All over the world cardiovascular diseases rank first in terms of mortality.

Every year in the world alone, a lot of people experience myocardial infarction, and the so-called “heart attack” occurs in a much larger number of our residents. About a third of patients are hospitalized late due to late seeking medical help, which has a negative impact on the subsequent treatment. Late treatment is caused by: firstly, underestimation of the severity of their condition; secondly, ignorance of the main symptoms of the disease; thirdly, lack of skills to provide self-and mutual aid.

What is a heart attack and what are its signs?

The term “heart attack” is used outside the professional domain of the medical professional, in the general public, and for public education.

For patients already diagnosed with coronary heart disease (CHD) and habitual angina pectoris, the term “heart attack” refers to an uncompensated and prolonged angina attack or the pain of myocardial infarction.

For those at risk for CHD and the rest of the population, a “heart attack” is often a first-time angina attack, as a manifestation of unstable angina or an incipient myocardial infarction, that requires urgent care.

Up to 50% of all those who die from myocardial infarction die within the first hour of the onset of a heart attack and before they are admitted to the clinic. That’s why it’s so important to know the symptoms of a heart attack, the emergency care algorithm, and activities that can save precious minutes of the “first golden hour.”

The main signs that indicate the presence of a heart attack

1. The nature of the pain: pressing, burning, constricting, heartburn-like or indefinite discomfort accompanied by a grievous sense of longing and anxiety. Typical comparisons: as if “a heavy stone (stove) was placed on the chest”, “the heart was squeezed by a vice”, “a stake was driven into the chest”, “boiling water was poured into the chest”, “the shoulder is everted”, “everything inside is on fire”, etc. Another name for an attack of angina is “chest pain”.
2. The intensity of pain: from moderate discomfort in the chest (but obviously paying attention) to intolerable pain (moaning, screaming).
3. Pain localization: behind the sternum, on the anterior surface of the thorax, in the heart area, in the left side of chest (clavicle, shoulder, forearm, scapula, left side of neck, lower jaw), in both shoulders, shoulder blades, lower chest with involvement of upper abdomen, scapula area.
4. Area of pain: large, wide without clear borders, the patient shows it with the whole palm of his hand or with his fist.
5. Pain duration: from several minutes to 2-3 hours, often wavy pains with an interval of 1-5 hours, the second-third waves are usually more intense.
6. Relationship of pain to body position, breathing: indefinite or absent.
7. The behavior of a patient during an attack: as a rule, pain causes fear or anxiety for his life; he stops working, stops or sits; sometimes there is sudden weakness (“cotton legs”), vegetative reactions (pale or red face, “cold sweat”, fever, sweating); nausea, one or two times vomiting, expressed shortness of breath up to suffocation is possible. In some cases, the patient “cannot find his place”: gets up, sits down, walks around the room, keeps his hand on his chest, shirt collar unbuttoned. He never smiles or cries, relatives often do.

In such a situation, the most important thing for the patient and his relatives or friends (if they are nearby) is not to get confused or panic. Their actions in the first minutes after the appearance of symptoms of a heart attack depend on the effectiveness of further medical care.

It is necessary:

• Urgently take (chew and swallow) one tablet of aspirin (acetylsalicylic acid) in a dose of 0.5 g and one tablet (capsule, inhalation) nitroglycerin under the tongue. Contraindications for taking aspirin are only its intolerance: allergic reactions, “aspirin” asthma or apparent exacerbation of peptic ulcer disease;
• provide rest and access to fresh air;
• repeat the intake of nitroglycerin if the pain persists after 3-5 minutes. You should know that in open tubes nitroglycerin may lose its effectiveness, so you should always have a new unopened tube (better-inhaled nitroglycerin – “nitromint”, “isoket”, “aerosonit” and others);
• call the ambulance at 103 and take another nitroglycerin tablet if the pain persists after 3-5 minutes.