Heart conditions
Cardiovascular disease is a term which describes disease to the heart and blood vessels, including stroke. According to the Heart Foundation, cardiovascular disease is the leading cause of death in Australia, accounting for 38% of all deaths in 2002; claiming the lives of more than one in three Australians.
Coronary artery disease is the greatest single cause of death among Australians, followed by stroke. The heart is a muscular pump, approximately the same size as its owner's fist and is located behind and slightly to the left of the breastbone. The heart pumps blood to all parts of the body. The blood provides the body with the oxygen and nourishment it needs to function. Waste products carried by the blood are removed from the body by the kidneys and lungs.
The body contains about five litres of blood, which passes through the heart about every minute. When necessary, such as when exercising, the heart can pump up to four times that amount per minute. A network of blood vessels carries the blood pumped by the heart around the body. The heart and blood vessels together make up your circulatory system.
Due to factors such as lack of exercise, poor diet, advanced age and chronic disease, the heart is sometimes compromised and serious cardiac conditions develop. The four major conditions are: angina, heart attack, heart failure and cardiac arrest.
Chest pain
Chest pain can be one of the most difficult observations to make as every person has a different 'pain threshold'. Always ask open questions such as "can you describe your pain to me", not "does your pain feel sharp".
Pain can be described as squeezing, crushing, vice-like, heavy, dull, sharp, pressure and many others. Cardiac pain is usually in the centre of the chest or behind the breastbone. The pain may spread or radiate to the shoulders, neck, jaw and/or arms.
Heart attack
A heart attack occurs when a coronary artery is suddenly blocked by a blood clot and the part of the heart muscle supplied by that artery is damaged due to lack of oxygen. Also known as a coronary occlusion or myocardial infarction, a heart attack can occur at any time, at any age.
With heart attack, every minute counts. If the warning signs are present, do not waste vital moments wondering whether it is a heart attack or not. Take immediate action.
Fatty deposits called plaque build-up inside blood vessels and reduce the blood flow. In some cases the plaque builds up so the vessel is blocked completely. Reduced blood flow can also allow a clot to form and the clot block the vessel. When a blockage occurs, oxygen is not delivered to the heart and part of the heart muscle dies. Blockage can occur in one or several coronary arteries.
Certain people are at greater risk, due to factors such as hereditary influence, lack of exercise, and smoking, poor diet and high blood pressure. Urgent medical attention is vital.
Signs and symptoms
Angina and heart attack have very similar signs and symptoms:
- Pale, cool skin
- Sweating
- Rapid, irregular or weak pulse
- Rapid, shallow respirations or difficulty breathing
- Chest pain or discomfort, usually in the centre of the chest, may spread or radiate to the shoulders, neck, jaw and/or arms
- Nausea and/or vomiting
- Collapse
Care and treatment
- Call Triple Zero (000) for an ambulance
- Rest the casualty in a position of comfort, usually sitting
- Assist the casualty to take their medication (nitro-glycerine tablets or spray)
- Reassurance
- Monitor vital signs
- If advised by medical direction, give casualty an aspirin tablet and have them chew it slowly, unless it is known the person has been advised not to take aspirin.
Angina
Angina Pectoris (literally 'pain in the chest'), is a condition caused by constriction of the blood vessels supplying the heart muscle with blood. The chest pain or discomfort is due to a reduction of blood supply to the heart.
Angina has very similar signs and symptoms to a heart attack. Some casualties do not feel 'pain', just an unpleasant sensation or discomfort in the chest. Angina will usually occur when the heart has to work harder than normal, such as during exercise or in response to stress. It does not occur all the time because the blood supply, although reduced, is usually able to keep up with the heart's normal demands.
Angina is usually relieved by rest. When rest alone does not bring rapid or effective relief then the use of nitro-glycerine tablets or spray is often needed. The pain or discomfort is usually relieved within a couple of minutes, however, if symptoms last more than 10 to 15 minutes, call an ambulance and treat the casualty as if for a heart attack.
Signs and symptoms
Angina and heart attack have very similar signs and symptoms.
- Pale, cool skin
- Chest pain or discomfort, usually in the centre of the chest, may spread or radiate to the shoulders, neck, jaw and/or arms
- Sweating
- Rapid, irregular or weak pulse
- Breathlessness
Care and treatment
- Call Triple Zero (000) for an ambulance
- Reassure and rest the casualty in a position of comfort, usually sitting
- Assist the casualty to take their medication (nitro-glycerine tablets or spray)
- Monitor vital signs
- If, after three tablets or sprays over 10 - 15 minutes, the pain does not diminish, then the condition should be considered a heart attack.
Heart failure
Heart failure occurs when the heart is unable to perform its proper function, blood and fluid collects around the lungs and in the body. The casualty finds it difficult to breathe and swelling of the ankles and legs occurs as fluid pools in the extremities.
Sign and symptoms
- Pale, cold, clammy skin
- Chest discomfort, difficulty breathing
- 'Bubbly', gasping breaths
- Frothy sputum
- Swelling of the extremities, especially the ankles, which may show 'dimples'
- Partial collapse
Care and treatment
- Call Triple Zero (000) for an ambulance.
- Rest, position of comfort, usually sitting
- Reassurance
Do not elevate legs.
Heat and cold emergencies
The human body maintains a temperature between 36-37ºC. Any excessive variation to this range has a detrimental effect on body functions. As a general observation, the human brain does not react well to excessive body heat and the heart is sensitive to cold.
The body has some natural defence mechanisms against excessive heat and cold. It regulates body heat by sweating, releasing heat through the body surface (heat loss) and through lung moisture evaporation. Cold is managed by shivering, which generates heat within the body.
Often, environmental influences determine the stability of the human body's temperature. These influences are important in relation to first aid. Heat and cold related conditions may bring on serious functional impairment. Heat related conditions are those brought on by exposure to high temperatures and humidity.
The most spectacular example of a serious heat related problem is the televised distress suffered by athletes during long distance running events, conducted during hot and humid conditions.
Heat may induce heat cramps, heat exhaustion and/or heat stroke. Less well known are industrial and engine room situations which can mimic tropical conditions while outside temperatures are actually much lower.