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Don’t ignore signs of heart attack

26 Aug 2020 By HUBERT VAZ

Are you debating between life and death by delaying a crucial visit to a clinic to avoid exposure to COVID-19? Conditions like heart attacks/strokes don’t quite disappear during a pandemic. So, if you experience symptoms, don’t put off your visit, to avoid irreversible damage to your heart

During the COVID-19 pandemic, doctors across the world have reported a sharp decline in patients coming to the hospital for many conditions, especially heart attacks and strokes. They, however, caution that these conditions don’t stop during a pandemic. In fact, the decline has worried doctors because those experiencing symptoms may worsen their condition if they chose to stay home and expect it to pass.

Heart attacks and strokes require emergency care, even in the face of the COVID-19 pandemic. Hence, if one experiences symptoms, one is advised not to postpone a visit to the clinic as it could have disastrous consequences with every passing minute, sometimes fatal.

Patients may be understandably nervous about going to a hospital during COVID-19, but hospitals have implemented many safety measures to protect visitors. So, the consequences of not seeking timely care for heart attacks and strokes can be far greater than the risk of COVID-19 exposure in a hospital or clinic as getting care quickly is critical to treatment as well as recovery.

When an artery gets blocked, the part of the heart it supplies blood to is starved of oxygen and nutrients and that part ‘dies’.

Time is muscle

According to Dr Benny Panakkal, medical director and senior interventional cardiologist, Badr al Samaa Group of Hospitals, “A heart attack or myocardial infarction happens when an artery supplying blood to the heart muscle (myocardium) is suddenly blocked due to the formation of a blood clot. When the artery is suddenly blocked the part of the heart it supplies blood to is starved of oxygen and nutrients. If this continues beyond a certain time, that area ‘dies’ or get infarcted. So, in the case of heart attack, we say ‘time is muscle’.”

Dr Benny points out that if one delays a visit to the clinic, after suffering symptoms, the longer one takes causes greater damage to heart muscle. In fact, earlier the artery is opened, it is better and saves more muscle from damage. It is important to note that once the heart muscle is damaged, it is permanent. And with more damaged muscle, the working of the heart becomes weaker.

“It is important to get treatment as early as possible in the event of a heart attack. If there’s doubt, better go to the emergency care of the hospital. Earlier the better. The doctor will assess the situation and plan the treatment options either by clot dissolving medications or by doing an emergency angioplasty to open the blocked artery,” Dr Benny explained, adding, “Sometimes, heart attack strikes with no or little chest discomfort.”

Often there is only upper abdominal discomfort, like in gas. So, it is said that gas is the greatest enemy of the heart as it could mislead the patient. In some situations, the person may not feel chest discomfort and unusual weakness, sweating, dizziness, nausea, may be the only symptoms.

In few curious cases, continued hiccups could also be a symptom. Also, atypical symptoms are more common in diabetics, older people, and ladies, but by all means, it may happen even in others.

Crucial 24 hours

“Most of the deaths in the case of a heart attack happen during the first 24 hours. Sudden deaths from a heart attack is always due to cardiac arrest, a deadly complication due to the electrical system generating the heart beats going out of order and the heart stops beating or beats abnormally. This is why, during the first 24 hours of a heart attack, patients are monitored in a coronary care unit. If a cardiac arrest occurs, it needs immediate attention and electrical shocks are delivered by an instrument called defibrillator to reset the heart beats. If several minutes pass without restoring heart beat and circulation, death follows,” he cautioned.

Another cause of death in a heart attack is cariogenic shock – when a large amount of heart muscle is damaged, the heart loses its ability to pump. This pump failure leads to low blood pressure and failure of circulation of blood in the body leading to multiple organ failure and death, Dr Benny explained, adding, “All these can be prevented by early and correct treatment.”

Discomfort like indigestion

Most people equate heart attack to any kind of chest pain. It’s important to note that often the heart attack or myocardial infarction is felt as a ‘discomfort’, pressure, heavy weight in the chest, burning sensation, or as a feeling of indigestion. The discomfort may be in the centre of the chest, left side of the chest, right side of the chest, upper part of the abdomen, above the belly button, throat, lower jaw, both or either arms, and the central area between the shoulder blades.

“The discomfort may radiate from the chest to throat, left or right arms. It may or may not be associated with sweating, vomiting or nausea, and is sometimes difficult to distinguish from indigestion. So if you’re at a higher risk of having a heart attack, say above 45 years, have a history of high blood pressure, diabetes, high cholesterol or you smoke, it is better to go and get checked at an emergency care unit, if any of the symptoms persist, Dr Benny cautions.

It is also important to remember that heart attack will not cause momentary, sharp, pointed pains that lasts few seconds. It usually lasts minutes to hours and is not a well localised pain that one can locate with a finger.

Emergency treatment should be sought, even in these days of pandemic. All hospitals have mechanisms and triage to segregate suspected COVID patients from other patients. Also, all proper precautions are mandatory in hospitals in Oman, as per Ministry of Health guidelines. “So it is safe to go to a hospital and get treatment if you feel you are in need,” he assured.



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