Deconstructing a Heart Attack

Deconstructing a Heart Attack on

What happens before, during, and after a heart attack

While most people are familiar with the general symptoms of a heart attack – chest pain, shortness of breath, and fatigue, among others – the dynamics of the event aren’t quite so well-known.

Heart attacks cause permanent damage to the heart’s muscle fibers. “Infarction” is when the blood supply to bodily tissues is cut off, causing those cells to die. The medical term for a heart attack is a myocardial infarction (MI). “Myo” refers to muscle.

While a myocardial infarction can lead to cardiac arrest (when the heart stops beating) or heart failure (when the heart isn’t strong enough to support the body), the three conditions are not synonymous.

What exactly is a heart attack?

If you answered with “a blockage to the heart’s arteries, such as a build-up of plaque” you’re partially correct. The most common type of heart attack is just that; however, there’s another variety.

Spasms in the coronary arteries – although uncommon – can restrict blood flow enough to result in myocardial infarction. Severe coronary spasms can be caused by stress, drugs, allergic reactions, smoking, or pharmaceutical interactions with certain health conditions.

What happens during a heart attack

Regardless of the cause, the results of a myocardial infarction, in general, are the same.

Our hearts deliver themselves oxygen and nutrients via an encompassing network of coronary arteries. When one of these arteries becomes clogged or spasms enough to restrict blood flow, it causes a myocardial infarction.

During an MI, nerve signals to the brain can become disrupted, causing what’s known as “referred pain.” The most frequently reported referred pain associated with heart attacks is felt in the left arm.

Angina – pain or discomfort caused by a lack of oxygen – is another symptom to be aware of. When the heart isn’t pumping enough blood to keep muscles functioning properly, muscles in the neck, jaw, and shoulders can become painful.

Other heart attack symptoms include:

  • Tightness and/or pressure in the chest
  • Cold sweats
  • Fatigue
  • Shortness of breath
  • Nervousness
  • Sense of impending doom
  • Trouble sleeping
  • Nausea or abdominal discomfort
  • Acid indigestion-like symptoms
  • Feeling lightheaded or dizzy

If you or someone you’re in the presence of experiences these symptoms, get help immediately.

The road to recovery

Treatments and recovery periods vary based on the patient and any specifics of the attack. For those who make it to a hospital and get treatment, the first two days after a heart attack are the most dangerous. Most patients require between three and five days of care in a CCU (coronary care unit).

After an MI, the heart may not be as efficient as it used to be, thereby causing poor circulation and fatigue. Doctors require patients to rest and eat lightly in the days after a heart attack to allow the heart and body to begin recovery.

Damage to the heart might also disrupt its electrical control. In such cases, a patient might need to have a pacemaker implanted to help the heart maintain a proper rhythm.

For mild to moderate heart attacks, usually, the heart will settle back into a healthy rhythm within two days. From there, physical activity should be gradually increased to rebuild the heart’s strength. At this point, the risk for a second attack becomes significantly less.

What to do if someone is having a heart attack

How witnesses respond to a heart attack victim is often the difference between life and death. Recognizing the symptoms and calling 911 is a crucial first step, but not always enough, especially if the individual goes into the sudden cardiac arrest (SCA).

To learn more about helping a heart attack victim, we encourage you to read our blog, “Heart Attack Safety Begins With knowing What to Do.”

But I Was Only Trying to Help: Do Good Samaritan Laws Cover CPR?

But I Was Only Trying to Help: Do Good Samaritan Laws Cover CPR? on

Every state in the country has Good Samaritan laws. These laws were enacted to protect you if you administer CPR or other emergency help in good faith

It’s a bad scenario. You render aid to someone who’s in distress, possibly saving their lives. The next thing you know, you’re hit with a lawsuit.

In a perfect world where people act with good intentions, this scenario shouldn’t even be possible. You might wonder why anybody who’s been trained to administer first aid and CPR would do it when there’s a possibility of this happening.

Here’s reassuring news. If you’re trained to administer CPR – and you’re delivering it in an emergency situation – you are most likely protected by what’s known as a Good Samaritan law. Here’s what you need to know:

Good Samaritan laws aren’t the same in every state

Every state in the country has Good Samaritan laws. They were enacted to protect you if you administer CPR or other emergency help in good faith. It’s important to note that the information you’re reading here should not be taken as legal advice – especially because Good Samaritan laws vary by state.

