[Plz Read]...What you must know about heart attack

He clutched his chest when the pain ripped through his heart. His mouth opened in a silent scream before he collapsed in a heap on the floor. The fall was witnessed by the people around him in the market place. Before you knew it, many well-wishers started trying to help.

The noise was alarming. “Bring water to pour on him,” said one. “No,” said another. “Force him to drink it.” “Take him to Baba behind the market,” said one man. “Take him to the general hospital,” was the final conclusion.

But the general hospital refused to admit him. “Why are you

bringing a dead man to the casualty ward? Who killed him?” the doctor asked.

This scenario is all too common and occurs almost daily in Nigeria. It could happen somewhere or to someone close to you; so, you need to know what to do.

Heart attack and cardiac arrest

Heart attacks occur when the heart muscle tissue is damaged or dies due to a lack of blood supply. This usually occurs when there is a blood clot, or severe narrowing of the arteries supplying blood to the heart itself. This leads to damage to the heart and if excessive, the heart stops working (cardiac arrest). Heart failure can also occur when the electrical activity of the heart fails. The heart then cannot pump blood out of its chambers effectively. This could lead to shortage of blood to the brain and other vital organs.

The brain stops working almost immediately, since it needs a continuous flow of blood carrying oxygen and nutrients for it to survive. This leads to the person fainting and collapsing to the floor. Once the brain stops working, other parts of the body such as the lungs and the ability to breathe also stop soon after. Death is then not far behind. Therefore, immediate efforts to get the heart working again are required, to keep the blood flowing to the brain. Delay of more than a few minutes can be fatal and lead to death.

What blocks the arteries?

The arteries supplying blood to the heart are called the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle, allowing it to function in keeping you alive. Coronary Heart Disease is a disease in which a waxy, oily, thick substance called plaque builds up in the coronary arteries. Plaque narrows the arteries and reduces blood flow to your heart muscle. This can partially or fully block the flow of oxygen-rich blood to the portion of heart muscle fed by the artery. This can lead to injury or death of that particular muscle and the damage causes a heart attack.

Prevention of heart attack

The heart of an adult beats about 70 times a minute to get the required amount of blood flowing all over the body. The heart also beats in a steady rhythm. Preventing plaque from building in the arteries is very important. This is best done through sensible eating, avoiding cigarettes, avoiding fatty, oily foods and engaging in exercise. Exercise keeps the heart working at top condition and keeps the blood flowing well. Also, treat hypertension and diabetes properly and listen to the advice of your doctor. Some patients may need Aspirin and cholesterol-bursting drugs for life.

How to save lives?

When the heart stops working, it is important to help the victim by physically pumping the blood in the heart. This is done by pressing the heart through the chest wall in a steady rhythm to imitate the normal activity of the heart.

So what do you do if someone collapses right in front of you?

So if someone collapses right in front of you or you find them slumped and not responding, you must act quickly. Ask the person ‘are you okay’, ‘can you talk’? See if they respond. If they respond, then it may not be so bad yet. If they do not respond, see if they are breathing. Do this by looking at the chest to see if it is rising up and down. Check to see if they are obviously breathing through the mouth or nose. Can you feel their breath on your face or back of the hand? Grab the shoulders and shake the person to see if this wakes them up. If it does not, you need to work fast, if you are going to save the person.

Doctors advise that the very first thing you should do now is shout for help.

Then, please do no harm and do not move the victim without proper care and due diligence. No rough dragging, no sitting up and definitely no pouring concoctions or drugs into the mouth.

Someone who is unconscious and vomiting should be turned on to their side. This will allow the vomit to pass out of the mouth safely and prevent choking. The important point is that air cannot go into the lungs if the tongue, vomit, blood or food is blocking the airway. The resuscitation skills we need to teach people is simple to learn and simple to apply.

You need only remember that it is as simple as A, B, C.

A means Airway. Is the airway clear? Not obstructed by food, vomit, blood or the tongue? If you think it is, then, please open the mouth and clean away any of these liquids and remove any food particles. Tilt the head and lift up the chin. This will also help open the airway.

B means Breathing. Are they breathing? Can you feel their breath on your face? Can you hear their breathing? Is the chest moving, rising up and down? If not, then they are not breathing and you need to breath for them. This means the kiss of life must be given. Pinch the nose close (in an adult) and open the mouth. Then, you take a deep breath and sealing your mouth closely over the victims’ mouth, breath out into their lungs. Do it twice. Keep the victims’ nose closed and the mouth open as you do this.

C means Circulation. Do they have a pulse? Feel their radial artery or carotid pulse. If no pulse or if it is faint, start cardiac massage. This has to be taught and is not simple to describe. Essentially, it means compressing the heart through the chest bone 30 times without breaking the ribs or doing any harm. This must then be alternated with the kiss of life. Do 30 chest compressions and then two kisses of life. Continue doing this until the victim wakes up or medical help arrives.

For your information: There are courses and seminars on cardiac massage and the kiss of life in different parts of the country. Find one close to you and get you, your family members and co workers trained. It could save your life.

- Dr. Biodun Ogungbo (ogungbo@btinternet.com)

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