One-hour window to limit heart damage

Despite recent lifesaving advances in heart attack treatment, only a small minority of patients get medical help soon enough to benefit, US public health officials say.

They have launched a campaign to get heart attack victims to hospitals more quickly.

There is a window of opportunity in the first hour after a person begins to experience the symptoms of a heart attack for medical treatments to limit the damage, says Dr Claude Lenfant, director of the National Heart, Lung and Blood Institute, part of the US National Institutes of Health.

But only about one in five Americans who have a heart attack gets to a hospital within an hour after the onset of symptoms, Dr Lenfant says. Most wait two to four hours before seeking medical help - and some more than a day.

The American Heart Association president, Dr David Faxon, says 1.1 million people suffer heart attacks annually in the United States, and 40 per cent of the attacks are fatal. Among those who die, half never even make it to a hospital.

"In many cases, the deaths could be prevented if they were treated quickly," Dr Lenfant says.

Dr Lenfant and Dr Faxon have written an editorial the journal Circulation, published by the heart association, calling on doctors to tell patients about the symptoms of a heart attack and what to do if they suffer one.

The most important thing patients can do to save their lives while having a heart attack is to call the emergency telephone number immediately to get an ambulance to the hospital, they say.

Dr Bruce MacLeod, who heads the emergency medicine department at Mercy Hospital of Pittsburgh, says it is vital for people to know the symptoms of a heart attack. He says "the classic symptom" is discomfort or pain in the centre of the chest.

But many people having a heart attack also experience discomfort in the arms, back, neck, jaw and stomach. Some have shortness of breath, break out in a cold sweat, and suffer nausea and lightheadedness.

"Many Americans don't have a realistic view of what actually a heart attack is. Most of what folks think they know comes from the movies and from TV," Dr MacLeod says.

He cites the misleading image of the "Hollywood heart attack" in which a person suddenly falls to the floor with crushing chest pain.

"Most heart attacks don't fit that image.

"Heart attacks usually start slowly, only with mild pain and discomfort. People don't even realise they're having a heart attack," Dr MacLeod says.

"Women are more likely to delay getting help and less likely to believe that they're actually having a heart attack," he says. "But, remember, heart disease is the No 1 killer of women, just as it is for men."

A heart attack is caused by a blood clot that blocks off an artery to the heart. The portion of the heart muscle that gets no blood dies over the next few hours.

"If the blood vessel can be reopened again quickly, then that heart muscle does not die - or only a small portion of that heart muscle dies," Dr MacLeod says. "So heart attacks can be made smaller, less dangerous, by opening up the artery as soon as the symptoms occur."

- REUTERS

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