Health. How does emergency medical assistance respond to a myocardial infarction?

What should you do if you think you are having a heart attack?

Professor Patrick Henry : "Many people fear having a heart attack when they feel chest pain. However, this pain can have many causes, often benign.

Specifically, the pain associated with a heart attack is intense , located in the center of the chest or in the back, and can radiate to the shoulders, sometimes to the arms, but never to the hands. It is generally a pain that is unprecedented in its intensity and location, and it lasts for at least 15 to 20 minutes.

If you feel this pain, the only thing to do is lie down and call for help immediately. Any exertion or movement can cause heart rhythm disturbances—in this case, a racing heart—and increase the risk.

If help is not available (abroad, for example), it is best to lie down in a car and be transported quickly to the nearest hospital. Never drive yourself, as a rhythm disturbance could cause an accident.

Why is excessive exertion very risky for the myocardium (heart muscle)?

Professor Henry : "Exertion forces the heart to work harder even when it is already in great pain. In addition, it triggers a reflex that can cause cardiac rhythm disturbances, which can sometimes be fatal. The longer we wait, the more the affected area of ​​the heart dies and becomes irreparable, which degrades cardiac function.

The extent of damage and after-effects is generally not influenced by the efforts the patient may be making at the time of the infarction.

On the other hand, exertion can promote the appearance of cardiac rhythm disorders, from the very beginning of the infarction. These are fatal if an electric shock is not administered urgently. This is one of the main reasons for the presence of defibrillators in cities.

What can we do and what actions should we take while waiting for help?

Professor Henry : "In this stressful situation, lie down and try to breathe slowly and deeply. Do not walk. The lying position is preferable because it reduces the workload on the heart. Moreover, in the event of a sudden increase in heart rate, it prevents falls and injuries."

What will the emergency services do on the way to the hospital?

Professor Henry : "The emergency services will begin by confirming the diagnosis with an electrocardiogram. They will ensure your safety by continuously monitoring your heart rate and assessing the effects of the heart attack on your body.

If there is a complication, such as a racing heart, they may administer medication to slow it down or administer an electric shock (which you won't feel). Treatment will be initiated quickly because a heart attack is caused by a clot blocking an artery in the heart.

The medication administered will aim to reduce this obstacle and will be adjusted based on your distance from the hospital. If you are far away, a more potent medication will be used.

Emergency services will take you to a hospital equipped with a coronary angiography suite, where cardiologists will immediately clear the blocked artery. In addition to monitoring your heart rate and assessing your heart function, the treatments you begin will aim to dissolve or facilitate the dissolution of the clot, in order to reopen the artery. When the heart is severely affected, medications may be administered to help it function.

The faster the intervention, the less severe the after-effects will be. In practice, it is rare for there to be serious after-effects if the blocked artery is reopened within an hour and a half following the infarction. Generally, the after-effects are at their peak after six hours. Beyond this time, the very question of reopening the artery arises.