Heart Attack: What To Do When It Happens

A heart attack can strike suddenly, causing severe chest pain, sweating, and difficulty breathing. If a loved one experiences these symptoms, it is crucial to act quickly and calmly.

Here is a step-by-step guide for patients, relatives, doctors, and the general public:

1. Reach the hospital immediately. The first hour after symptoms begin is called the “Golden Hour.” Getting to the hospital within this time increases the chance of saving the heart by more than 80%.

2. If you are in contact with a doctor and a heart attack is suspected, give the patient Dispersible Aspirin 325 mg to chew.

3. Perform ECG and Troponin tests immediately upon hospital arrival. These tests help confirm the type of heart attack.

4. Two main treatment options:

- Thrombolysis (TPA injection): • Given in the hospital as an injection (Streptokinase, Tenecteplase, Alteplase) to dissolve blood clots. • Success rate is 50-70%. • Cost ranges from ₹3,000 (Streptokinase) to over ₹30,000 (Alteplase/TPA).

- Primary Angioplasty (best if available): • The patient is taken immediately to the Cath Lab where the blockage is removed and a stent is placed. • Success rate is 90-95%. • Cost ranges from ₹1.5 lakh to ₹2.5 lakh depending on stent type and hospital. • Some hospitals offer free or subsidized treatment under Ayushman Bharat or Mahatma Phule schemes.

5. If Angioplasty is not possible, perform Thrombolysis without delay. In rural areas or hospitals without Cath Labs, Thrombolysis is often the only option. Rescue Angioplasty may be done later if needed.

6. Hospital stay is usually 4-5 days. After stent placement, 1-2 days are spent in ICU followed by general ward.

7. Ongoing care includes medicines, diet, and cardiac rehabilitation. Lifelong blood thinners (Ecosprin, Clopidogrel), blood pressure and sugar control, and lipid-lowering medicines (statins) are necessary. Lifestyle improvements help prevent future attacks.

8. Cardiac rehabilitation is essential but often overlooked. It includes walking, breathing exercises, diet, and psychological support. Scientific evidence shows it reduces future heart attacks. Year-round monitoring programs like Just For Hearts are very helpful.

9. Do not panic but do not waste time. Avoid delays such as ambulance getting stuck, waiting for doctors, or missing injections by being prepared. Relatives learning CPR is also beneficial.

10. To prevent heart attacks: keep Blood Pressure, Diabetes, and Cholesterol under control. 90% of heart attacks are lifestyle-related. Walking 30 minutes daily, a healthy diet, and regular check-ups are the best prevention.

Share this post with your family and groups. In emergencies, there is no time to think twice. This knowledge can save lives.

Dr Ravindra L. Kulkarni, MD, DNB, FSCAI (Cardiology) Just For Hearts