What to do if you think you're having a heart attack

by Ruth Nichol / 02 September, 2017
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Dial 111 without delay if you think you’re having a heart attack.

If Leonie Pope’s reading glasses had been nearby when she started experiencing the classic symptoms of a heart attack – tightness in her chest and shortness of breath – she probably would have rung to make an appointment with her doctor rather than calling an ambulance.

Luckily for her, it was easier to dial 111 than it was to find her specs to look up the GP’s number, because within a few minutes she had also developed deep pain in her left armpit and a fuzzy feeling down her arm. Soon, she was on her way to hospital, and the next day she had surgery to insert a stent to clear a blockage in her coronary artery.

In the lead-up to her heart attack, Pope, who is now fully recovered, had become increasingly lethargic and short of breath and found activities such as walking up the steep drive of her Hamilton home difficult.

“When I did the vacuuming, I’d just do the lounge, then a couple of days later I’d do the bedrooms and hallways.”

She put her symptoms down to getting older, but she now realises they were typical of what many people experience before they have a heart attack.

“A lot of people will have symptoms on and off, such as chest discomfort when they’re doing things like walking up a hill in cold weather,” says Gerry Devlin, a Hamilton cardiologist and medical director of the Heart Foundation.

Leonie Pope.

Heart attacks occur when one or more coronary arteries are blocked, usually by a blood clot. They rarely happen the way they do in movies, in which characters collapse gripping their chests in agony.

The reality for most people is much less dramatic – a feeling of discomfort in the chest that lasts for 10 minutes or more, often accompanied by symptoms such as pain that spreads to the jaw, shoulder or back, sweating, shortness of breath and nausea.

Without treatment to open up the blocked artery – either by inserting a stent or by using clot-busting drugs – heart attacks can cause permanent heart damage and serious long-term health problems. But many people die soon after having a heart attack because it triggers a heart-rhythm disturbance called ventricular fibrillation, which can result in a cardiac arrest – when the heart stops beating so that no blood is pumped to the brain and the person loses consciousness. About 1500 New Zealanders die following a cardiac arrest every year, frequently caused by a heart attack.

It makes sense, therefore, to do what Pope did and call an ambulance if you suspect you’re having a heart attack.

“Early diagnosis leads to early treatment, which leads to less damage to the heart muscle and better outcomes in the long term,” says Devlin.

Gerry Devlin.

Even more important, calling an ambulance means you’re less likely to die from a cardiac arrest following your heart attack. That’s because ambulances carry defibrillators, which staff can use to detect abnormal heart rhythms, then “reset” them by sending a controlled electric shock to the heart.

“What’s going to save your life is having the rhythm disturbance recognised quickly and having it treated quickly with a defibrillator.”

However, although a recent Heart Foundation survey found that most New Zealanders are familiar with the symptoms of a heart attack, many said they would be reluctant to dial 111 if they were experiencing them. The survey found that just over half would call an ambulance immediately. Of the others, 13% said they would wait for the symptoms to go away and 12% said they would get someone to drive them to hospital (or drive themselves).

Among the reasons they gave for not calling an ambulance was that they didn’t want to waste people’s time or they thought the symptoms would go away by themselves. Devlin has a simple message for them: call an ambulance.

“We see it all the time – people delay because they’re not quite certain about what’s going on or they don’t want to bother anyone. Actually, we want to be bothered. If you’ve got the classic symptoms of a heart attack, you should dial 111. We want to see you.”

Visit heartfoundation.org.nz for more information about heart-attack symptoms.

This article was first published in the July 22, 2017 issue of the New Zealand Listener.

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