Cardiac Conditions, including Chest Pain
The Heart
The heart is a muscle; a small organ roughly the size of a clenched fist that lies directly behind the sternum. It works continuously propelling blood around the body and maintaining blood pressure. All cardiovascular function ultimately depends on the heart. This muscular organ beats approximately 100,000 times each day, pumping roughly 8000 litres of blood. To function the heart’s cardiac muscle cells require reliable supplies of oxygen and nutrients. The coronary circulation supplies blood to the muscles of the heart, if this supply is interrupted or slowed the heart can no longer function to its full capacity resulting in a loss of consciousness.
Angina (Chest Pain)
Angina is a condition in which exertion or stress produces temporary chest pain due to an inadequate supply of oxygen to the heart muscle. The chest pain of angina is typically severe and crushing. There is a feeling just behind the sternum of pressure and suffocation, squeezing in the centre of the chest and pain in the neck, shoulder, jaw, upper arm or upper back.
Angina is usually relieved by rest. When rest alone does not bring rapid or effective relief then the use of nitroglycerine tablets or spray is often needed. Anginine is a common medication taken by Angina sufferers. The pain or discomfort is usually relieved within a couple of minutes, however, if the signs and symptoms last more than 10 minutes, an ambulance should be called immediately, and the casualty managed for heart attack.
Pale, cool skin.
Chest pain or discomfort radiating from the centre of the chest, may radiate to the neck, jaw, shoulders, arms and/or back.
Sweating.
Rapid, irregular or weak pulse.
Breathlessness.
Follow the DRSABCD emergency action plan.
Call 000 for an ambulance.
Encourage the casualty to immediately rest in a position of comfort, usually in an upright seated position.
Reassure the casualty.
Assist the casualty to take their medication if they have it with them.
Monitor vital signs; airway, breathing and circulation.
Discourage visit to the toilet.
If pain and discomfort persist for longer than 10 minutes, then the condition should be considered a heart attack.
Angina and heart attack have very similar signs and symptoms.
If it is the first time the casualty has experienced chest pain
call 000 for an ambulance immediately,
monitor airway, breathing and circulation
and be prepared to commence CPR.
Heart Attack
A heart attack is the death of heart muscle due to the loss of blood supply. The loss of blood supply is usually caused by a complete blockage of a coronary artery, one of the arteries that supplies blood to the heart muscle. Death of the heart muscle, in turn, causes chest pain and electrical instability of the heart muscle tissue.
The electrical instability of the heart causes ventricular fibrillation (chaotic electrical disturbances affecting the ventricles, the lower chambers of the heart). Orderly transmission of electrical signals in the heart is important for the regular beating (and the efficient pumping) of the heart. A heart undergoing ventricular fibrillation simply quivers and cannot pump or deliver oxygenated blood to the brain. Permanent brain damage and death can occur unless oxygenated blood flow is restored within five minutes.
Many heart attack deaths are due to ventricular fibrillation that occurs before the casualty can reach any medical assistance. Early heart attack deaths can be avoided if a first aider commences CPR within five minutes of the onset of ventricular fibrillation.
A person’s survival following a heart attack can be improved with appropriate treatment and clot-dissolving medications that clear the blocked artery, restore blood supply to the heart muscle and limit damage to the heart. Treatments are most effective if administered as soon as possible following the onset of symptoms with benefits declining with delays in treatment.
A heart attack is also called a myocardial infarction or an MI. Myocardial refers to the myocardium, the heart muscle. Infarction is tissue death due to a local lack of oxygen.
Most people will experience some warning signs, however it is important to remember that heart attacks can occur in people who do not have chest pain as one of their symptoms.
Warning signs of heart attack usually last for at least 10 minutes. If warning signs are severe or get worse quickly, act immediately!
Pale, cool skin.
Chest pain or discomfort radiating from the centre of the chest, may radiate to the neck, throat, jaw, shoulders, back, either or both arms and into the wrists and hands.
Pain may be limited to the neck, throat, jaw, shoulders, back, either or both arms and into the wrists and hands.
Sweating.
Rapid, irregular or weak pulse.
Shortness of breath.
Feeling dizzy or light-headed.
Nausea and/or vomiting.
Collapse.
Follow the DRSABCD emergency action plan.
Call 000 for an ambulance immediately.
Encourage the casualty to immediately rest in a position of comfort, usually in an upright seated position.
Reassure the casualty.
Assist the casualty to take their medication if they have it with them.
Monitor airway, breathing and circulation.
Be prepared to commence CPR.
Discourage visit to the toilet.
For Women
Research by the National Institute of Health (NIH) U.S.A. indicates that women often experience new or different physical symptoms as long as a month or more before experiencing heart attacks.
These symptoms may be in addition to signs and symptoms listed under angina and heart attack above. Symptoms most commonly reported include:
- Unusual fatigue (70.6%).
- Sleep disturbance (47.8%).
- Shortness of breath (42.1%).
Reference Source: http://usgovinfo.about.com/cs/healthmedical/a/womensami.htm’ Viewed on the 3rd April 2010
Sudden Cardiac Arrest
Sudden cardiac arrest is the sudden, unexpected loss of heart function, breathing and consciousness. Sudden cardiac arrest usually results from an electrical disturbance in your heart that disrupts its pumping action and causes blood to stop flowing to the rest of your body.
Sudden cardiac arrest is a medical emergency. If not treated immediately, it is fatal. With fast, appropriate medical care, survival is possible. Administering CPR, or even just rapid compressions to the chest, can improve the chances of survival until emergency personnel arrive. Immediate CPR and use of an automated external defibrillator (AED) are essential for any chance of recovery. The chance of survival decreases 10% for every minute the AED is delayed.
Sudden cardiac arrest symptoms are sudden and drastic.
Sudden collapse and loss of consciousness.
No pulse.
No breathing.
No Signs of Life – unconscious, unresponsive, no movement, absence of normal breathing.
Sometimes, other signs and symptoms precede sudden cardiac arrest. These may include fatigue, fainting, blackouts, dizziness, chest pain, shortness of breath, palpitations or vomiting. But sudden cardiac arrest often occurs with no warning.
If you have frequent episodes of chest pain or discomfort, heart palpitations, irregular or rapid heartbeats, unexplained wheezing or shortness of breath, fainting or near fainting, or you’re feeling lightheaded or dizzy, see your doctor promptly.
When the heart stops, the absence of oxygenated blood can cause brain damage in only a few minutes. Death will occur within 8 to 10 minutes. Time is critical when you’re helping an unconscious person who isn’t breathing. Take immediate action.
Call 000 for an ambulance – Call First and Call Fast.
Commence CPR.
Attached an AED if available.
