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Don’t Miss a Beat in Seeking Treatment

Do you know the warning signs of a heart attack? In a survey reported by the CDC, 92% of respondents recognized chest pain as a symptom of a heart attack. However, only 27% were aware of all major symptoms ─ chest pain or discomfort; upper body pain or discomfort in the arms, back, neck, jaw, or upper stomach; shortness of breath, nausea, lightheadedness, or cold sweats ─ and knew to call 9-1-1.

Chances of survival are greater when emergency treatment begins quickly so don’t miss a beat! Dr. Suraj Kurup, cardiologist at Health Central, explains what may occur should you arrive at the emergency department with chest pain.

Immediate Tests

  • Electrocardiogram (ECG or EKG) records the electrical activity of the heart through electrodes attached to the skin. Because injured heart muscle doesn’t conduct electrical impulses normally, the EKG may show that a heart attack has occurred or is in progress.
  • Blood tests check for increased levels of certain enzymes normally found in heart muscle. Damage to cells from a heart attack may allow enzymes to leak into your blood.
  • Chest X-ray checks the condition of lungs and the size/shape of the heart and major blood vessels.
  • Computerized tomography (CT scan) is used to look for blood clots in the lungs (pulmonary embolism) or an aortic dissection.

Cardiac diagnostic measures are executed in a timely manner. For example, according to Rita Lewis, RN, Clinical Program Coordinator, patients who present to the Health Central ER with chest pain will complete an EKG within 10 minutes and blood work within 60 minutes of arrival. If the EKG is abnormal, treatment immediately follows.

Possible Follow-up Testing

  • Echocardiogram uses sound waves to produce a video image of the heart in motion. A small device may be passed down the throat to obtain better views of the heart.
  • Computerized tomography (CT scan) can be used to check arteries for signs of calcium, which indicate areas where plaque blockages have accumulated. Scans can also be done with dye to check for blockages and other problems.
  • Stress tests measure how the heart and blood vessels respond to exertion, which may indicate if chest pain is related to the heart. You may be asked to walk on a treadmill or pedal a stationary bike while hooked up to an EKG. Or, you may be given a drug intravenously to stimulate your heart in a way similar to exercise.
  • Coronary catheterization (angiogram) helps doctors identify individual arteries to the heart that may be narrowed or blocked. A liquid dye (which becomes visible on X-ray) is injected into the arteries through a catheter — a thin tube that’s fed through the wrist or groin to the heart.


Certain treatments are usually initiated right away if a heart attack is suspected, even before the diagnosis is confirmed, such as aspirin (to prevent further blood clotting), nitroglycerin (to reduce heart’s workload and improve blood flow), and oxygen therapy.

Once a diagnosis of a heart attack is confirmed, doctors begin to try to restore blood flow through the blood vessels supplying the heart. The two main treatments are clot-busting medicines and coronary angioplasty, a nonsurgical procedure that opens blocked or narrowed coronary arteries using a catheter with a balloon that is inflated to compress the plaque against the artery wall. During the procedure, a small mesh tube (stent) may be placed to keep the vessel open.

Other treatments following a heart attack may include medicines (ACE inhibitors, anticlotting medicines, anticoagulants, beta blockers, statin medicines); medical procedures (bypass); heart-healthy lifestyle changes (diet, exercise, smoking cessation, stress and weight management, etc.), and cardiac rehabilitation.

New Medication

Entresto tablets, approved this past summer by the U.S. Food and Drug Administration, have been shown to reduce the rate of cardiovascular death and hospitalization related to heart failure. Heart failure is a common condition, affecting about 5.1 million people nationwide, in which the heart can’t pump enough blood to meet the body’s needs.

“Heart failure is a leading cause of death and disability in adults,” said Dr. Kurup. “Heart failure is typically caused by heart attacks or high blood pressure, which can damage the heart, and it generally worsens over time as the heart’s pumping action grows weaker. Treatment can help people with heart failure live longer and enjoy more active lives.”

Heart Attack Symptoms

  • Squeezing, heavy chest pain behind breastbone, especially with:
    • Exercise or exertion
    • Emotional stress
    • Cold weather
    • A large meal
    • Quick onset
  • Pain in shoulder, arm, or jaw
  • Shortness of breath
  • Sweating, clammy skin
  • Nausea
  • Weakness
  • Loss of consciousness
  • Anxiety, especially feeling a sense of doom or panic without apparent reason

Other symptoms ─ usually more common in women:

  • Stomach pain
  • Back pain
  • Confusion
  • Fainting

Sources: Centers for Disease Control and Prevention (CDC), Health Central, Mayo Clinic 

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