How to Survive a Heart Attack

Editor's Note: Republishing this due to the number of officers we've seen die lately of heart attacks.  Pay attention.  Reduce your risk.

You think you are safety conscious: you wear your vest, you clean your weapons, you practice at the range, you wear your seatbelt, you train and train and train. You have gone through thousands of worst case scenarios over and over in your mind.  But do you know the symptoms of a heart attack?  Do you know what to do if you are having one?  What about if you are alone?  Do you know your risk factors for heart disease?  What is the smallest piece of safety equipment that you can carry capable of saving your life? 

There are two good reasons you should know the basic information about how to survive a heart attack. First, odds are very high that either you or someone you love will suffer from a heart attack during your lifetime.  In the United States alone, there are 1.2 million heart attacks per year, and about half of those are fatal (CDC).  Heart disease is the leading cause of death in the USA, and accounts for approximately 25% of all deaths.   On average, someone in the United States suffers a heart attack every 26 seconds and every minute someone dies of a heart attack. Secondly, whether you (or your loved one) survive that heart attack may depend on what you and your doctors do about it during the first few hours as well as over the long term.  For heart attack victims, every minute counts. Most people who die from a heart attack die within two hours of the first sign.

The National Institute for Occupational Safety and Health (NIOSH) reports that the risk for cardiovascular disease is higher among law enforcement officers than it is for the rest of the population, According to the Officer Down Memorial Page there were 173 in the line of duty deaths last year.  The four leading causes of these deaths were:  gunfire (67); automobile accident (35), vehicular assault (12), and heart attack (11).  In fact these four types of deaths accounted for almost 75% of all of the line of duty deaths for law enforcement officers in the year 2011.  Thus far, 2012, there have been 6 heart attack deaths, accounting for 6½% of all duty deaths. 

What Is a Heart Attack?

The common name for a myocardial infarction (MI) is a heart attack.  Although the heart itself is full of blood; the heart muscle has its own specific veins and arteries to provide it with oxygenated blood. An infarction is caused by blockage of the heart's circulatory system due to an embolism usually made of plaque. Plaque is a combination of fatty acids and white blood cells that collect along the walls of arteries. Plaques restrict the flow of blood, and they reduce the elasticity of arterial walls (a process usually referred to as hardening of the arteries). When a piece of plaque breaks loose from an artery, it passes through the bloodstream until it lodges in a space through which it cannot fit.  The blocked blood vessel does not allow for a smooth flow of oxygenated blood. The portion of the heart muscle being supplied by the blocked artery then begins to die. It's the death of heart muscle that defines an MI.

Why Are the First Few Hours of a Heart Attack Critical?

Following a heart attack, most people can go into cardiac arrest immediately; or within the first several hours.  Cardiac arrest is the sudden, unexpected loss of heart function, breathing and consciousness occur within the first several hours following a MI.  CPR and/or the use of an automatic external defibrillator (shock) are the methods of choice for kick starting your heart again…but what if those methods are not available? Your chances of surviving cardiac arrest are exponentially greater if you are under medical care at an emergency treatment center following a MI.  Opening the blocked artery is of paramount importance. If treatment is given within three or four hours, much of the permanent muscle damage can be avoided. Delaying treatment by any longer significantly decreases the chances of heart muscle survival; after 12 hours the damage is usually irreversible.

In order to get the help you need you must be aware of the signs and symptoms of a heart attack.  You should know what to do if you think you are experiencing a heart attack. You should also know your risk factors for cardiac disease, including heart attacks, and work on a prevention strategy.   

Heart Attack Signs and Symptoms

Although the classic symptoms of a heart attack are usually easily identified (pain, sweating, shortness of breath); other more subtle signs may not be.  Unfortunately, the more vague symptoms are often ignored.  This can be a fatal mistake.  Additionally, not all symptoms are immediate; they can take weeks to develop.  Nor do all myocardial infarctions cause cardiac arrest; but that does not mean that significant cardiac damage has not taken place.

• Intense, sometimes squeezing, pressure or pain in or around the chest (the most classic symptom) 
• Profuse sweating
• Unexplained sudden shortness of breath
• Intense anxiety
• Racing Heart
• Overwhelming sense of fear or impending doom
• Relatively mild discomfort in the chest, back, abdomen, shoulders, arms
• Nausea and vomiting
• Feeling of “heartburn”/indigestion
• Sudden cold sweats
• Lack of energy
• Lightheadedness
• Dizziness
• Change in normal behavior or mental status
• Anyone who has one or more risk factors (listed below) for coronary artery disease needs to pay close attention to any sudden, unusual or unexplained symptoms involving the upper half of the body.

