Most of us become conscious on listening the word 'heart attack'. For us, heart attack means a situation causing danger to life. Is it really that dangerous?

Blood flow of the heart decreases, when it is obstructed due to certain causes. During obstruction, heart gives a heavy response or signal which can be considered as a sign. This sign is called as heart attack. Obstruction or decrease in blood flow can occur suddenly or gradually. As a result, certain blood vessels of heart stop working and stop performing all functions. This condition is quite serious. Sometimes, such conditions may arise when all of a sudden person gets a heart attack. His heart beats stop along with his breathing activity. Within few seconds, person steps at the doorstep of death. This kind of heart attack is known as heart arrest or heart failure.

Heart attack can occur anywhere and to anybody. Few heart patients suffer from heart attack while eating their meals, others during excretion of wastes. Few patients get a heart attack in bus, train, office etc..... Causes of such kind of silent heart attack is not known. In such situations, through first aid measures efforts can be made to save patient from dying. These heart arrests are of severe form which directly result in death of the patient.

To save a person from dying due to heart attack, certain measure can be adopted. When a person suffers from heart attack, his heart stops beating. To make his heart to function again an activity is performed. This activity is known as cardio pulmonary resuscitation (CPR).

SYMPTOMS:-

How to diagnose that a person in front of you is experiencing a heart attack? This can be diagnosed by following symptoms. 

Pain:- 

Heart attack can be diagnosed by pain in the chest. This is very usual and main symptom. This pain is of sharp type and is quick in pace. Sometimes, pain instead of developing in chest can occur in fingers of hands, in shoulders, back etc..... This should also be kept in mind.

In heart attack, patient experiences severe pain which is sudden in nature. Most of the times, this pain develops exact below the bone in between ribs. Pain is severe in form which makes person restless. Pain never subsides. It keeps increasing. Sometimes, pain also occurs in upper portion of the stomach. Sometimes, pain initiates from neck and radiates to the hands. 1 tablet of nitrate relieves pain in angina patients. But, pain in case of heart attack does not show any improvement. If pain radiates till fingers of the arms then it is a pain of heart attack.

Some patients do not experience pain at all whereas others feel excessive pressure on chest. Patient during heart attack due to pain cannot relax and become restless. In such conditions, doctor should be readily made available to the patient or else if hospital is near by then he should be taken to the hospital. 60% of the heart patients die within 1 hour of their heart attack. Thus, time should not be wasted and immediate medical help should be provided to the patient.

Shock:-

Sometimes, patient does not experience chest pain, instead experiences dizziness, sweating, nausea and vomiting. Face becomes pale and person looks tired. These symptoms look severe than the one which occur in normal circumstances. This condition persists only for certain time.

Difficulty in breathing:-

This sign is quite severe and usually occurs a few seconds prior to heart failure. Once patient have already faced heart attack he experiences this symptom very commonly. He faces difficulty in breathing even on doing slight physical work, on climbing stairs, on walking for short duration, on communication for a long time etc..... Thus, care and medications have to be taken as per advice by the doctor to avoid heart attacks in future.

Fluctuations in heart beat:-

This symptom is a sign of instability of heart. In certain individuals, heart attack develops due to mental stress, shock etc..... Due to exposure to excessively cold weather, on excessive consumption of fat rich products and in many such conditions where heart needs to work more than its efficiency, patient will face a heart attack.

FIRST AID:-

Sometimes, heart attack is so severe that patients heart immediately stop beating. He faints. No signs of life is seen in him. These kind of severe heart attacks should be given first aid treatment within 3-4 minutes. This is because if heart does not receive blood for 3-4 minutes then possibility is that patient may die. 

When such emergency arises, patient can be saved by following measures:-

• Patient made to lie down in correct position,
• Opening respiratory passages of patient,
• Pressing heart of patient in rhythm,
• Mouth to mouth respiration,
• Forceful attack on patients heart

Patient made to lye down in correct position:-

Person when gets a heart attack, he faints easily. Immediately, he should be made to lie down on his back. No pillow should be kept beneath his head. 2-3 pillows or chair or trunk should be kept beneath his legs in order to raise them above the ground at a height of more than 1 foot. Whether person is breathing or no should be checked. Also, his heart beat should be checked by placing ear on his heart. Nearby doctor and ambulance has to be called immediately. Patient clothes should be a little loosened which will help him to breath easily. Patient should not be given water or food and he should not be allowed to move. He should just be made to lye down on his back.

Opening respiratory passages of patient:-

Sometimes, respiratory passages do not open up completely in case of a heart attack. To open the respiratory passages, one should sit near head of the patient in such a way that one knee is parallel to patient's head and the other knee is kept near the side of the head. If one is sitting on right side of the patient, then right hand should be kept below the back of the patient's neck and it should be slightly raised up. With left hand, patient's head should be pressed. Whole of the mouth should be tilted backwards and upwards. This automatically opens patient's mouth. This will open up respiratory passages. If patient's heart is beating then he will start taking air inside. If something is stuck in patient's mouth or else if patient uses artificial denture then with the help of the finger, such things should be removed.

