Section 1: Questions about Heart Attacks

The Early Heart Attack Care (EHAC) program is designed to educate the public to the earliest warning signs of heart attack.  These symptoms can be non-specific or specific.


  • Chest discomfort
  • Chest pressure
  • Chest ache
  • Chest burning
  • Chest fullness


  • Weakness
  • Sweating
  • Nausea
  • Dizziness

These mild symptoms may herald the onset of a heart attack.  Early recognition and response can save lives.  Don't wait until chest pain becomes severe. At the first signs of chest discomfort, seek medical attention.

1. What do we know about heart attacks?
It is the number one killer of the adult population in the United States. There are over 800,000 deaths each year from cardiovascular disease.

2. What causes a heart attack and why do people die?
Consider the heart as a pump and a great pump with tremendous reserve capacity. It is a muscular pump and as such needs a blood supply with nutrients to survive. There are three major blood vessels supplying it. When blockage takes place, there is interference of blood supply and the muscle supplied by the blocked vessel easily dies. This damages the pump and we either die or live with less of a pump and become less of a person.

3. What causes the blockage?
A disease called atherosclerosis or "hardening of the vessels." Our life style allows the risk factors such as hypertension, cholesterol and cigarette smoking to incubate over a long period of years leading to a 90 to 95 percent cholesterol plaque which finally ruptures allowing a clot and spasm to close the vessel. Within six hours there is usually total damage.

4. Can heart attacks be helped?
Yes, it can be helped. Risk factor reduction during the incubation stage can reduce heart disease. What we need is the identification of a risk factor when the heart attack is starting. Chest pain is the main risk factor and we have to understand it. Let's put this under a microscope and look at what is taking place.
Over time plaque builds up in the areas that feed blood to the heart. When the plaque tears away or ruptures, it creates a hole. The body immediately begins to repair itself by clotting in order to heal the tear. But as the clot gets bigger and bigger, it blocks the heart from getting blood flow. Without blood, the heart begins to die.
The sequence in most cases is: chest discomfort which leads to chest pain which leads to unstable angina worsening which leads to damaging myocardial infarction which leads to sudden death.
Before chest pain there is in most cases a milder form of chest discomfort that is centrally located coming and going that may be present for hours and/or days before the chest pain becomes severe and does not go away. The real problem of the heart attack situation lies here, in that patients don't come into the hospital until the crash takes place. The early symptoms are called prodromal and can be likened to the prodromal symptoms of a cold.
If it is treated early, prevention can take place, and namely, sudden death and cardiac damage can be averted.

5. What kinds of heart attacks are there and how can I help?
There are actually three presentations of a heart attacks and if you are the first person upon the scene, you are called the first responder. The first responder is the good samaritan who performs CPR, calls 911 or convinces a potential victim to get medical help as soon as possible.
Type 1: The heart attack stops you dead in your tracks. This is called the CPR scene. In the first type of heart attack, we need to know cardiopulmonary resuscitation (CPR) and perform it well.
Type 2: A heart attack where damage is taking place (the six hours we have talked about). The patient is experiencing the Mack truck sitting on his chest. Call 911 and behave as an executive spouse because the patient usually does not put up much of a fuss, is in severe pain and is weak like a kitten.
Type 3: The heart attack is just beginning and EHAC provides a beneficial impact. This is the most difficult time to get someone to seek medical care. The victim will normally complain, but then excuse it as food poisoning or gas. The patient has minimal symptoms but is practicing maximal deniability. The patient to first responder interaction can be frustrating. The patient may be embarrassed or wants to ignore it. At this point, they can convince the first responder to contribute to the denial. Even paramedics find it difficult to convince a conscious patient to go to the hospital. This is the reason why the heart attack remains the number one killer of the adult population.

6. Is there a secret to working out the problem? How can it be turned around?
The first responder (or bystander) has to become knowledgeable and know that the time to help the patient is when the heart attack is in the beginning stages. Be prepared to argue for the patient to seek out an early check up in an emergency room. It is important to be active or proactive and be heart smart. A Good Samaritan will solve the problem with their timely actions.

7. Why is denial such an important part of the unraveling of the heart attack problem?
Because it is part of our lifestyle. We constantly forget about ourselves and live our lives as if we are indestructible or immortal, and only are brought to reality when we are taken to our knees. However, we can minimize the damage and change the outcome. A heart attack - even in its infancy stages - is a great transformer and a great reality check. The secret is to nip it when it is in the beginning stage, i.e., chest discomfort before the severe damage or the sudden death.

8. How can I help someone?
We review several strategies in Section 3 of this document, but a great tip to remember is that the faster someone receives medical care, the better chance they have to regain their full life. If someone manages to survive a heart attack, their life is forever changed and they have a slim chance of living the life they once enjoyed.

9. Any final words?
Yes, I ask people if they were to develop a blockage in one of their heart vessels, what scenario would they like to be in and have action taken? Pumping on the chest for a cardiac arrest victim, helping a patient with a Mack truck sitting on his chest and trying to get him into the hospital or perhaps encouraging a patient with minimal symptoms to have it checked out - to be safe rather than sorry. Several hours here can make the difference between a pleasurable and enjoyable life versus no life or cardiac invalidism. Be alert, be active, be heart smart - be an Early Heart Attack Care provider.

Lesson for 2: Why Don't Patients Come in Early?

Listen to Your Heart!

  • Heart attacks need not kill or destroy heart muscle if you listen when your body is trying to tell you something.
  • Be aware of a pressure - not necessarily pain - in the chest. If it subsides when you rest, but increases with activity, it is your warning of a heart attack. Quick treatment by experts can stop it.
  • Get medical help as soon as possible. Go straight to the nearest hospital emergency room. And don't try to rationalize it away as something else. Your body knows what it is talking about.
  • Delay in seeking medical attention is the real risk factor. It is more important than cholesterol, smoking or other risk factors.
  • Early Heart Attack Care is knowing the subtle danger signs and symptoms and acting upon them before damage occurs.
  • By listening to your heart, many heart attacks might be prevented.