How to help someone having a heart attack

Cardiologist Dr. Chi-Ming Chow shares what to do if someone has a heart attack, cardiac arrest or stroke

Cardiologist Dr. Michael Chow with a portable defibrilator unit.

By: Isabel Teotonio Living reporter, Published on Tue May 28 2013

On Sunday, about 13,000 cyclists will participate in Ride for Heart , the largest charity cycling event in Canada. The sold-out event raises funds to support research about heart disease and stroke.

The Star spoke with Dr. Chi-Ming Chow , a cardiologist at St. Michael’s Hospital and spokesperson for the Heart and Stroke Foundation, about what to do if you or someone you know has a heart attack, cardiac arrest or stroke.

He shared why no one should be afraid to do CPR, even if they don’t know how, the difference between a heart attack and cardiac arrest, and why Stayin’ Alive should never be too far from your lips.

The difference between a heart attack and cardiac arrest

During a heart attack, the heart keeps beating. People often have discomfort in their chest that radiates up to the jaw, and a pressure or squeezing pain can radiate down the left arm — or both arms. They may be short of breath, sweating or nauseous.

A heart attack occurs when the coronary arteries that supply the heart with blood are blocked. If blocked for more than six minutes, the heart will be damaged. “If not opened up immediately, either by our own body defence mechanism or mechanically, by coming to a hospital for an angiogram or angioplasty, then permanent damage may set in,” says Chow.

A cardiac arrest is different, because the heart suddenly stops. Between 15 and 30 per cent of heart attacks can progress into a cardiac arrest; others may be caused by inborn structural abnormalities to the heart. Stroke, electrocution, suffocation and drug overdose may also cause cardiac arrest.

People having a cardiac arrest lose consciousness. There is no pulse, and they stop breathing and turn blue. “Usually, it’s very dramatic, because there’s no circulation through the body,” says Chow.

Both require medical attention, but it’s important to know the difference. People who have had a heart attack should get to the emergency room as quickly as possible. If someone’s had a cardiac arrest, it’s important that a bystander performs CPR immediately to get the blood flowing and keep the person alive until medical attention arrives.

How to spot a stroke

Studies show up to 60 per cent of people aren’t familiar with the warning signs for heart attack and stroke.

A stroke may result in problems with speech and vision, facial weaknesses or paralysis and an inability to move one side of the upper arm or lower arm. The person may suffer a severe headache or loss of consciousness.

That’s because strokes are lack of blood supply to the brain, either by a blockage or rupture of a blood vessel. Permanent brain tissue damage starts to set in after six minutes, and it’s crucial to get treatment within three to four hours. Doctors can give a patient a clot-buster to restore circulation.

What to do if you’re having a heart attack or stroke

“With heart attack and stroke — which we call a brain attack — it’s important people recognize the signs and symptoms and call 911 or go to the closest emergency department,” says Chow. Avoid going to the hospital by yourself.

“I’ve had patients who’ve driven with crushing pain in their chest, but they keep driving and they come right into Emergency. It’s important they stop what they’re doing, call 911 and chew an Aspirin,” says Chow.

What to do it you see someone have a cardiac arrest or stroke

About 80 per cent of cardiac arrests occur outside a hospital — often at home or work.

If you see someone has a cardiac arrest, call 911, ask someone to get an AED (automated external defibrillator) and start CPR as quickly as possible.

Don’t know CPR? You’re not alone.

“It’s a conservative estimate, but I would say about 60 to 70 per cent of people (in Toronto) have not attended a CPR course,” says Chow.

There are 40,000 cardiac arrests in Canada each year. The chance of surviving is about 1 in 20. It’s crucial the average person know CPR, because it can increase a person’s chance of survival by 70 per cent.

“The Heart & Stroke Foundation’s main message is: If you don’t know CPR, learn it. And learn how to use an AED,” says Chow.

What to do if you don’t know CPR

CPR has gotten a lot simpler. Check for unresponsiveness, call 911 — have someone get an AED, if possible — and start chest compressions. Push hard — two inches down — and fast in the centre of the chest at a rate of 100 compressions per minute. Think of the rhythm in “Stayin’ Alive” by the Bee Gees—that’s the beat at which you should be pushing.

“There have been studies showing people who played that song in their head performed better CPR in terms of the rhythm,” says Chow.

“There is a possibility of doing it wrong,” says Chow, but “it’s better to do it and try to save someone’s life than not do it. You may break a rib, but it’s better to have broken rib than die.”