Chest pain? Don’t delay calling 911

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New recommendations released Monday urge everyone who experiences worsening chest pain over 5 minutes to call 911, particularly if they feel short of breath, weak or lightheaded.

These are the warning signs of a heart attack, the report notes, and the faster patients are treated, the more likely they are to survive without lingering complications.

"At the top of the list of these guidelines is the need for patients to recognize their symptoms and respond promptly,” co-author and former president of the American Heart Association (AHA) Dr. Sidney C. Smith, Jr., told Reuters Health.

Other symptoms of a heart attack include chest pain radiating into the arms, back, neck, jaw or stomach, and excessive sweating.

The recommendations are part of a set of new guidelines on treating heart attack assembled by the AHA and the American College of Cardiology (ACC).

Although people are often quick to identify the signs of heart attack in others, they are less likely to do so for themselves.

For instance, in a study conducted in 20 US cities, 89 percent of respondents said they would summon an ambulance if they witnessed someone having a heart attack. Yet among people who had themselves suffered chest pain, less than one-quarter had called for an ambulance.

According to the latest report, approximately 500,000 Americans have a heart attack called an ST elevation myocardial infarction, or STEMI, every year. This type of heart attack generally occurs when one of the blood vessels feeding the heart becomes completely blocked.

It is particularly important to treat this type of heart attack quickly, the report notes, for patients can develop permanent damage within 20 minutes. More heart function is lost with every extra minute that patients remain untreated, noted Smith, who is based at the University of North Carolina in Chapel Hill.

Life-saving treatments for people having a heart attack include surgery to open up a blocked blood vessel and drugs to dissolve blood clots, which can completely close off blood vessels.

The guidelines, which are published on the AHA and ACC Web sites (http://www.americanheart.org and [url=http://www.acc.org]http://www.acc.org)[/url] and will also appear in the June 15 issue of the medical journal Circulation, include tips to help doctors decide whether to treat MI with a clot-busting drug or surgery.

Smith and his colleagues also recommend that heart attack patients take aspirin daily and receive beta-blockers and ACE inhibitors to keep their hearts healthy. Patients with high levels of LDL ("bad") cholesterol should receive cholesterol-lowering drugs, as well, they add.

In an interview, Smith said that it is also heart attack patients’ responsibility to take any medicine their doctors give them, as well as to make any necessary changes in their diets or lifestyles to prevent any further heart problems.

SOURCE: Circulation: Journal of the American Heart Association, June 15, 2004.

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