Gaby
Throughout our lives, we encounter heartaches in various forms. Some people experience them from childhood or adolescence, while others may face this uncomfortable state just before menopause. In the first case, doctors often reassure us with, “You’ll grow out of it,” while in the latter, they say, “It will pass.” However, ischemic heart disease (IHD) becomes a more pressing concern as we approach retirement age. What symptoms should raise alarm bells, and how can we distinguish between an angina attack and a heart attack?
The Consequence of Strain
Sharp chest pain during physical exertion or stress is often caused by atherosclerosis and ischemic heart disease, which can lead to angina. Irregular heart rhythms and disruptions in heart function stem from reduced coronary blood flow and are linked to physical activity. A squeezing pain and rapid heartbeat signal that the heart is not receiving enough blood and oxygen.
A stable course without signs of deterioration over weeks characterizes the most common form of IHD—known as stable angina. This condition primarily affects men aged 50-60 (70% of patients) and women aged 65-75. With the right therapy, individuals can live and work without significant limitations, but crisis attacks require immediate medical attention, as they can lead to a heart attack.
Angina Attack
Pain in the heart area typically arises after physical exertion or emotional stress. The nature of the pain is not sharp, cold, or cutting; rather, it is a squeezing sensation. The feeling of pressure behind the breastbone radiates to the left shoulder blade, left arm, and left shoulder, gradually intensifying, especially with breathing. Eventually, the pain becomes unbearable. The patient may turn pale and experience a fear of death. Generally, the painful sensations last from two to four minutes—definitely not exceeding fifteen minutes. Afterward, the pain gradually subsides (in stable angina, the pain eases at rest), and the person complains of severe fatigue and weakness.
During a heart attack, it is crucial to immediately stop any physical activity, lie down on a high pillow or an elevated headrest, or sit in a chair with armrests. The patient should be helped to breathe easier: open a window for fresh air, loosen their collar, and relax their belt.
First Aid
Immediately take acetylsalicylic acid (chew and swallow a 0.25 g aspirin tablet) and place a validol tablet under the tongue; if unavailable, take 30 drops of Valocordin or Corvalol. If you have angina, always carry nitroglycerin: during an attack, place one tablet under the tongue and repeat if the pain persists for more than five minutes. If the attack does not stop even after taking nitroglycerin, this may indicate a myocardial infarction: call for emergency help.
While waiting for the doctor, the patient may faint, so do not leave them alone. Allow the patient to smell a cotton ball soaked in ammonia and position them with their legs elevated: this can help revive them. If there is no heartbeat or breathing, begin cardiopulmonary resuscitation (CPR). If performed by one person, the rhythm is as follows: four breaths, 15 chest compressions, and two breaths. If two people are assisting, alternate five chest compressions followed by one breath. Compress quickly: 60-80 times per minute. Artificial respiration can be done using the “mouth-to-mouth” or “mouth-to-nose” method (through a handkerchief or gauze folded in half).
Actions During a Heart Attack
A likely symptom of a heart attack is a very strong squeezing pain behind the breastbone lasting from 20 minutes to several hours. The chest pain during a heart attack is usually more intense than during an angina attack, and this pain does not subside at rest. Pain that does not relieve with nitroglycerin may radiate to the left side of the chest, left arm, or shoulder blade, as well as the neck and jaw. Additional signs include agitation, sudden pallor, nausea or vomiting, cold sweat, rapid and irregular pulse, shortness of breath, and a fear of imminent death.
Sudden weakness, low blood pressure, dizziness, sweating, severe headache, acute coordination issues, speech or vision disturbances are contraindications for taking nitroglycerin and validol. These first aid medications should not be given to the patient without measuring their blood pressure!
Immediately call for an ambulance and ensure the patient remains calm and has access to fresh air.
To help soothe them, place 30 drops of Valocordin or Corvalol on a piece of sugar and let them dissolve. To reduce the risk of blood clotting, give the patient an aspirin tablet (chew it and wash it down with water). However, do not combine ibuprofen with aspirin: two tablets of analgin can help alleviate pain. If blood pressure remains high, you can give the patient a nitroglycerin tablet under the tongue (0.5 mg capsule). After it fully dissolves, the next tablet can be given after five minutes. This can be repeated no more than three times. If nitroglycerin is unavailable, give validol. In the event of clinical death, it is crucial to begin indirect heart massage until the resuscitation team arrives.
Life Goes On
For those with ischemic heart disease, angina, or after experiencing a myocardial infarction, it is essential to continuously monitor heart rhythm. The optimal pulse rate is 55-60 beats per minute. If angina persists after a heart attack (a common occurrence), lifelong use of nitrosorbide, isoket, or isosorbide-5-mononitrate will be necessary (consult an ophthalmologist regarding medications if you have glaucoma).
To monitor cholesterol levels (the acceptable limit is 5.2 millimoles/liter), blood tests should be done every three months. If cholesterol levels exceed normal, it’s time to say goodbye to fatty and spicy foods—such diets raise cholesterol levels. Opt for plant-based fats over animal fats, and favor vegetables, fruits, cereals, low-fat dairy, fish, and white (chicken) meat. Olive oil, fermented dairy products, and seafood should be consumed at least three to four times a week, while poultry, eggs, and sweets should be limited to once a week. It’s time to part ways with nicotine and alcohol if they were part of your life. Stress also increases cholesterol levels, so it’s important to try to stay calm despite everything.
