A) Always keep ready (i) Phone Nos of nearest Cardiac Ambulances and Hospitals (ii) Nitroglycerine (Angised) or Sorbitrate tablets (iii) Aspirin tablets
B) Symptoms of heart attack are pain in the chest, pain radiating from chest to left arm, shortness of breath and cold sweats. However, nearly half of all heart attacks are of the 'silent' type with no obvious symptoms, but the outcome can be equally risky.
C) Learn Cardio-Pulmonary Resusciation (CPR). This is a procedure of rapid chest compressions for manually pumping blood through the heart and thus the body.
D) At any time, if symptoms are as per 'A' above, make the person sit, loosen clothing and keep the Nitroglycerine or Sorbitrate or Aspirin tablet under the patient's tongue. If the patient is not breathing, carry out Cardio-Pulmonary Resuscitation (CPR).
E) Simultaneously, phone up the Ambulance service and ask them to send a Cardiac Ambulance immediately. If the patient has consulted any Cardiologist earlier phone him too. Call the Hospital through the Cardiologist or directly and ask for an ICCU bed.
F) To the Hospital, the patient should not drive or travel in a taxi or autorickshaw. The patient should also not walk. It is important that he or she is shifted from home to the Hospital in a stretcher carried by the Ambulance staff.
G) Until the Cardiac Ambulance arrives, keep the patient calm. Do not allow the person to speak.
H) Inside the Cardiac Ambulance while it is on the way, the Doctor and staff on board will hook up the patient to the medical equipment and attend on him or her continuously. Ideally, a close family member should travel in the Ambulance.
I) The family member travelling to the Hospital either with the patient in the Ambulance or separately, must be able to pay on arrival at the Hospital the deposit amount in cash or by means of a credit card. Private Hospitals in Indian metros need a deposit of Rs 50,000 or more.
J) As soon as the Ambulance arrives at the emergency entrance of the Hospital, the patient will be shifted by the Ambulance staff to ICCU. It must be ensured that admission of the patient is not held up due to paperwork and formalities.
K) After arrival at the Hospital, ECG as well as high-sensitivity Troponin I marker test would be carried out on the patient, in order to confirm or rule out heart attack. Heart attack is confirmed if the cardiac Troponin concentration is more than 5 nanogram per decilitre and in that case, patient is administered blood-thinning medication.
L) An Angiography is conducted within the shortest number of days and based on the extent of blockages, the hospital may decide on an Angioplasty or a Bypass Surgery.
M) If Angioplasty is to be done, the patient has the option of choosing a bio-degradable stent (BVS) or a drug-eluting metal stent. 'BVS' is much more expensive but dissolves in 2-3 years leaving no metal product in the artery.
N) Angiography and Angioplasty are conducted by a Cardiologist in the Hospital's Cath Lab, whereas Bypass Surgery is performed by a Cardiac Surgeon in the Hospital's Operation Theatre.
O) Finally, remember that survival chances are very good if treatment is received within an hour of the heart attack, the so-called "Golden Hour".