IIa) or handsonly
CPR (Class IIa). The rescuer should continue CPR
until an automated external defibrillator arrives and is
ready for use or EMS providers take over care of the
victim.


● If the bystander was previously trained in CPR but is not
confident in his or her ability to provide conventional CPR
including high-quality chest compressions (ie, compressions
of adequate rate and depth with minimal interruptions)
with rescue breaths, then the bystander should give
hands-only CPR (Class IIa). The rescuer should continue
hands-only CPR until an automated external defibrillator
arrives and is ready for use or EMS providers take over the
care of the victim.

Read and download the pdf document Hands-Only (Compression-Only) Cardiopulmonary
Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest

CLAMMY AND WEAK LIKE A HEART ATTACK THE MAN WITH THE ELEVATED CARDIAC ENZYMES NEEDED A MEDICAL DETECTIVE TO FIND OUT WHAT HIS HEART ATTACK REALLY WAS

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I read a fascinating story about a man in his early forties who had severe chest pain and all the signs of a heart attack. How can you tell if the chest pain is from a heart attack? YOU CAN'T. IF you have Chest Pain CALL 911 IMMEDIATELY for an ambulance. Let the doctors decide. Time is critical and it's better to err on the side of caution. Anyway,it's a big problem. You don't want to miss a heart attack but it turns out that many times chest pain can be due to another cause. This man was sweating and clammy and weak. He even had elevated blood cardiac enzymes like a heart attack. Many people think a normal electrocardiogram EKG means you don't have a heart attack. But you can have a heart attack or cardiac problem even with a normal EKG. Doctors look for chemicals, cardiac enzymes in the blood for evidence of heart muscle damage. This man did have elevated chemicals in the blood. It took a medical detective to figure out what the man with chest pain really had. It was not a heart attack but something much more mysterious. It turned out the answer was in his urine!




"When Decter (the doctor) heard that, something stirred in his memory. Cola-colored urine. Perhaps this was the key. Had he had this kind of dark urine since then? he asked. The patient told him that a couple of times a month his urine would turn brown and he’d feel achy all over. It happened whenever he was sick or tired or when he exercised too hard. He’d told lots of doctors about it, but none of them could figure out what was going on".



















"Decter knew he was on to something. Urine that dark is usually caused by muscle breakdown. When muscle cells are damaged, they leak CPK,( there are fractions of CPK that are more specific for heart muscle. There is also another chemical called troponin for heart muscle) but they also spill several other chemicals. One of them, the compound that gives skeletal muscle its distinctive deep red hue (myoglobin), can turn urine a dark brown. Were the brown urine and the elevated CPK caused by the same problem? Were they both signs of some longstanding disease process that was destroying this patient’s muscle"?



"Decter sent his patient to Dr. Alfred E. Slonim, a pediatric endocrinologist by training who spent his career investigating diseases of the muscle. The patient called Decter after seeing the specialist, almost speechless with excitement. Slonim spent more than an hour with him and his wife, getting the history of his strange illness. “Tell him about what happens on Yom Kippur,” his wife prompted near the end of the interview. Every year on the Jewish day of atonement, the patient would fast for a day, from sunset to sunset. And every year, he would spend the day after Yom Kippur in bed, crippled by an aching in his muscles and passing dark brown urine. Once he said that, Slonim had the diagnosis:".




He had a genetic condition called carnitine palmitoyltransferase II deficiency. Carnitine palmitoyltransferase II deficiency is a condition that prevents the body from converting certain fats called long-chain fatty acids into energy, particularly during periods without food (fasting). Carnitine, a natural substance acquired mostly through the diet, is required by cells to process fats and produce energy. People with this disorder have a faulty enzyme that disrupts carnitine's role in processing long-chain fatty acids.



The myopathic form is the most frequent and typically the least severe form of carnitine palmitoyltransferase II deficiency. It has a variable age of onset and is characterized by recurrent episodes of muscle pain (myalgia) and weakness. This condition is sometimes associated with the abnormal breakdown of an oxygen-binding muscle protein called myoglobin (myoglobinuria) so that the protein winds up in the urine or the breakdown of muscle tissue (rhabdomyolysis). Rarely, myoglobinuria can result in kidney failure.

When Is a Heart Attack Not a Heart Attack?

Carnitine palmitoyltransferase II deficiency

AS TECH BLOGGER MALIK HAS HEART ATTACK WE REVIEW CHEST PAIN SIGNS OF HEART ATTACK AND TESTS AND EVALUATION OF CHEST PAIN

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I had a heart attack on Dec. 28. I was able to walk into the hospital for treatment that night and have been recovering here ever since. With the support of my family and my team, I am on the road to a full recovery. I am going to be OK. That is what Om Malik, author of the popular tech blog, GigaOm, wrote about his experience of a recent heart attack. That a young man of 41 can have a heart attack is a sobering reminder to us all of the importance of health and constant vigilance and how important it is that even the young and athletic not automatically discount chest pains. I wish him well.

