HEART PROBLEMS   HEART PROBLEMS  HEART

Heart Anatomy

The Heart is a pump which pushes blood around the body. The blood carries food, water and oxygen (air) to all the cells of the body and removes waste products.

The circulatory system consists of:   Blood, heart, arteries, veins and capillaries                              When the heart is pumping, we can feel a PULSE  We find the pulse in the ARTERIES      Position of heart inside chest cavity
We can measure the pulse by: RATE - the number of beats per minute. STRENGTH - strong or weak. RHYTHM - regular or irregular. Average ADULT pulse - 60-90 beats per minute. Average CHILD pulse - 70-110 beats per minute. Average INFANT pulse - 70-120 beats per minute.
	ECG used to measure activity of heart               4 chambers of the heart

Pulse rate increases with:                 

Exercise - excitement - illness. Doctors use an  electrocardiogram to measure the electrical activity of the heart. Changes in the read out indicate heart problems. Radioactive or contrast dyes are used by radiographers and cardiologists to show occlusions in the cardiac blood vessels. Echo cardiograms can show changes as well.

Risk Factors

What are the major risk factors that can't be changed?

What are the major risk factors you can modify, treat or control by changing your lifestyle or taking medicine?

Tobacco smoke — Smokers' risk of developing coronary heart disease is 2–4 times that of nonsmokers. Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease; smokers have about twice the risk of nonsmokers. Cigarette smoking also acts with other risk factors to greatly increase the risk for coronary heart disease. People who smoke cigars or pipes seem to have a higher risk of death from coronary heart disease (and possibly stroke) but their risk isn't as great as cigarette smokers'. Exposure to other people's smoke increases the risk of heart disease even for nonsmokers.

High blood cholesterol — As blood cholesterol rises, so does risk of coronary heart disease. When other risk factors (such as high blood pressure and tobacco smoke) are present, this risk increases even more. A person's cholesterol level is also affected by age, sex, heredity and diet.
High blood pressure — High blood pressure increases the heart's workload, causing the heart to thicken and become stiffer. It also increases your risk of stroke, heart attack, kidney failure and congestive heart failure. When high blood pressure exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times.

Physical inactivity — An inactive lifestyle is a risk factor for coronary heart disease. Regular, moderate-to-vigorous physical activity helps prevent heart and blood vessel disease. The more vigorous the activity, the greater your benefits. However, even moderate-intensity activities help if done regularly and long term. Exercise can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people.

Obesity and overweight — People who have excess body fat — especially if a lot of it is at the waist — are more likely to develop heart disease and stroke even if they have no other risk factors. Excess weight increases the heart's work. It also raises blood pressure and blood cholesterol and triglyceride levels, and lowers HDL ("good") cholesterol levels. It can also make diabetes more likely to develop. Many obese and overweight people may have difficulty losing weight. But by losing even as few as 10 pounds, you can lower your heart disease risk.
Diabetes mellitus — Diabetes seriously increases your risk of developing cardiovascular disease. Even when glucose levels are under control, diabetes increases the risk of heart disease and stroke, but the risks are even greater if blood sugar is not well controlled. About three-quarters of people with diabetes die of some form of heart or blood vessel disease. If you have diabetes, it's extremely important to work with your healthcare provider to manage it and control any other risk factors you can.

What other factors contribute to heart disease risk?

Stress — Individual response to stress may be a contributing factor. Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life, their health behaviors and socioeconomic status. These factors may affect established risk factors. For example, people under stress may overeat, start smoking or smoke more than they otherwise would.

Alcohol — Drinking too much alcohol can raise blood pressure, cause heart failure and lead to stroke. It can contribute to high triglycerides, cancer and other diseases, and produce irregular heartbeats. It contributes to obesity, alcoholism, suicide and accidents. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women or two drinks for men per day) is lower than in nondrinkers.

Angina
- poor supply of blood to the heart muscle.

Symptoms
- pain warning on exercise or excitement.
- breathlessness.

Casualty Management
- rest and reassure the casualty.
- loosen tight clothing.
- call for medical aid.
- encourage casualty to take heart tablets if they say they have them.

IF PAIN PERSISTS
- it could be a HEART ATTACK.

Heart Attack - Acute Myocardial Infarction - Death of part of the heart muscle

Heart attack and stroke are life-and-death emergencies -- every second counts. If you see or have any of the listed symptoms, immediately call 0-0-0. Not all these signs occur in every heart attack or stroke. Sometimes they go away and return. If some occur, get help fast! Today heart attack and stroke victims can benefit from new medications and treatments unavailable to patients in years past. For example, clot-busting drugs can stop some heart attacks and strokes in progress, reducing disability and saving lives. But to be effective, these drugs must be given relatively quickly after heart attack or stroke symptoms first appear. So again, don't delay -- get help right away!

Heart Attack Warning Signs
Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

• Chest discomfort. Most heart attacks involve discomfort in the centre of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.   

• Shortness of breath. May occur with or without chest discomfort.  

• Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness    

Deposits in cardiac arteries

As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

If you or someone you're with has chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help. Call 0-0-0... Get to a hospital right away.

Calling 0-0-0 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive -- up to an hour sooner than if someone gets to the hospital by car. The staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.

Casualty Management
- rest and reassure the casualty.
- call for URGENT medical aid. Send for the ambulance.
- if ambulance likely to be delayed for 30 minutes or more.
- give 300mg of Aspirin in water (unless allergic to aspirin, asthmatic or on anticoagulants).

Remember - A CASUALTY WITH CHEST PAIN USUALLY PREFERS TO SIT UP IF CONSCIOUS.

Cardiac Arrest           

Sudden death - pump stopped

Signs
- unconscious
- not breathing
- no pulse

Casualty Management - Perform Cardio-Pulmonary Resuscitation - CPR

Heart muscle contractions stop and the circulation of the blood ceases. This is a life threatening condition and CPR must commence as soon as possible. Every minute wasted reduces the chance of a full recovery by 10 %.