Most of these laws, however, cover the same general aspects:

Why you’re acting

Good Samaritan laws protect those of us who selflessly agree to help. This means you’re performing life-saving services like CPR without any expectation of a reward. These laws generally do not apply to medical or emergency rescue staff. These professionals are paid for their services, whereas you’re likely acting out of the goodness of your heart.

Some states have Good Samaritan laws constructed in such a way that your protection may be revoked if you end up being given a reward for your efforts – even when there was no expectation.

Do you need to be certified?

Being certified to perform CPR is, unfortunately, a requirement in some states in order to be protected under their specific Good Samaritan laws. But many states have shown a higher commitment to encouraging their residents to feel comfortable about responding and rendering aid in emergencies.

While it is very important to be properly trained in the CPR technique, survival rates for victims of cardiac arrest are boosted even when someone administers this aid in a less-than-perfect fashion. If anything, this should be the reason that you decide to undergo formal training and receive certification.

The consent requirement explained

You must have someone’s permission to legally provide CPR or other first aid. The loophole is that someone who has gone into cardiac arrest or is otherwise unconscious is unable to provide this consent.

Because every minute counts, Good Samaritan laws generally protect you by permitting you to assume consent would be given to save someone’s life. This may include the use of an automated external defibrillator.

For this reason, you should immediately determine whether someone is conscious. Call out to them and ask, “Are you okay?” Do this even before checking to see if they have a pulse. Even people who aren’t trained in CPR can save a life by performing just chest compressions.

First things first

If you’ve taken a CPR certification course, you know that you should immediately call 911 and report the situation before attempting to render aid unless it’s an infant or small child who isn’t breathing or lacks a pulse; this situation calls for two minutes of immediate CPR. It’s also crucial to make sure both you and the person you’ll assist aren’t in any danger.

The ability to save a life should never be put into doubt by concerns about liability. It’s why all 50 states have Good Samaritan laws in place. Get certified and then keep your CPR certification current – and follow your training in an emergency.

To review Florida’s Good Samaritan Act, click here.

Hands-Only CPR vs. Traditional CPR

Hands-Only CPR vs. Traditional CPR on

Despite the recent approval of the hands-only technique, mouth to mouth is still a crucial element of CPR

The American Heart Association (AHA) recently revised their CPR guidelines to de-emphasize mouth-to-mouth resuscitation. While there are studies backing this decision, it doesn’t mean the technique is no longer recommended.

In general, CPR is the combination of two techniques: rescue breathing (mouth-to-mouth) and chest compressions. Hygienic and other concerns regarding mouth-to-mouth make performing it an obstacle for those not properly trained in CPR. This reluctance, unfortunately, can come at the expense of saving lives.

Something is often enough – and always better than nothing

Incorporating mouth-to-mouth with chest compressions can be difficult even for trained paramedics. For untrained bystanders, the demand can be prohibitive. Regardless of the reason behind not performing mouth-to-mouth, viewing it as a requirement is thought to prevent bystanders from helping at all.

A study led by Dr. Ken Nagao at Tokyo’s Surugadai Nihon University Hospital examined the implications of this failure to respond. Cardiac arrest victims on whom no CPR was applied (approximately 70% of 4,068 incidents) were not only far less likely to survive, their chances of suffering brain damage from the incident increased if they did pull through.

18% of the victims in the study received traditional CPR that included mouth-to-mouth. Those patients saw an improved survival and recovery rate. 11% of those in the study had the chest-compression-only technique applied – and they were 2.2 times less likely to experience brain damage than those who didn’t receive any CPR at all.

Aside from the reluctance to perform rescue breathing, compressions are often all that is necessary – in certain situations. In these cases, the body already has enough oxygen to survive until emergency services arrive, but only if chest compressions are administered.

Infant victims, drownings, and other scenarios in which mouth-to-mouth is still required

The new guidelines are definitely not a one-size-fits-all approach. When cardiac arrest is caused by asphyxiation – a lack of respiration – mouth-to-mouth can be the difference between life and death.

