Treating a Heart Attack

If an electrocardiogram (EKG) shows that you are having a heart attack, several medications can be used to help your heart. Here is a description of some common drugs to treat you during a heart attack.

Nitroglycerin

Nitroglycerin helps open up the vessels that supply blood to the heart. This medication, often administered under the tongue, works quickly to reduce or relieve chest pain. Nitroglycerin also can be given intravenously (through the veins) so that it works quicker.

A person who uses nitroglycerin tablets at home is usually told to take a tablet as soon as there is chest pain. The pills can be repeated at five-minute intervals for a total of three tablets. If chest pain is still present after taking these doses of nitroglycerin, you should call 911. Don't drive yourself to the hospital.

Thrombolytic agents

These are the newest medications available to treat a heart attack. Thrombolytics, or "clot busters" as they are often called, are given intravenously to dissolve the blood clot that is causing the heart attack. When given during the first hours of a heart attack, thrombolytics can save heart muscle that would otherwise be destroyed during a heart attack. This is one reason why you should get immediately. Your doctor will determine if you can get this treatment, since some medical conditions may prevent you from receiving thrombolytic agents. Emergency angioplasty or coronary artery bypass grafting procedures are often carried out instead of using thrombolytic agents.

Anticoagulants

If you have chest pain that could signify the onset of a heart attack, you may be told to chew an aspirin before being brought to the hospital. If you are not having a heart attack, the aspirin will not harm you. If you are having a heart attack, the aspirin will "thin" your blood and possibly prevent further clotting. Another medication called heparin is often given intravenously for a few days after a heart attack. Heparin also "thins" your blood and reduces the risk of more clotting. "Thinning" your blood actually refers to reducing its tendency to clot.

Beta-blockers and calcium channel blockers

These medications are often given to help reduce the heart's requirements for oxygen after a heart attack. They can be administered by mouth or intravenously. Your doctor may have you continue beta-blockers after leaving the hospital.

Anti-arrhythmic agents

Since the heart is irritable after a heart attack, anti-arrhythmic drugs to prevent life-threatening, abnormal heart rhythms are sometimes used.

Is It a Heart Attack or Heartburn?

You'll know when you're having a heart attack by that telltale elephant-sitting-on-your-chest feeling, right? Probably, but not always.
Women, more so than men, often have something other than that classic crushing or squeezing pain in the chest when they're having a heart attack. Women may feel fatigue, weakness, abdominal or back pain, nausea, or dizziness. Neither they nor their doctor may recognize those as signs of a heart attack.

"Some women go to the emergency room with GI (gastrointestinal) problems, and they are told they have reflux or an ulcer," says Rita Baron-Faust, author of Preventing Heart Disease: What Every Woman Should Know.

"Or, one symptom of a panic attack is fear you're having a heart attack, so there is the assumption that a woman is having a panic attack."
Yet, doctors say the cause of chest pain isn't easy to diagnose.

"Heart attacks can present in such weird ways in general," says Stephen A. Siegel, clinical assistant professor of medicine at New York University School of Medicine, New York, whose medical specialty is cardiology. "I've seen patients who have had pain in their ear.

"Coronary artery disease is a major killer of men and women in the United States. Women tend to think of heart disease as a man's disease because men tend to develop it 10 years earlier than women. However, once a woman reaches menopause, she catches up and even exceeds a man's risk. That's because her estrogen, which protects against heart disease, drops in menopause.

Women's heart attacks more damaging
Women are nearly twice as likely to die from a heart attack as men, according to the American Heart Association (AHA). Women's heart attacks tend to be more damaging and more likely to happen again. Also, women generally don't do as well with bypass surgery as men do.
No one knows exactly why the scales seem to be tipped against women. One theory is that because women develop heart disease at a later age than men, they usually have more health problems, Siegel explains. Their vessels are stiffer. They have had a longer exposure to high cholesterol and a thicker buildup of cholesterol plaque in their coronary arteries. Furthermore, they may never get the typical pains that men often get - the chest pain or pressure, which may radiate into the arm or neck, sometimes accompanied by shortness of breath, sweating or nausea.

