70, 000 people die every year in Germany from a heart attack. Many of them because heart attack patients in Germany about 15 hours (!) Need before they are in the hospital. Much too long! The reason is usually the patient himself: Waiting, whether the symptoms disappear by themselves, do not take pain seriously, do not bother anyone ...
Brustenge - When the circulation of the heart tissue is disturbed
Chesting and heart attack have very similar symptoms. That's why they are grouped under the term Acute Coronary Syndrome. A heart attack or angina pectoris (chest tightness) is usually caused by deposits (plaques) in the coronary arteries on the floor of years progressing arteriosclerosis.
The coronary arteries (synonym: coronary arteries) are designed to provide the heart muscle with oxygen and nutrients. If they are narrowed by the plaques, there is an undersupply of the heart muscle with oxygen. This can manifest itself as a recurring chest pain, especially under stress, stress, cold. In short: angina pectoris.
But the occlusion of a coronary artery may also go unnoticed and / or continue to progress until such a plaque suddenly tears and a clot attaches to it and the vessel abruptly closes: the heart attack, a life-threatening emergency!
Become aware of even the smallest alarm signal
If you experience the following symptoms, you should immediately think of angina pectoris or a heart attack:
- Breast complaints: dull, oppressive, narrow, burning, flat in the middle of the chest, lasting more than 5 minutes or going away and returning
- Complaints elsewhere: in one or both arms, upper abdomen, neck, back or neck
- Aerial distress: often with other complaints
- Other complaints: nausea, dizziness, weakness, cold sweat
- If these symptoms occur for the first time and last more than 10 minutes: Immediately go to the hospital, the best way to call the emergency 112 Tel.
First aid with nitro spray
In the best case, a few minutes after the occurrence of the above-mentioned pain, an emergency doctor will accompany the patient and escort him to the hospital in an ambulance. If he has the suspicion of angina pectoris or even heart attack, he should first apply emergency drug no. 1: Nitro-Spray (eg Nitrolingual® N-Spray).
This medicine, sprayed under the tongue with two strokes, expands the coronary arteries in minutes, thereby improving the blood flow in the heart. And it helps to distinguish between infarction and angina. Because: If nitro-spray does not improve the symptoms, it is highly likely to start from a heart attack. The doctor will then administer painkilling, soothing and blood thinning medicines.
Emergency assistance in the hospital
In the hospital, an attempt is then made to make the coronary vessel through again. Through the undersupply of oxygen, the heart muscle tissue dies irreversibly, the more, the worse the long-term consequences such as heart failure, says Prof. Dr. med. Michael Kentsch, chief physician at Klinikum Itzehoe.
This process begins after just 30 minutes, so the faster the blood vessel can be made through again, the smaller the damage. Experts therefore speak of the golden first hour after a heart attack. Unfortunately, according to Prof. Kentsch, she is often missed, because the patients first wait a long time or do not come directly to the hospital for a heart attack.
"The first hour after symptom onset is particularly dangerous because of sudden onset of sudden cardiac death and life-threatening ventricular fibrillation Ventricular fibrillation means cardiac arrest Heart can not pump anymore Only immediate resuscitation with electrosurgery (defibrillation) can help here The faster medical help arrives, the better. "
Cardiac catheter opens the vascular occlusion
After a myocardial infarction is detected by symptoms and possibly ECG, the vascular occlusion is best reopened by means of cardiac catheter. An alternative is the medicinal clot dissolution. During treatment by means of a cardiac catheter, a thin tube is advanced over the inguinal artery to the heart, at the end of which there is a small balloon. Under X-ray control, it is inflated exactly at the bottleneck, thereby unfolding a stent lying on it.
Even after removing the balloon, it keeps the coronet open - the blood can flow unhindered again. Ideally, this procedure happens in the first hour after the infarction - and no heart tissue is destroyed yet.
Too late to the hospital
However, if the patient only comes to the hospital very many hours later, valuable time is lost and the vasodilation often makes no sense, because too much heart muscle tissue has gone under. This is exactly the case for over half of the patients. Late succession: heart failure, ie pumping failure of the heart with shortness of breath in efforts such as climbing stairs.
If a patient has angina pectoris with regularly recurring symptoms (stable angina pectoris), the doctor will prescribe a nitro spray for everyday use in addition to other medicines. In case of complaints bring one to two strokes of this drug, sprayed under the tongue, quick remedy.
If the symptoms disappear completely and persistently within a few minutes, the problem is solved acutely. Otherwise one speaks of an unstable angina pectoris. Because a heart attack threatens here, the emergency doctor should be called immediately.
What do I do if someone has a heart attack?
- First: Dial the emergency call (phone 112), say who you are and what you report. Stay in the line until there are no further questions from the control center.
- Is the affected person conscious: Talk to him, calm him down. Loosen tight clothes (tie, shirt collar) and store it with slightly raised upper body.
- If he has nitro-spray with him and a strong pulse, spray two strokes under the tongue!
- If the patient is unresponsive, does not breathe and does not move, this means: cardiac arrest. Quick action is important now - breath and chest compressions!
- Place the patient on a hard surface
- 30 times chest compressions, (Frequency: 100 times per minute): Pressure point about 3 to 4 cm above the sternum end, ie the point where the ribs meet. Lay one hand flat on it, the second hand on top of it. When pushing in the chest (with stretched arms) about four inches deep. Most common mistake: It is not pressed hard enough. Then ventilate twice again.
- Extend the patient's head and perform 2 x mouth-to-mouth or mouth-to-nose resuscitation.
- Continue until the ambulance arrives or the patient breathes again.
"When you have a heart attack, you have to weigh up: Waiting means: sudden cardiac death, heart failure, shorter lives." Responding means surviving, staying productive, living longer ", says Prof. Dr. med. Michael Kentsch.