The following are examples of when compression-only CPR is not recommended:

  • Children and infants. In a majority of pediatric cardiac arrests, breathing ceases before the heart stops beating. In other words, asphyxiation causes cardiac arrest, rather than the other way around. Respiratory problems are the most likely cause of cardiac arrest in children and infants –unlike adults, for whom heart problems are typically the cause.
  • Upon discovering a cardiac arrest victim. When someone encounters a person already in cardiac arrest, there’s no way of knowing how long it’s been since their breathing stopped. The body is likely to already be starved of oxygen, therefore, including mouth-to-mouth may improve the chances for resuscitation and recovery.
  • Non-cardiac arrest respiratory failure. Drownings, allergic reactions, asthma attacks, choking – if the heart stops due to a respiratory event, mouth-to-mouth combined with chest compressions can help maintain oxygen levels in the victim’s body.

Training and practice save lives

As those trained in CPR know: the first step is calling for help. After that, it’s time for training to kick in. American Heart Association CPR and AED (automated electronic defibrillator) instruction teach you how and when to perform CPR based on the condition of the patient.

One Beat CPR+AED offers AHA certified CPR and AED courses to South Florida businesses, schools, medical professionals, families, and individuals. To learn more about what’s involved in our AHA–certified classes, we encourage you to read our blog, “CPR Training Demystified”.

CPR for Babies and Children: What You Need to Know

CPR for Babies and Children: What You Need to Know on

Critical knowledge can save a young life

If you’re a parent or someone who takes care of young children, you probably think about their safety constantly. Whether they’re just crawling, taking their first steps, or ready to hop on a bike, you’re filled with a little trepidation about what could possibly hurt them.

This is why it’s always good to plan ahead. And while you may have done plenty of baby-proofing and taken other precautions, would you know how to respond in a real emergency?

According to statistics from the American Heart Association (AHA), over 7,000 children suffer a cardiac arrest outside of a hospital every year. For kids under the age of one, choking and suffocation is the leading causes.

Sadly, only about six percent of infants survive. Those numbers could be much better if parents and caregivers know CPR. It’s important to realize, however, that while similar, CPR for adults isn’t exactly the same as it is for children. Let’s go over the differences:

Before beginning CPR

For someone of any age, the first thing to do is assess the situation and see if they are okay. For adults, you’re supposed to shake or tap them, and you can do the same – although a little more gently – for kids. However, infants should never be shaken. Instead, you can flick the bottom of their feet to get a reaction.

If the person is unresponsive, you’ll need to do CPR. If you’re with someone, have them call 911. However, if you are alone, you will need to start CPR immediately. You should perform it for two minutes on a child or infant before making a call.

CPR steps

1.  Airway management

With the child or infant lying on their back, you’ll want to tilt their head back a little and lift the chin. For 10 seconds or less, listen carefully to determine if the child is breathing. If they’re not, take a look inside their mouth; it’s possible something is blocking their airway. If you don’t see anything, move on to step two.

2.  Mouth-to-mouth resuscitation

When doing mouth-to-mouth resuscitation on an adult, you would pinch the nose and breathe into their mouth. The same is true for children. But because infants are so much smaller, you will need to put your mouth over both their nose and mouth.

For both children and infants, you should first give two rescue breaths. If there is still no response, it’s time for compressions.

3.  Chest Compressions

Compressions for adults and children are pretty much the same; you’ll put the heel of one hand on the center of their chest, the heel of your other hand on top of that one, and lace together your fingers. For smaller children, it may be easy just to use one hand. Do 30 fast compressions, going about two inches deep.

When doing compressions on infants, just use two fingers, placed about one finger length below the nipple line. Do the same number of compressions, but only go about 1.5 inches deep.

4.  Keep going

After the compressions, you’ll give two more rescue breaths and then repeat the process until either the child starts breathing or a trained professional can take over. If you are in an area with an AED, you’ll need to stop performing CPR while that is being administered.

What about hands-only CPR?

Recently the AHA re-examined their CPR guidelines and decided that in many instances, mouth-to-mouth might not be necessary and just doing compressions would be as effective. However, when it comes to children, standard CPR should still be used. This is because a lack of respiration is commonly the cause of cardiac arrest in children and infants, meaning they are likely deprived of oxygen.

Get certified for your family

While familiarizing yourself with the basics can be a big help, getting hands-on training will enable you to know exactly what to do if you need to perform CPR. At One Beat, you’ll be trained by experienced first responders in CPR as well as the use of AEDs.

Take a look at our classes to find a time that fits into your schedule.