Top Ten Risk Factors for Heart Attacks

According to the American Heart Association the ten leading factors that put you at risk for coronary artery disease or a heart attack are:

1. Age: Men who are 45 or older and women who are 55 or older are more likely to have a heart attack than are younger men and women.
2. Gender: Men have a greater risk of heart attack than women do, and they have attacks earlier in life.
3. Family history: Those with parents or close relatives with heart disease are more likely to develop it themselves.
4. Ethnicity: Heart disease risk is higher among African Americans, Mexican Americans, American Indians, native Hawaiians, and some Asian Americans compared to Caucasians.
5. Smoking: Cigarette smoking increases your risk of developing heart disease by 2-4X
6. High cholesterol
7. High blood pressure
8. Sedentary lifestyle
9. Excess weight
10. Diabetes

You Think You are Having a Heart Attack; You are Alone…Now What?

Pull over if you suffer an attack while driving. You may only have seconds before you lose consciousness.  If you experience chest discomfort (or any of the heart attack symptoms listed above) call 911 right away.  Don’t over analyze this; be safe and not sorry or dead.  Never wait more than 5 minutes to make that call. Don’t try to drive to a hospital unless there is literally no other alternative. Then chew an aspirin.  During a heart attack, taking a full dose (325 mg) aspirin can actually save your life.  Make sure you chew it for 30 seconds, and swallow it.  The sooner you take the aspirin, the better your chances.  Aspirin makes blood platelets less likely to stick to each other, assisting blood flow and reducing clots.  Aspirin can save your life as easily as your bullet resistant vest.  Command - buy a bottle for the locker room!  Officers - keep one with you at all times.  You may not ever need it, but someone else may.

Remember, a heart attack is a dynamic event, and early intervention can limit the damage. The paramedics can give you oxygen and medication, and they’ll monitor your blood pressure and heart rhythm to forestall complications as they whisk you away to the emergency room. Paramedics have the equipment and are trained to revive a person if his/her heart stops.  They will also be able to give ER staff in depth information about your condition before you enter the doors.  In the hospital, doctors will take EKGs and blood tests to see if in fact you are having a heart attack.  If you are they will usually try to open the blocked artery with an angioplasty, stent, or with a clot-busting medication.

While you wait for paramedics lie or sit down and rest.  The more exercise or stress you put on the heart, the more damage the heart attack will do.  Don’t panic, try to stay calm.  Hopefully help is on the way.

An Ounce of Prevention…

How you live your life affects the health of your heart and can increase or decrease your chances of having a heart attack. The good news, however, is that 80% of premature heart attacks and strokes are preventable.  If you have a heart condition follow up with your physician, there are many medications to treat heart disease. The following ten steps can also help prevent a heart attack and/or help you recover from one. 

1. Quit smoking: The single most important thing you can do to improve your heart's health is to stop smoking. Avoid secondhand smoke. Being around secondhand smoke can potentially trigger a heart attack.
2. Maintain a healthy cholesterol level: Your total blood cholesterol is a measure of LDL cholesterol, HDL cholesterol, and other lipid components. The recommended total cholesterol level is below 200.  If your LDH "bad cholesterol” levels are high, your doctor can prescribe changes to your diet and medications to help lower the numbers. 
3. Control your blood pressure:  Your goal is 120/80 or lower.
4. Exercise regularly: Doctors recommend 30 minutes of cardiovascular exercise three times a week at the bare minimum.
5. Get adequate sleep:  Doctors suggest that you should get about 8 hours of sleep per night.
6. Maintain a healthy weight and body mass index.
7. Eat a heart-healthy diet.  Cut down on saturated fat, cholesterol, and salt.  Increase your consumption of fish, whole grains, nuts, fruit and vegetables. 
8. Manage/reduce stress in your day-to-day activities.
9. Aspirin Therapy:  The American Heart Association recommends that people at high risk for a heart attack should take a daily low-dose of aspirin (if told to by their physician).  Additionally, heart attack survivors regularly take low-dose aspirin.  Your doctor will suggest a dosage of 75-325 mg.
10. If you drink alcohol, do so in moderation. In moderation, alcohol helps raise HDL levels (good cholesterol) and can have a protective effect against heart attack. Men should have no more than two drinks a day, and women should have no more than one.

In conclusion: Did you know?

• Studies have shown that nearly 50% of police officers die of heart disease within five years of retirement
• Chronic stress is linked to more heart disease among police officers
• Police officers live an average of 15years less than the average American
• Statistically, law enforcement officers are 25 times more likely to die from cardiovascular disease (CVD) than from the action of a suspect.

It is time to take your cardiac health seriously.  Be careful out there.  Double check your pocket, is your aspirin still there?