Recognizing a Heart Attack Quickly
Heart attack: symptoms, consequences and diagnostics
Cardiovascular diseases continue to be one of the most common causes of death in Germany. In 2022, over one third of all the approximately 1 million deaths were attributable to this group of diseases – especially, ischemic heart diseases and heart attacks.1
Myocardial infarctions carry a high risk of a fatal outcome. Within seconds, arrhythmic events such as ventricular fibrillation can occur, which may lead to a cardiac arrest. In this situation, emergency responders must make a fast and precise diagnosis so that they recognize the heart attack quickly and take appropriate action. At the same time, they must be able to rely absolutely on their medical devices.
This article contains all the key information about heart attacks: from the typical symptoms to possible consequences and diagnostics. You will also learn how MEDUCORE Standard² from WEINMANN can support you with both diagnosis and treatment.
What is a heart attack (myocardial infarction)?
A heart attack is caused by a complete blockage of one or more coronary arteries, primarily brought about by the formation of a blood clot (thrombus). As a result, part of the heart muscle (myocardium) can no longer be adequately supplied with oxygen-rich blood. In the event of delayed reperfusion therapy, a persistent undersupply will cause myocardial cells to die.
For prehospital and hospital management of a myocardial infarction, knowledge of the affected coronary artery and the extent of the ischemic area is critical. Quick action is required, especially if the main trunks of the coronary arteries are narrowed, or if areas that are vital for the heart’s pumping function are affected.
Causes and risk factors
When a heart attack occurs, the affected coronary blood vessels are often damaged or narrowed as a result of arteriosclerosis. Cardiovascular diseases, such as coronary heart disease, increase the likelihood of atherosclerotic plaques forming within the arterial vessel walls, which significantly increases the risk of a myocardial infarction developing.
The risk factors for a heart attack also include persistently high blood pressure and cholesterol levels as well as diabetes mellitus. Other factors are:
- Smoking
- Alcohol consumption
- Lack of exercise
- Obesity
- Unbalanced diet
- Excessive stress
What are the symptoms of a heart attack?
The symptoms of a heart attack vary. They can manifest differently from case to case, and sometimes a heart attack may occur without any warning signs. Asymptomatic progression, known as silent myocardial infarction, can remain undetected for a long period of time – even for years.
Women and men experience different symptoms when suffering a heart attack. There is a significantly higher incidence rate in men: at 322.6 men per 100,000 inhabitants, the full inpatient hospitalization rate in 2021 was double that of women (149.7).2
Heart attack symptoms in men
A frequent sign of a heart attack in men is retrosternal pain. It may radiate into other parts of the body – such as the left arm, shoulders, back or upper abdomen.
Other symptoms of a heart attack in men include:
- Angina
- Burning in the chest
- Shortness of breath
- Dizziness
- Cold sweating
- High blood pressure
Heart attack symptoms in women
Symptoms of a heart attack in women are often less clear-cut and less pronounced than in men, which makes an early diagnosis more difficult.
The symptoms include:
- Pressure or tightness in the chest
- Shortness of breath
- Nausea
- Vomiting
- Pain in the upper abdomen
The hormone estrogen protects the heart for many years and offers effective protection against coronary heart disease, but it does not rule out the development of a myocardial infarction, especially before the age of 60. According to the German Cardiac Society (DGK), the risk of dying from a heart attack is actually higher in women than in men in some respects.3
Diagnosing a heart attack
Diagnosis and treatment of a heart attack are time-critical processes, in which there is usually a very short window available. This means there is a direct correlation between the duration of a myocardial infarction and the severity of the resulting damage to the heart. The longer a myocardial infarction lasts, the worse the potential cardiac complications.
“Every second counts when it comes to cardiac arrest. If first responders start CPR immediately, the chances of surviving a heart attack are two to three times higher. The longer blood doesn’t flow to the brain, the greater the likelihood that the patient will suffer permanent damage”, explains Dr. Birgit Plöger, Chief Physician at the CER (Central Emergency Room) at Marburg Hospital and Emergency Physician.