When researchers asked about 60 women who had survived heart attacks whether they had known the warning signs beforehand, more than half said that they had not, according to a presentation at a Federation of American Societies for Experimental Biology's annual meeting.
Many studies also show women take one to two hours longer than men to go to the emergency room after symptoms start.

What's worse, Baron-Faust says, is that some patients tend to "self-diagnose" and attribute their discomfort to heartburn or stress and other problems unrelated to cardiac conditions. Unfortunately, their doctors don't always pick up on the true cause. Women also are far less likely to be referred for diagnostic testing that would reveal underlying heart disease.

"Women get treated less aggressively than men," Siegel says. "There's no doubt there's a gender bias, but I think a lot of it is an age bias."

Signs of a heart attack
Whether you're male or female, Siegel says you should know learn the signs of a heart attack and to act fast.

How can you tell if you have heart pain? The classic tightening, squeezing or burning feeling in the chest, called angina, occurs when the heart doesn't get as much blood - and therefore, as much oxygen as it needs. The feeling is almost always associated with physical activity, or exertion.

"If it comes on with exertion and goes away with rest, that's angina. If it comes on with exertion and does not go away with rest, then that's a reason for urgent evaluation. It could be a heart attack," Siegel says.

Some people tend to dismiss angina because it does not feel like sharp, knife-like chest pain. In fact, sharp pains in the chest are unlikely to be a sign of angina. They also may confuse it with indigestion because their pain can be brought on by emotional stress or a heavy meal.
Time is the enemy if you suspect you are having a heart attack. If you have nitroglycerin tablets, take them. Nitroglycerin reduces the pain of angina by widening blood vessels to allow more blood to reach the heart muscle. Aspirin - and it must be aspirin, not ibuprofen or acetaminophen - also works. Aspirin keeps the arteries open by preventing clotting.

Research published in the journal Circulation found that, almost 10,000 more people would survive heart attacks if they would chew one 325-milligram aspirin tablet when they first had chest pain or other signs of a heart attack

HealthTips

How to Take Your Pulse


your pulse is usually taken during a routine doctor's visit. From time to time,though, you may want to check it yourself. You may have wondered how fast your heart beats while you're exercising or you may have felt an irregular or faster than normal thumping in your chest.
Each time your heart muscle contracts, it sends a wave through your arteries. This creates a pulse beat that you can feel when you place your fingers over an artery. Taking your pulse is easy. Here's how:
Get a watch with a second hand so you can count seconds.
Place the first two fingers along the palm side of your left wrist just below where your wrist and thumb meet.
Move your fingers around until your pulse is easier to feel. Begin counting the beats.
Count the number of beats for a full minute. You can also count the beats for 20 seconds, and multiply by three for the number of beats per minute.
If you have a hard time feeling your pulse at your wrist, you may want to try feeling your pulse at your neck. Here's how you can feel the pulse of the carotid artery. Take the same two fingers and gently place them between the wind pipe and neck muscle (on either side), just under the lower jawbone. Be careful not to press too hard or rub your neck while you're feeling for a pulse. Count the heartbeats as described above.
If you're having a hard time finding your pulse, don't worry. Your heart is still beating! At your next doctor's visit, ask the nurse or doctor to show you how to take it. Sometimes it just takes practice.
What's normal? Everyone's heart rate is different. Normal adult rates range between 60 and 80 beats per minute when resting or mildly active. The number rises while you're more physically active or exercising. Ask your doctor what's normal for you. If you're trying to exercise more vigorously, for example, learn what your "target" heart rate is. If you're straining, your rate will be higher than usual. If it's a low or moderate number, you may want to work out a little harder to raise your heart rate.
Irregular heartbeats The beats-per-minute number is just one thing worth checking. Your pulse also can reveal irregular heartbeats. This means how steadily your heart beats, not how quickly or slowly.
Notice whether beats are evenly spaced and steady. A normal heartbeat is so regular that you can predict when the next beat will occur. There may be skipped beats or extra beats.
If you have an irregular heartbeat, it may be atrial fibrillation or another heart rhythm problem. Atrial fibrillation is more common in people over 65. It can put you at higher risk for a stroke.
If think you might have an irregular heartbeat, talk to your doctor. Your doctor may want to see you for an exam.