Do you know the difference between angina and heart attack?
Angina is where the coronary arteries (the blood supply to the heart) are narrowed. This means that the heart has a poor blood supply.
A heart attack is where one or more coronary arteries are blocked, resulting in part of the heart muscle not receiving any blood… this causes death of part of the heart muscle. People suffering from a heart attack may be conscious.
If too large a part of the heart muscle is affected this can cause a change in the heart’s rhythm; the person will collapse and then go into cardiac arrest. Many people confuse heart attack and cardiac arrest.
Scarily both angina and heart attack can present identically.
Key signs might include:
- pale, cold, clammy
- fast, panicky breathing
- racing and/or irregular pulse
- anxiety
- chest pain… most people think this is ‘central left chest pain, sometimes radiating down the arm and up the jaw‘, however sometimes it is perceived as a ‘tight band around the chest‘, as a ‘heavy weight‘, occasionally it can ‘radiate on the right side of the arm/jaw’ and sometimes rather than complaining of pain the casualty complains of ‘severe indigestion‘.
The problem:
According to the Chain of Survival – the sequence of events which gives the victim of a heart attack the best chance of survival – number one in the chain is recognition and call for help. If we are able to recognise a suspected heart attack and get emergency 999 help before the casualty goes into cardiac arrest, they will have a much better outcome.
Statistics from the Resuscitation Council UK reveal that in the UK:
- NHS Ambulance Services attempt resuscitation in approximately 30,000 people each year.
- The annual incidence of out-of-hospital cardiac arrest (OHCA) is approximately 55 per 100,000 inhabitants.
- Most cardiac arrests (72%) occur in the home or a workplace (15%).
- Half of all OHCA are witnessed by a bystander.
- Most cardiac arrests occur in adults (98%), amongst whom one third (33%) were aged 15-64 years.
- Bystander CPR is attempted in 7 out of 10 OHCA.
- Public access defibrillator use is reported as being used in less than 1 in 10 OHCA.
If we don’t act quickly for someone with a poorly heart, then it is possible that cardiac arrest will occur …. then CPR and an Automated External Defibrillator (AED) are needed to save a life. An AED is most effective statistically if it is used within 4 minutes, yet in the statistics above it is rare that a public access defibrillator is deployed. We need to raise awareness in our community of where our nearest AED’s are located and teach people to use them!
What should I do if I suspect someone is has a poorly heart? (I won’t know if it is angina or a heart attack!)
- Stay calm – the casualty will be calmer if you are
- Sit them down on the floor in a ‘Lazy W’ position, loosen tight clothing around the neck (this decreases the work of the heart)
- Keep them comfortable (shade in hot weather, blanket in cold weather) but nothing to eat/drink
- Ask them if this has happened before – if yes, they might have prescribed medication which you can locate for them. If they don’t, or if it doesn’t work its more likely to be a heart attack than angina.
- Call 999 (or 112 from a mobile phone) and ask for ‘Ambulance’. Tell them what you see, and what the casualty is telling you.
- Stay with the casualty until help arrives and monitor how they are doing.
Ambulance control staff will help you with first aid over the phone. They might suggest offering Aspirin if the casualty is over 16 years of age – this affects clotting in the body. They might ask you to get a nearby AED – please don’t put it on a conscious breathing casualty – it’s close just in case they deteriorate.
If you want to learn more about CPR and AED, check out the AED Awareness video that I made previously, or even better get yourself booked onto a First Aid course.
Do keep an eye out for community AED’s they will be in cabinets like in the picture below – half the battle is knowing where they are located when you need one.
Author: Helen Underwood