Pressing heart of patient in rhythm:-

To press heart in rhythm, person should stand on his knee beside patient heart. Both the hands should be kept on end point of middle bone of the chest. Pressing should be rhythmic. Within 1 minute, 60-70 times this activity should be performed. With the pressure exerted, chest should bounce back 4 c.m. After 15-20 times of exerting rhythmic pressure, artificial respiration should be given. Fusion of exerting rhythmic pressure on heart and giving artificial respiration should be continued for 5 minutes. Once patient starts breathing, this activity has to be stopped.

Mouth to mouth respiration:-

For artificial respiration, head of the patient should be tilted slightly towards backward and mouth should be pointing upwards. Person who wishes to give artificial respiration should open his mouth, breath deeply and lock his mouth with patient mouth. Nose of the patient should be closed with one finger and a thumb. Air enter lungs of the patient and lungs show signs of fullness. Mouth locked should be unlocked and air that was sent in should be allowed to come out. This activity has to be repeated for at least 5 minutes.

If air does not come out of lungs then it means there is obstruction in respiratory passage. Once again, head of the patient should be tilted backwards and mouth upwards and air should be sent inside lungs. If air does not come out then patient should be made to lye on either of his side ways. Back of the patient shoulder should be tapped with force so that obstruction clears out. If any obstruction is seen stuck in the oral cavity or throat should be removed with finger. Within a minute, at least 10 times air should be filled in patient mouth.

If patient's mouth does not open then artificial respiration can also be given through nose. Usually, within 5 minutes, patient's respiration begins. Once respiration begins, this activity has to be stopped. While patient is been taken to the hospital, in the way too, artificial respiration should be continued. With this method, life of the patient can be saved.

Forceful attack on patients heart:-

When a person gets a heart attack or else due to any reason if his heart beat stops then immediately on lower edge of middle bone of chest, forceful punch should be made by folding all the fingers of the palm. The thought should not arise in mind that this activity is going to hurt unconsciously lying patient. Actually, this activity is an effort made to gift a new life to the patient. Punch should be with lots of force. Force should be so intense that chest should at least get pressed 2 inch inside. With this force, heart will become excited and will start functioning again. This activity should be performed for 8-10 times. Within 15-20 seconds, heart should start beating. If this does not work, then patient should be taken to the hospital.

Number of heart attacks in this polluted and tense world are increasing day by day. To overcome this problem, it is necessary that all the family members should be well trained in performing these activities. Actually, to save heart patients from such emergency situations, there should be a national level program. Until such programs are implemented in country, it is everyone's duty to train their family members in more and more number so that they can help a person either inside family or some one from outside facing such a critical emergency condition.

IF HEART STOPS WORKING:-

In this condition, patient becomes unconscious. If immediately first aid is given and heart is massaged slightly along with mouth to mouth respiration then in most of the cases, heart starts to function again and patient's life can be saved. While massaging heart, mid bone of the chest should be pressed for a second and left. This is done till patient does not respond or unless other treatment measures are made available. Method is easy and very essential. Process acts like a life saver in case of many patients. Mouth to mouth breathing should also be continued.

HOW TO PREVENT HEART ATTACK:-

To prevent heart attack following precautions have to be followed:-

• High blood pressure has to be kept under control.
• More amount of cholesterol and triglyceride i.e., fat producing food stuffs should not be consumed.
• High fiber rich diet should be consumed.
• Diabetic patients are also at high risk of developing heart attack. Thus, one has to protect himself from becoming diabetic patient and a diabetic patient should keep his diabetes under control.
• Obesity has to be prevented.
• Exercise has to be done regularly.
• Smoking should be quit as soon as possible.
• Tobacco chewing has to be stopped.
• Alcohol consumption should be totally stopped.
• Oral contraceptives have to be taken only under doctor's prescription. If these medicines have been taken since a long duration then one has to go to doctor for regular check up.
• One has to learn to live life tension free.

TREATMENT:-

Since heart attack is a dangerous situation, its treatment has to be done under supervision of doctor only. No medicines have to be given without doctor's permission.

Doctor gives heart attack patients following medicines:-

• Anti-coagulants:- These medicines result in thinning of blood.
• Anti-clotting medicines:- These medicines avoid formation of blood clots.
• Beta blockers:- These group of medicines reduce discomfort and pain experienced during heart attack.

Apart from medicines, oxygen mask is applied to the patient which will enable him to breath properly.

Coronary angioplasty, coronary artery bypass grafting, ST segment elevation myocardial infarction, thrombolysis, are some of the treatments doctors will make use of, to treat heart attack patients.

PRECAUTIONS:-

Complete precautions have to be taken in food and drinks by a patient who is at risk of heart attack or who has already suffered from it.

