Doctor: Americans still too slow in responding to heart attack

Updated 12:00 noon February 16, 2004

Doctor: Americans still too slow in responding to heart attack

By Kara Gavin
UMHS Public Relations

What would you do if you started feeling chest pains right now, or if someone around you suddenly felt short of breath?

If you're like most Americans, you might wait it out for an hour or two, just to see if the symptoms go away. But that's just about the worst way to react to such symptoms, says a U-M heart expert. They could be caused by a heart attack—and if so, every minute of delay may mean the difference between life and death, or between health and disability. Many treatments work wonders, but only if given soon after an attack.

Instead of waiting, says Cardiovascular Center heart attack specialist Dr. Eric Bates, patients at risk for heart attack should call 911 and get emergency help immediately for any symptoms such as chest pain, arm or shoulder pain, shortness of breath, fatigue, abdominal pain or nausea.

In fact, he says, you should wait no longer than five minutes before calling for help. Even if the symptoms turn out to be unrelated to your heart, it's better to play it safe.

Most of the 1.1 million Americans who suffer a heart attack each year go for hours without getting help, Bates says, because they're not sure what is happening to them, or they don't want to "make a fuss." Often they try to get to the hospital on their own, rather than taking an ambulance, which would speed up their arrival and treatment.

You should wait no longer than five minutes before calling for help.

As a result, more than 200,000 Americans each year die before they even get to the hospital, and many more doom themselves to permanent, serious health problems, says Bates, a member of the national heart attack guidelines committee. If only they had reached the hospital sooner, they might have gotten clot-buster drugs, angioplasty, or other modern, fast-acting treatments that stop damage to the heart muscle.

"The speed with which a patient seeks treatment is critically important, because most of the risk of a heart attack occurs within one hour of the start of symptoms," he says. "The problem is that most patients wait two hours or more to seek medical attention, so most heart attack deaths occur before the patient gets to the hospital."

The risk of death from a heart attack is highest in the first hour after symptoms begin—and modern treatments give the best results if they're given in that same first hour. Some heart attacks even can be stopped entirely if they're treated quickly.

"As soon as the ambulance team arrives, you're relatively safe," says Bates, a professor of cardiovascular medicine at the Medical School. "But if you're transporting yourself by car, or waiting two hours before you call an ambulance, you're at risk for dropping over dead from cardiac arrest. And after three hours, the heart is damaged to the point where there's not much heart muscle that can be salvaged."

Bates and his colleagues on the national heart attack guidelines panel hope to publish their recommendations late this spring.

Doctor: Americans still too slow in responding to heart attack

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