Heart Attack

A heart attack, also known as a myocardial infarction (MI), is caused by partial or complete obstruction of one or both of the coronary arteries or their branches. In most cases, the severity of the attack depends on the size of the obstructed artery and the amount of myocardial tissue nourished by that artery. For example, if a small branch of a coronary artery is obstructed, the myocardial damage and symptoms may be mild, whereas the damage is usually extensive and the symptoms intense if a coronary artery is completely blocked.

The principal symptom of a heart attack is chest pain or discomfort. The chest pain is described by patients as squeezing or crushing pressure, severe indigestion or burning, heaviness, or aching. The chest discomfort can range in severity from feeling only mildly uncomfortable to being intense and accompanied by a feeling of suffocation and doom. The pain is usually felt behind the sternum and may radiate to the neck, throat, jaw, both shoulders, and arms. The pain associated with a heart attack is prolonged and is usually not relieved by resting or taking nitroglycerin. Other signs and symptoms of a heart attack include shortness of breath, profuse perspiration, nausea, and fainting.

If the medical assistant suspects that the patient is having a heart attack, EMS should be activated immediately. Meanwhile, loosen tight clothing and have the patient rest in a comfortable position that facilitates breathing. If cardiac arrest occurs, the medical assistant should begin CPR immediately.

Stroke

A stroke, also called a cerebrovascular accident (CVA), results when an artery to the brain is blocked or ruptures, causing an interruption of the blood flow to the brain.

The signs and symptoms of a stroke include sudden weakness or numbness of the face, arm, or leg on one side of the body; difficulty in speaking; dimmed vision or loss of vision in one eye; double vision; dizziness; confusion; severe headache; and loss of consciousness.

If the medical assistant suspects that the patient is having a stroke, EMS should be activated immediately. Meanwhile, loosen tight clothing and have the patient rest in a comfortable position. If respiratory arrest or cardiac arrest or both occur, begin rescue breathing or CPR, or both, as required.

Shock

For the body to function properly, adequate blood flow must be maintained to all the vital organs. This is accomplished by the three important cardiovascular functions:

1. Adequate pumping action of the heart,

2. Sufficient blood circulating in the blood vessels, and

3. Blood vessels being able to respond to blood flow. When an individual suffers a severe injury or illness, one or more of these cardiovascular functions may be affected, which can lead to shock.

Shock is defined as the failure of the cardiovascular system to deliver enough blood to all the body's vital organs. Shock accompanies different types of emergency situation such as: hemorrhaging, a myocardial infarction, and severe allergic reaction.

The five major types of shock are categorized according to cause: hypovolemic, cardiogenic, neurogenic, anaphylactic, and psychogenic. Each type of shock is described in this section. If not treated, most types of shock become life threatening. This is because shock is progressive; once it reaches a certain point, it becomes irreversible and the patient's life cannot be saved.

The signs and symptoms of shock are caused by the failure of the vital organs to receive enough oxygen and nutrients. The organs most affected are the heart, brain, and lungs, which can be irreparably damaged in just 4 to 6 minutes. The general signs and symptoms of shock are weakness, restlessness, anxiety, disorientation, pallor, cold and clammy skin, rapid breathing, and rapid pulse.

If not treated, these symptoms can rapidly progress to a significant drop in the blood pressure, cyanosis, loss of consciousness, and death. It is important to know that the signs and symptoms of shock may be subtle or pronounced. In addition, no single sign or symptom will determine accurately the presence or severity of the shock. Because of this, it is extremely important to consider the nature of the illness or injury in determining whether the patient is a possible victim of shock. For example, if a patient suffers a traumatic injury to the abdomen, shock should be considered a possibility, even if the patient's signs and symptoms do not suggest shock.

Shock (with the exception of psychogenic shock) requires immediate medical care. The medical assistant should activate the emergency medical services without delay so that proper medical care can be obtained as soon as possible.