Posted on 09/09/2006 7:12:02 AM PDT by FairOpinion
Chest pain, breathlessness call for quick action, study finds
"Sudden cardiac death" often isn't all that sudden, and lives can be saved by training people about the symptoms of impending cardiac arrest and what action to take, a German study shows.
"A study of 406 sudden cardiac death patients indicates that they often have symptoms, especially the typical symptom angina pectoris [chest pain] for as long as 120 minutes before an arrest," said study lead author Dr. Dirk Muller, a cardiologist and emergency physician at the Medical Clinic II, Cardiology and Pulmonology, in Berlin.
"Two-thirds of cardiac arrest patients have a history that predisposes them to sudden cardiac death," Muller added, so efforts to reduce the toll should focus on teaching their family members to recognize the symptoms and how to perform cardiopulmonary resuscitation (CPR).
In the study, 72 percent of cardiac-arrest cases occurred at home, and two-thirds were witnessed by others.
The researchers collected information about symptoms preceding cardiac arrest for 323 patients. The most common warning sign was chest pain, which occurred for at least 20 minutes, and, in some cases, for hours, before cardiac arrest. Chest pain occurred in 25 percent of the patients whose cardiac arrest was witnessed by other persons and in one-third of other cases.
Breathlessness was the next most common symptom, seen in 17 percent of witnessed arrests and 30 percent of other cases. Other common symptoms were nausea, vomiting, dizziness or fainting.
CPR was performed on 57 patients, and 13 of them survived to be discharged from the hospital. The survival rate for those who did not get CPR was 4 percent -- 13 of 349 patients.
One notable fact was that CPR was more likely to be performed when cardiac arrest occurred in public cases -- 26 percent of the time, compared to 11 percent of the time when the attack occurred at home.
The study results were expected to be published in this week's issue of Circulation.
There are two significant messages from the study, said Dr. Ann Bolger, a professor of clinical medicine at the University of California, San Francisco, and a spokeswoman for the American Heart Association.
"The first is that people need to be educated about how cardiac symptoms can present," Bolger said. "We always try to encourage people not to discount such things as shortness of breath, things that really should demand a response, because they could be a harbinger of early death.
"The second thing is that the family is important," she added. "Many of these patients have a known history of heart problems. They are not taking us by surprise. We know that one of these things can happen to them, so, it is important to get education that if there is chest pain that does not respond to nitroglycerine, they should call 911. When a patient has active heart disease, I try to make sure that they and their family get basic training about calling 911 and get the emergency medical service on the scene. People who don't get CPR before they get to the hospital have much worse outcomes."
According to the American Heart Association, cardiac arrest is the sudden loss of heart function. The victim may or may not have diagnosed heart disease; the most common cause of death is coronary heart disease.
The AHA estimates that 330,000 Americans die each year from heart disease before reaching a hospital and urges CPR training on a large scale.
More information
For more on CPR, visit the American Heart Association.
Good info. Hope many read it. I had chest pains for three days last year. Figured that I had injured my sternum when antacids didn't relieve it. I drove to the hospital when they would not go away and got worse. I didn't even find it serious enough to even have my wife drive.
An emergency angioplasty and five stents later I now walk 5-7 miles a day and run a mile or two of it when my knees cooperate. On days we don't walk 30-50 miles on the bikes take it's place. 75 pounds less weight and four prescriptions and I feel twenty years younger.
i recently had 2 stents put in my right coronary artery at ava hospital-the doctors emphasized that taking the follow up meds-aspirin,beta blocker,and especially plavix for the recommended time and never skipping a dose was essential to avoiding a heart attack-a lot of people stop taking plavix because of sometimes unpleasant side effects
btt
My money is on "Adrenal fatigue". DHEA once or twice a day goes a LONG way towards regulating that cyclical problem. It is no laughing matter.
Sounds like a possible malpractice issue on the part of that doctor and nurse. Have you considered that?
Hi there - I live just up the road from you two suburbs to the north ;-).
Boy, it just shows how we don't think sometimes. I keep aspirin at home, tho I usually take tylenol and ibuprophen for pain. It never occured to me to add aspirin to my stock of 'just in case' meds I carry around with me.
Thanks for the heads up. I'm giong to add some aspirin to my stash right now.
He died 10 minutes after her arrival, and unfortunately was almost unconscious and was not able to communicate with her.
He was only 66, and our Dad had dropped dead at the age of 64, but Mama didn't want to have an autopsy done at the time of Daddy's death. We encouraged my s-i-l to have one done, not only for the benefit of our three surviving brothers, but also for their four sons! It would be helpful to know if there had been any congenital problems that the others could work around. She had it done, but I've never learned if they found anything in particular which would explain his death.
Before all the testing, when I was having heart palpitations, my regular doctor put me on some medicine that was supposed to prevent palpitations; I had them anyway, so he took me off that. He also put me on Warfarin; I hated the way it made me feel. After the Cardio guy told me there was no disease, I told my regular doc I wanted OFF the Warfarin. I told him I'd take an 81mg aspirin everyday instead, which I had been doing, before the Warfarin. He agreed, and I haven't had any real problems since.
I still have the swelling in the ankles, but the palpitations almost never happen anymore. I'm pre-menopausal, though, and they only usually happened when I was ovulating, so I always though they were hormonal, anyway.
Great! I'm bookmarking it and bumping this thread.:)
"Boy, it just shows how we don't think sometimes. I keep aspirin at home, tho I usually take tylenol and ibuprophen for pain. It never occured to me to add aspirin to my stock of 'just in case' meds I carry around with me."
Careful w/the Tylenol and Ibuprofen for pain. Don't mix them on the same day. They shouldn't be intermixed. Same w/aspirin. Pick one and stay with it. Mixing the different drugs isn't good. Usually on the bottle or box, it says don't take aspirin if taking Tylenol, or vice versa. Or Ibuprofen. Check w/your doc about this or look up on Web MD on interactions.
Thanks. I know about the not-mixing. I use them for different issues. I find the ibuprophen works well for my sinus headaches but does nothing for the arthritis in my hip. Two tylenol, however, do the trick. I was taking prescription strength aleve and getting very little relief. After a chat w/the pharmacist, I tried tylenol and have not had to take anymore prescribed meds for pain. On the other hand, 2 tylenol do not put a dent in my sinus pain.
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