How to Foil Death by Heart Attack

February 2013


This article was contributed by Dr. Raymond Bahr, Cardiologist & a founder of the Society of Cardiovascular Patient Care

Death is inevitable and we all face it sooner or later. We try our best to avoid it and we position ourselves to extend life by doing what is right for our bodies. Death that comes early in life is not fair because none of us want to be cheated out of what life has to offer. What most people do not know is that one has to prepare for conditions that take life unexpectedly. We don't always win when we plan, but we can reduce the risk of having death occur.
The number one cause of death in the United States is having a heart attack and then arriving too late at the hospital. Each year some 800,000 Americans will succumb to this tragedy. The major reason is that we have allowed heart attacks to be a crashing presentation to the emergency room of the hospital.
"What you don't know will wind up killing you," is a quote from the past. The corollary to this is "what is it that we don' t know that can help us prevent the kill?" This is a good first point to start our exploration. We need information to start preparing a plan to offset death. When you rent a hotel room for the night, the first thing you see when when you close the door is the instuctions on the back of the door in case there is a hotel fire. You should know that your chances of dying from a heart attack are far greater than dying from a hotel fire. If you believe in preparing for an unexpected emergency, then my second point is that you should have a plan for an unexpected heart attack.
What information is out there? Well, we do have a plan if you experience a cardiac arrest. We can do Cardiopulmonary Resuscitation (CPR). The American Heart Association has put together "The Chain of Survival" to help you negotiate through this process and get the patient to the nearest hospital as soon as possible. Furthermore, the American College of Cardiology and the American Heart Association have made great efforts to get the crashing chest pain patient into the hospital and the Cardiac Catheterization Lab to have the blocked coronary vessel opened as soon as possible (also known as door-to-balloon time).However, the third point that you need to know is that CPR and reducing door-to-balloon times are efforts to deal with a heart attack as a crashing illness.
Perhaps, the fourth point and most important piece of information available to you is the fact that "heart attacks have beginnings" that occur at some time before the crash and that these beginnings can be recognized and thus be acted upon, and even better have a pathway in the hospital such as a Chest Pain Center that is set up to manage patients with such early presentations. Such early intervention can prevent death from occurring. Death can be foiled and life extended.
How can we as a nation come together and reduce significantly heart attack deaths in the United States? We need to plan ahead and have our hospitals set up and give priority to patients in the community presenting with early but recognizable symptoms of a heart attack. We need to add this Early Heart Attack Care (EHAC) education to all existing CPR/ACLS Programs that are being taught in the hospitals and in the communities. We need to convert crashing heart attack care to early heart attack care. As stated above,"what you don't know will kill you" is now left up to you to decide what you need to know to prevent your unexpected heart attack death when your heart is too good to die.
Action Step: New Year Resolution Number One: Get your hospital to become part of the solution to significantly reduce heart attack deaths in the United States by adding the Early Heart Attack Care Education (EHAC) to existing CPR/ACLS programs being taught at your hospital. The importance of this can not be overstated enough. Get busy in doing so! Contact me if you need help in convincing your administrator.

Best of Luck in Saving a Life,
Raymond D.Bahr MD