Heart Disease

Heart disease is the leading cause of death n India, with one-third of deaths being due to a heart attack, according to a 2008 advisory from the Union government.

It's alarming. Especially because not every heart attack warns you with that squeezing pain in the chest that is typically depicted in the movies. And waiting for the ambulance is not your only option either. Knowing the more uncommon symptoms and emergency aid required could save your life, or someone else's.

The feel of cardiac trouble Pain in the left upper chest, often radiating into the arm, is the classic warning of a heart attack. However, for diabetics and women, these classic symptoms are not common.

"Stomach pain mistaken to be acidity, feeling weak or dizzy, general feeling of unease with sweatiness are some of the lesser-known warning signs," says Sunita Maheshwari, senior consultant, paediatric cardiologist and head of department, Narayana Hrudayalaya, Bangalore.

"Besides clutching at the chest (indicating pain there), other external signs are pallor and sweaty, clammy skin," says Dr Maheshwari. Someone who seems incoherent or confused and displays any of these symptoms could be having a heart attack.

It is important to distinguish between a stroke and a heart attack. Unlike a heart attack, a stroke is neurological (though it may be associated with cardiovascular problems). Because it often causes disorientation (a key symptom), a stroke is even less likely to be recognized by the person experiencing it. Other symptoms to look for in a stroke are "eyeballs moving upwards, jerky movements of one side of the body or face, and drowsiness," says Dr Maheshwari. This calls for an emergency visit to the hospital.

Save yourself: selfmedicate Little-known fact: If it is a heart attack rather than a stroke, you actually need a common over-the-counter medicine even before you get to the hospital.

The immediate thing you can do is take an aspirin, crush it in your mouth and swallow. "Everyone should carry an aspirin tablet in their wallet or purse at all times, and take it themselves or give it to someone suspected of having a heart attack right away," Dr Maheshwari emphasizes. If you are giving it to someone else, try to crush the pill before administering it, in case the person has difficulty chewing or swallowing (nausea and choking are possible sensations during a heart attack).

Also, if no ambulance is available, get someone else to drive you to the hospital. "Ideally, (the patient) should not drive and strain (themselves)," says Dr Maheshwari. Get to the nearest hospital--not necessarily the "best", biggest or one with a specialized cardiac care unit--as time is of the essence in limiting permanent damage.

The initial intervention can be done at even smaller hospitals, and you might actually have a shorter wait before someone attends to you.

Larger hospitals not only require navigating larger distances (the area is bigger, there is usually a lobby to go through, the doctor may be on another floor or ward, etc.) and the sheer number of people arriving there on a daily basis is typically more.

If you're trying to get a possible victim to the hospital, have the person lie/sit still while you drive. If an ambulance is used and an oxygen cylinder is available, give him/her oxygen. Call the hospital ahead to inform them you are bringing someone in, and it looks like a heart attack, so that they have a team on standby and can tell you exactly where to go when you get there.