Heart Attack: The Most Important
By Paul Stefek, MD
At the Cayuga Heart Institute we have
the local capability to intervene during an acute heart attack to remove the
blood clot, open the artery, and restore blood flow to the heart. However, this
is only part of the equation in saving the lives of heart-attack patients. The
other critical factor is helping people understand their own esponsibilities in
seeking medical care as quickly as possible in order to save their heart muscle
and their lives.
What is the most important message
to get out to people?
The most important message is that
your actions at the time heart-attack symptoms begin are absolutely critical.
The sooner heart-attack patients put themselves in the hands of a cardiac-care
team, the better their outcomes.
What happens when people wait,
rather than act?
With the passage of time the
ongoing lack of oxygen to the heart muscle permanently damages it and the size
of the clot blocking the artery gets bigger. This increases the risk of
permanent heart damage, disability, and death, and makes it more difficult to
perform PCI (percutaneous coronary intervention). By comparison, the ability to
open an artery during the early stages of a heart attack is much easier and
patient recovery is much more complete because more heart muscle function has
What should I know about
1) Symptoms can occur in the center
of the chest from the bottom of the ribs to the neck, and may also involve the
throat, arms, jaw, and back.
2) The sensation can feel like
pressure, burning (similar to indigestion), an ache, or a feeling of tightness.
3) Patients often describe these
symptoms as discomfort, rather than severe pain.
4) The symptoms don’t go away, they
5) Symptoms may be accompanied by
shortness of breath, nausea, vomiting, and sweating.
Anyone with any combination of
these symptoms needs medical assessment. If, in the days or weeks beforehand,
you’ve had these symptoms with exertion in a milder form but they subsided with
rest, this may be the warning signs for a heart attack. The key is to pay
attention to symptoms and realize that something is wrong. For example, if
walking brings on a sensation of indigestion that seems to go away when you
stop walking, call you doctor.
I just saw my doctor last week and
got a clean bill of health, so how could this be a heart attack?
You don’t always experience warning
symptoms prior to a heart attack. If you haven’t experienced any symptoms to
draw to your doctor’s attention, your doctor may not be able to spot an
impending heart attack.
Why is it important to call 911?
If you are in the throes of a heart
attack you can deteriorate quickly. You are not stable enough to drive, nor
should you put your family or friends through the trauma of driving you to the
What if my loved one won’t agree to
go to the Emergency Department?
People in this situation are often
in a state of denial about the seriousness of their symptoms. If your loved one
refuses to get medical attention and you believe he or she is having a heart
attack, you might consider making the phone call to 911
yourself. An ambulance can be at your location in minutes, to begin
diagnosis and treatment en route to the hospital. The sooner the cardiac team
can open the artery and get oxygen to your heart, the better your outcome.
Stefek is board certified in cardiovascular disease and interventional
cardiology and is the director of interventional cardiology at Cayuga Medical
Center’s Cayuga Heart Institute. He is in practice with Ithaca Cardiology
Associates where he can be reached at (607) 272-0460.