ECG
The ECG is a key evaluation tool if a myocardial infarction is suspected.
An ECG examination can localize the myocardial infarction. It is particularly effective in ST elevation myocardial infarction (STEMI). With this form of infarction, characteristic changes in a segment of the ECG curve are seen: the ST segment displays significant elevations above the isoelectric line.
A non-ST elevation myocardial infarction (NSTEMI) is often more difficult to diagnose. This is because, even though T-wave changes and other deviations can occur, a clear ST elevation is not normally visible.
In order to make a precise diagnosis in such a case, certain parameters must be fulfilled during the laboratory examination.
Blood values
The blood values of the cardiac troponins cTnT and cTnI are considered the most important laboratory parameters for suspected myocardial infarction. Elevated troponin, or alternatively CK-MB levels, in conjunction with other factors – such as symptomatic and electrocardiographic signs – are a clear indication of a myocardial infarction.
Currently, the ESC guidelines recommend the following: if the oxygen saturation in the blood is below 90%, oxygen should be administered – regardless of whether an ST or non-ST elevation myocardial infarction is present. However, no oxygen should be given if the levels are higher.4
Recognizing a heart attack quickly with WEINMANN devices
In recent years, the number of deaths caused by heart attacks has been reduced thanks to improved emergency care and treatment methods: in 1991, 151 people per 100,000 inhabitants died of a heart attack; in 2021, it was just 48.5
Medical devices are being used ever more widely: they guarantee effective patient care and support emergency responders as well as medical staff – including in the most acute emergencies.
With a myocardial infarction, the difference between life and death is measured in seconds. For this reason, the personnel deployed should not only know all about the causes, symptoms and life-saving measures, but should also have the necessary devices to hand so as to provide the fastest and most effective aid possible in acute cases. MEDUCORE Standard² from WEINMANN offers optimum support in emergencies.
MEDUCORE Standard² combines diagnostics, monitoring and defibrillation in one device. The compact monitor/defibrillator has all the options required for further diagnostics, as well as a range of modes, including:
- Oxygen saturation monitoring via SpO2 measurement
- Non-invasive blood pressure measurement
- 6- and 12-lead ECG
Mode for manual defibrillation, including with synchronized shock delivery for cardioversion
- Display and evaluation of preceding diagnostics directly via the display (replay mode)
- Data management and transmission via e-mail, WLAN, Bluetooth® or mobile printer
In acute situations, such as a heart attack, this high-quality monitor system offers reliable patient monitoring. MEDUCORE Standard² enables the emergency services at the scene to carry out further ECG diagnostics and evaluate the data.
The emergency responders can then forward the evaluated data to the hospital quickly and simply in order to check for a suspected a heart attack and initiate the appropriate action for suitable further care.
If the patient requires ventilation, MEDUMAT Standard² and MEDUVENT Standard provide the necessary support. WEINMANN ventilators, with their state-of-the-art functions, ensure reliable ventilation in any emergency situation:
- Demand mode for pre-oxygenation (MEDUMAT Standard² only)
- MEDUtrigger for manual ventilation
- Capnography for CO₂ value measurement and monitoring the tube position (MEDUMAT Standard² only)
- Easy changeover to continuous ventilation
- Ventilation via Volume and Pressure Controlled Ventilation
- Display of pressure and flow curves for easy monitoring
- Monitoring of the expiratory tidal and minute volumes
1 https://de.statista.com/themen/69/todesursachen/#topicOverview
3 https://dgk.org/daten/Herzbericht-Geschlechter.pdf
4 Fortmüller, U. Routinemäßige Sauerstoff-Gabe bei Herzinfarkt erneut als wirkungslos entlarvt. CV 19, 10–11 (2019). https://doi.org/10.1007/s15027-019-1616-z