Omega 3 and the Heart






There are many causes of chest pain. Each year, millions of people seek emergency medical care because of chest pain,(and foolishly many people ignore chest pain when they ought to call 911) the most common symptom of heart attack. For many, heart attack is the clear diagnosis, but annually more than 6 million people are admitted to the hospital because the answer isn’t clear. Besides a heart attack other cardiac causes include angina. Even a normal EKG is not necessarily enough to rule out a heart related condition.



Many times just the story, the history, is enough to convince the doctor to hospitalize a patient.If the electrocardiogram (EKG) is normal and initial blood tests for "heart enzymes" such as CPK and troponin don’t show signs of dying heart muscle, patients are usually admitted for observation, repeat EKGs, blood tests and other tests to rule out heart problems. Many cases of chest pain are not heart related. Even so, it's pretty obvious that the heart is right up there on the list of causes that the doctor has to think about and identify ASAP. So the doctor starts pointed questions about the chest pain. Questions like

How long does it last?

What is the family history?

What is the personal history, high blood pressure,heart problems?

Where is it located?

What brings it on?

What sort of risk factors does Joe have?





As she enters the room, Joe Johnson's doctor can't help but notice the look of trepidation on Joe's face. She's seen him many times before but this time something is clearly bothering him. As she says hello and asks Joe how he's doing, the reason for Joe's distess is soon apparent. It turns out that he has been experiencing chest pains for the past month that are alarming him.

Many Causes of Chest Pain

In Joe's case, he's been under a lot of stress, sometimes waking up at night with a "feeling" in his chest and it seems to occur also when he's lifting or exerting himself.

The EKG, the Stress Echo, the Stress Myocardial Perfusion Imaging

This certainly sounds like it could be cardiac so the doctor orders an electrocardiogram (EKG) in the office. The EKG is where they attach the wires with little sticky things to the chest and see the wavy lines drawn on graph paper by the machine. Both the doctor and Joe are relieved to see that the EKG as well a chest x ray are both "within normal limits".








But the problem is that a person's EKG can look "normal" and yet the person may still have some blockage of the coronary arteries, the arteries that feed the heart muscle itself.



So what next? Well, the doctor could order a coronary angiogram to look for blockage. In a coronary angiogram, they insert a catheter into a blood vessel in the groin and thread it up to the heart and inject a dye. The dye helps to make the blood vessels of the heart visible on x ray. Using a series of pictures it's possible to see narrowing and blockages of the coronary heart blood vessels. But this is often not the first test that will be ordered.

Pictures and What is an Angiogram



Instead there are a group of "noninvasive" tests that can be used to gauge how the blood supply of the heart is doing.

Non Invasive Tests of Heart Blockage

Many of the non invasive tests involve exercise and then seeing how the heart responds to it. In some cases the patient may not be capable of doing the sort of aerobic exercising needed. In that case, there are ways to "chemically stress" the heart. Among the tests are

Treadmill Test, the Stress Test

Here they have you run in a treadmill while they see how your heart responds on an EKG

Stress Echo

Here you are exercising again but now they are looking at your heart with an ulrasound, like using ultrasound to see a baby in a pregnant woman. The ultrasound is valuable because they can see how your heart is beating, how the walls are moving. When the heart walls don't move properly it can indicate that a part of the heart is functiong incorrectly due to inadequate blood flow.




Watch the Video Classic Symptoms of Heart Disease Click the Arrow to Start

Stress Myocardial Perfusion Imaging (myocardial means heart muscle)


Here again you are exercising. This is probably one of the more informative "non invasive" tests. Here they inject of a small amount of radioactive material which circulates in the bloodstream. The radioactive material accumulates in the heart tissue according to the degree of good blood supply in the heart. If they see that when you exercise there is decreased blood supply compared to resting it indicates ischemia.

PET Scan

The PET Scan can see the blood flow of the heart. PET stands for positron emission tomgraphy. The PET scan is a relatively high tech scan that is not yet widely used. For one thing, it's very expensive. But it works well .

See what the Heart Association Says About Imaging the Heart

Electron Beam CT

You've probably heard this advertised. You don't need to exercise for this test. The special CT scanner looks for the presence of calcium deposits in the arteries.High calcium deposits have been associated with blockage of the arteries.