Individuals who due to their carelessness have already suffered from a heart attack should understand that they are gifted with a new life. Thus, they and their family members should follow certain precautions so that in near future they do not suffer from another heart attack.

Food:-

First of all, control has to be kept on diet. Food should not be eaten in a single meal or two meals. Small frequent meals should be consumed, 4-5 times in a day. Consuming large meal imparts ill effects on digestive system. Heart is also made to experience over load. Intake of drinks like tea, coffee should be stopped or reduced. Alcohol should never be consumed as it weakens muscles of heart. As a result, risk of developing heart attack increases.

Fruits and vegetables:-

Fruits and vegetables should be consumed in excess during and in between meals. Efforts should be made to consume them along with their skin. Flour should also be consumed along with husk. All purpose flour should not be consumed at any cost. Potato, carrot, cucumber etc..... should be consumed without peeling their skin. Amount of garlic should be increased and added during preparation of food. Ghee, butter, cheese should be consumed in very little amount. Olive oil should be used to cook food.

Sleep:-

At least 7 hours of sleep has to be taken. This will ensure proper rest to body.

Physical work:-

Work related to home and office should be kept restricted. Excessive work puts pressure on heart. Excessive physical effort is harmful. After patient is discharged from the hospital on recovering from the heart attack, he should not make an effort to climb stairs. Family members too in this aspect should follow proper care. Patient has to be made to sit on chair or on stretcher and should be taken to his home if it is located on top floor of the building. Patient should climb and get down stairs only after complete recovery.

Sexual relationship:-

A person who had a heart attack should not develop sexual relationship for at least 8-9 weeks or until he becomes healthy once again. Once person is able to easily climb and step down of stairs, only then he should develop sexual relation.

Weather:-

They should protect themselves from excessive heat and excessive cold weather. When leaving house, care should be taken in this aspect.

Announcement of happy and sad news and patient's behavior:-

Patient should not be given a news of happiness or sadness all of a sudden. It is better that patient keeps himself away from emotions. He should also save himself from anger. Family members should take care that such conditions should not arise where patient needs to lose his temper. Business related profits and loses should not be discussed in front of heart attack patient. Good news should also be informed to him very carefully. If he feels like discussing house related matter then one should listen to him, irrespective of whether his advice will be followed or not. But, he should neither be interfered in between nor debate has to be done in front of him. He should be made to feel that house requires his presence. This will arise in him the eagerness to live. He should not be thrown in a corner. He should not be made to feel that he is cut off from the house and no one requires him. Topics which irritate patient should not be discussed in front of him. This imparts ill-effects on him and his heart.

Exercise:-

If earlier exercise was not done then at least after recovering from heart attack, patient should engage himself in performing low intensity exercises. Initially, very low intensity exercise have to be done like moving his hands and legs to and fro. This can be followed by moderate exercises and later exercises which intensifies all the body parts can be performed. All these exercises have to be done slowly. Initially, duration of exercise has to be increased gradually. Exercise has to be done as per doctor's recommendation. If while exercising, patient experiences breathlessness then exercise has to be stopped and doctor's advice has to be followed.

Driving:-

Even if one loves driving, after heart attack for at least 3-4 months rest should be taken and patient should not be allowed to drive. Fast driving and traffic can increase the heart beats. Normal individuals do not get affected by these things but for heart patients these conditions are dangerous.

Traveling:-

If patient has to travel outdoor after a heart attack then before that he should go for proper medical check up. After taking doctor's permission, patient can travel. But, he has to travel with all the precautions and should not exert any kind of load on his body. He should not rush for anything. He should reach station before time so that he need not hurry himself to climb or get down the stairs. All the essential medications should be carried in a hand bag during traveling. Patient should not travel alone. Person accompanying patient should have all the knowledge regarding his medication. Patient should not make an effort to lift his luggage. After every 2 - 3 hours  he should make movement by standing or moving his arms and limbs. This will allow blood circulation to take place properly. Without advice of the doctor, places above 5,000 feet from sea level should not be visited.

Apart from above mentioned precautions, there are many other things which have to be taken care of. Medicines have to be taken at right time and should be taken as per doctor's prescription. Dosage of medicine should neither be increased or decreased. Regular check up should be done. Pressure should not be exerted during excretion.

On television, light comedy or spiritual programs should only be watched. Horror films, serials, one-day matches and other programs which excites heart should not be watched. Such programs may put serious effects on heart. Door bell also should not be loud and very harsh sounding. Light musical bell is better to be used. Phones should not be kept in room of the patient. If phones are kept in patient room then patient may be at risk of receiving good or bad news. This does not impart good effects on him. If patient is sleeping, his sleep should not be disturbed at all. Family members should try their best to keep heart patients happy and satisfied. They should create stress free and tension free environment in house. The more relaxed heart patient will be, his chances of recovering completely after a heart attack will also increase more. Along with treatment and medications prescribed by heart specialist, self care is also very important.