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Heart attack? Stroke? How will you know?

Health Matters

Hundreds of thousands of people in the United States will have a heart attack or stroke this year. Many will not make it to the hospital in time to receive lifesaving treatment, sometimes because they did not recognize the symptoms or waited too long before seeking medical assistance.

Heart disease is the No. 1 cause of death in the United States with stroke being the No. 4 cause of death. However stroke is the leading cause of disability in adults in the US.

This is why it is crucial to immediately seek medical attention if you think that you or someone with you might be having a heart attack or stroke. Treatment is available that in many cases can save lives and reduce disability by reducing permanent damage to the heart or brain.

A heart attack, also called a myocardial infarction, occurs when blood flow to a portion of the heart muscle is severely reduced or cut off completely. This usually occurs when the coronary arteries, which supply blood flow and oxygen to the heart muscle, slowly get thicker with a combination of fat, cholesterol, and other substances called plaque.

If this plaque breaks, blood clot forms around the plaque, blocking off the blood flow to the heart muscle. If the artery stays closed long enough, that part of the heart muscle is damaged and results in a heart attack.

The most common symptoms associated with a heart attack include chest pain or discomfort (pressure, squeezing, or fullness), pain or discomfort in the jaws, shoulders, arms, neck or back, shortness of breath, nausea, sweating or lightheadedness.

All of these symptoms do not need to be present and can occur in any combination. If you have these symptoms, even if you are not sure it is a heart attack, getting to a hospital as soon as possible is crucial. If you really are having a heart attack, the sooner you get to the hospital, the better chance that treatment can be started that limits the amount of heart muscle damage and maybe saves your life.

The fastest and safest way to get to the hospital is almost always calling 9-1-1. Emergency medical services staff can begin treatment right away, monitor heart rhythm and vital signs on the way to the hospital and communicate with the emergency department at the hospital so that they are ready to evaluate and treat you when you arrive.

A stroke occurs when a blood vessel leading to or within the brain is either blocked by a clot or bursts. When this happens, that part of the brain does not receive the blood and oxygen that it needs to function and starts to die.

Depending on which part of the brain is involved and the amount of damaged brain tissue, the resulting disability can include difficulty with speech, vision, or memory, or paralysis. Warning signs include sudden numbness or weakness of the face, arm or leg, especially on one side of the body, sudden confusion, trouble speaking or understanding, sudden difficulty seeing, sudden trouble walking or loss of balance, or sudden severe headache with no known cause.

If these symptoms occur, immediately call 9-1-1 so that trained emergency staff can quickly provide transport to the hospital. For certain types of strokes, there is a clot-busting medication called tissue plasminogen activator, or tPA, which when given within 3 hours of the onset of symptoms, may reduce long-term disability.

CMC Lincoln is an accredited chest pain center, which has the ability to determine whether you are having a heart attack. People having a certain type of heart attack may need immediate transfer to a cardiac catheterization laboratory where the blocked artery can be opened. Diagnostic tests and treatment can be initiated at CMC Lincoln with emergency helicopter transport to CMC Main in Charlotte for patients requiring emergency cardiac cath.

CMC Lincoln is also part of Carolinas Stroke Network. Diagnostic testing in the emergency department can determine whether you are having the type of stroke that can be treated with tPA. If so, the medication can be started in the emergency department and emergency transfer to CMC Main in Charlotte can be arranged for specialized stroke care.

Further information about heart attack and stroke can be found at www.heart.org .

Dr. Karen G. Cloninger works with the Sanger Heart and Vascular Institute at Carolinas Medical Center-Lincolnton.


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