TESTS FOR CHEST PAIN, VIDEO SYMPTOMS OF HEART BLOCKAGE AND HEART ATTACK MANY CAUSES OF CHEST PAIN

TESTS FOR CHEST PAIN,VIDEO SYMPTOMS HEART BLOCKAGE AND HEART ATTACK MANY CAUSES OF CHEST PAIN

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There are many causes of chest pain. Each year, millions of people seek emergency medical care because of chest pain,(and foolishly many people ignore chest pain when they ought to call 911) the most common symptom of heart attack. For many, heart attack is the clear diagnosis, but annually more than 6 million people are admitted to the hospital because the answer isn’t clear. Besides a heart attack other cardiac causes include angina. Also an aneurysm, a dilation of a blood vessel whose layers may be damaged or a blood clot in the lung could produce chest pain along with a host of other problems. Any chest pain needs to be addressed immediately. Always be extra cautious. Delay could be the mistake of a lifetime. A normal EKG is NOT necessarily enough to rule out a heart related condition.

Why Do Many Doctors Oredr a Fast CT Heart Scan Test to Detect Heart Problems




Many times just the story, the history, is enough to convince the doctor to hospitalize a patient.If the electrocardiogram (EKG) is normal and initial blood tests for "heart enzymes" such as CPK and troponin don’t show signs of dying heart muscle, patients are usually admitted for observation, repeat EKGs, blood tests and other tests to rule out heart problems. Many cases of chest pain are not heart related. Even so, it's pretty obvious that the heart is right up there on the list of causes that the doctor has to think about and identify ASAP. So the doctor starts pointed questions about the chest pain. Questions like

How long does it last?

What is the family history?

What is the personal history, high blood pressure,heart problems?

Where is it located?

What brings it on?

What sort of risk factors does Joe have?





As she enters the room, Joe Johnson's doctor can't help but notice the look of trepidation on Joe's face. She's seen him many times before but this time something is clearly bothering him. As she says hello and asks Joe how he's doing, the reason for Joe's distress is soon apparent. It turns out that he has been experiencing chest pains for the past month that are alarming him.

Many Causes of Chest Pain

In Joe's case, he's been under a lot of stress, sometimes waking up at night with a "feeling" in his chest and it seems to occur also when he's lifting or exerting himself.

The EKG, the Stress Echo, the Stress Myocardial Perfusion Imaging

This certainly sounds like it could be cardiac so the doctor orders an electrocardiogram (EKG) in the office. The EKG is where they attach the wires with little sticky things to the chest and see the wavy lines drawn on graph paper by the machine. Both the doctor and Joe are relieved to see that the EKG as well a chest x ray are both "within normal limits".








But the problem is that a person's EKG can look "normal" and yet the person may still have some blockage of the coronary arteries, the arteries that feed the heart muscle itself.



So what next? Well, the doctor could order a coronary angiogram to look for blockage. In a coronary angiogram, they insert a catheter into a blood vessel in the groin and thread it up to the heart and inject a dye. The dye helps to make the blood vessels of the heart visible on x ray. Using a series of pictures it's possible to see narrowing and blockages of the coronary heart blood vessels. But this is often not the first test that will be ordered.

Pictures and What is an Angiogram



Instead there are a group of "noninvasive" tests that can be used to gauge how the blood supply of the heart is doing.

Non Invasive Tests of Heart Blockage

Many of the non invasive tests involve exercise and then seeing how the heart responds to it. In some cases the patient may not be capable of doing the sort of aerobic exercising needed. In that case, there are ways to "chemically stress" the heart. Among the tests are

Treadmill Test, the Stress Test

Here they have you run in a treadmill while they see how your heart responds on an EKG

Stress Echo

Here you are exercising again but now they are looking at your heart with an ulrasound, like using ultrasound to see a baby in a pregnant woman. The ultrasound is valuable because they can see how your heart is beating, how the walls are moving. When the heart walls don't move properly it can indicate that a part of the heart is functiong incorrectly due to inadequate blood flow.




Watch the Video Classic Symptoms of Heart Disease Click the Arrow to Start

Stress Myocardial Perfusion Imaging (myocardial means heart muscle)


Here again you are exercising. This is probably one of the more informative "non invasive" tests. Here they inject of a small amount of radioactive material which circulates in the bloodstream. The radioactive material accumulates in the heart tissue according to the degree of good blood supply in the heart. If they see that when you exercise there is decreased blood supply compared to resting it indicates ischemia.

PET Scan

The PET Scan can see the blood flow of the heart. PET stands for positron emission tomgraphy. The PET scan is a relatively high tech scan that is not yet widely used. For one thing, it's very expensive. But it works well .

See what the Heart Association Says About Imaging the Heart

Electron Beam CT

You've probably heard this advertised. You don't need to exercise for this test. The special CT scanner looks for the presence of calcium deposits in the arteries.High calcium deposits have been associated with blockage of the arteries.