Emergency First Aid for Heart Attack or Myocardial Infarction

What are myocardial infarctions? What are the signs and symptoms of a Myocardial Infarction? What should you do if you suspect a myocardial infarction or heart attack?

What is a Myocardial Infarction?

A myocardial infarction is a heart attack, plainly put. Myocardial refers to the muscle of the heart and infarction refers to a blockage. In most cases of a heart attack, the blockage refers to a blood clot or other entity blocking the blood vessels that supply blood and nutrients the muscles of the heart. When the muscles of the heart cannot get enough blood supply, areas of the heart lack oxygen and begin to die off as a result. A blockage is not the only cause of a heart attack, but we will focus on this particular cause as it is the most common.

Unfortunately, any damage sustained by a heart cannot be reversed. This means that quick and timely interventions are critical for improved outcome.

Cardiovascular disease is one of the leading causes of death among women and those assigned female at birth (AFAB). Black women are particularly at risk of acute myocardial infarctions while Asian women are at an increased risk of death from a heart attack.

For men, the risk of plaque-related rupture is of a higher rate in the setting of an acute myocardial infarction.

What are the Signs and Symptoms of a Myocardial Infarction?

There are some general signs and symptoms of a heart attack, but keep in mind that they do present in women differently than men. If you are AFAB, these unusual presentations will be relevant to you as well due to the physiology of the body.

The most common symptom is of course related to chest discomfort. This discomfort can be pain, pressure, or general discomfort that is usually in the centre or the left side of the chest. This pain will last more than a few minutes or it might come and go. This chest discomfort often is described as the feeling of an elephant sitting on one’s chest.

Sometimes, this discomfort can be “referred” elsewhere as is the case with most pain that originates in a visceral/internal organ. This discomfort may be felt in the jaw, neck, back, and/or in both arms or shoulders. Most commonly, the chest pressure will be present with pain travelling down the entirety of the left arm.

Symptoms also include feelings of weakness, lightheadedness, or faintness. Keep in mind that a heart attack is caused by a blockage in the heart’s blood vessels, which causes the heart to become less effective. When the heart is less effective, the rest of the body also suffers from less oxygen distribution making our body tell us to slow down or become weak as a result.

Another symptom is the feeling of being short of breath. This is often seen in the setting of the chest pain. Our body wants more oxygen and tries to compensate by getting more oxygen through increased respirations.

Diaphoresis or sweating is also a sign of a heart attack. With a heart attack, this is often a cold sweat, making the skin feel clammy.

Signs and symptoms of a heart attack can also include nausea, vomiting, indigestion or heartburn, or general feelings of fatigue. In women or persons AFAB, difficulty sleeping, indigestion, and feelings of anxiety can be a sign.

Quick Recap of Signs and Symptoms of a Heart Attack

  • Chest pain, heaviness, or discomfort.

  • Pain in the arms, shoulders, abdomen, jaw, neck, and/or back.

  • Shortness of breath.

  • Weakness, lightheadedness, dizziness or fainting/feelings of faintness.

  • Difficulty sleeping and Anxiety (particularly in AFAB and women)

  • Nausea and/or vomiting, indigestion, heartburn

  • Cold sweats or feeling clammy.

What Should You Do or What Does First Aid Treatment Look Like for a Suspected Heart Attack / Myocardial Infarction?

First and foremost, call 911 or whatever your local emergency number is. If you have aspirin on hand, have it ready in case the operator instructs you to take some. During level three occupational safety training, we were told to administer 325 mg of Aspirin (also known as acetylsalicylic acid or ASA for short) and instruct the patient to chew it before swallowing it for quicker absorption.

In your case, however, it is more important to call 911 and await the operator’s instruction as there might be an indication to not take ASA during a suspected heart attack. When the emergency personnel arrive on scene, they will likely administer oxygen at a conservative rate as oxygen can actually act as a vasoconstrictor. In other words, oxygen can cause your blood vessels to become smaller, which would restrict blood flow more.

It is incredibly important that you are open and honest about what medications you are taking. This is especially true if you have taken medication for erectile dysfunction within the last 24 hours, because emergency personnel might use a sublingual medication spray called Nitroglycerin. This medication relaxes blood vessels, allowing blood to flow easily throughout the body. One side effect of this is it can cause your blood pressure to drop significantly. As erectile dysfunction medications have a similar functionality, you can go into a state of relative hypovolemic shock as your blood pressure would drop so much that your tissues would no longer have perfusion.

Summary of First Aide for Heart Attack or Myocardial Infarction

  • Call 911

  • Keep aspirin on hand

  • Await further instructions

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