When an individual displays symptoms of a heart attack, known by medical professionals as a myocardial infarction or MI, there are many symptoms they may display. These symptoms may vary depending on the individual’s age, gender, and co-morbidities (other medical problems) including diabetes and neuropathy. Not every heart attack victim has crushing chest pain, which is a major reason for high mortality rates among certain populations. It’s important to know the symptoms, which can include, but are not limited to:
- Chest pain or heaviness
- lethargy (extreme tiredness)
- profuse sweating
- nausea and vomiting
- pain in back, jaw, teeth, left arm, or shoulder
- a feeling of doom, or that death is near
- an intense urge to deny that anything is wrong
- light-headedness, fainting, or unconsciousness
- rapid pulse rate
- difficulty breathing, shortness of breath, or a feeling of being smothered
Any of these symptoms, but especially when someone has one or more, should prompt them to call EMS (Emergency Medical Services), which in most locales is 911. It’s best to get a paramedic to the patient immediately who can administer life-saving medications and call ahead to possibly alert a team at the hospital that deals with procedures needed to help heart attack victims. That’s why driving someone who may be having a heart attack to the hospital by a private vehicle isn’t advised — they won’t receive help on the way, the hospital won’t be aware they are coming, and they could possibly die en route.
However, a concerning report came out this week about pre-hospital emergency care. This report stated that patients who may be having a heart attack only receive aspirin about half the time from pre-hospital emergency providers. This is problematic because aspirin has the ability to stop platelets from sticking together, which means that a clot that may be formed and causing a heart attack won’t be able to grow bigger or attract more platelets once aspirin is in the patient. If the patient gets no aspirin, the clot could become bigger, and therefore the heart attack more serious or causing more damage to heart muscle, which is often permanent.
National guidelines recommend giving aspirin to heart attack patients as soon as possible, but emergency medical service (EMS) providers sometimes omit this vital step, the authors say. Lead author Dr. Katie Tataris, an EMS Medical Director in Chicago and assistant professor of Emergency Medicine at the University of Chicago, said that getting aspirin early in a heart attack reduced death by 23 percent.
“We were interested in knowing how often patients that presented with symptoms suggestive of a heart attack were given aspirin by EMS providers.”
Unfortunately, it seems that social disparities may cause paramedics to deliver different care to different populations, though the authors are not certain why that is. Overall, paramedics gave aspirin to about 45 percent of patients that would be potential candidates for aspirin. Black, Asian and Hispanic patients were more likely than white patients to receive aspirin from the EMS provider. People living in the South were less likely to get aspirin than those in the East, West or North.
Patients with government insurance such as Veteran’s healthcare were the least likely to receive aspirin, according to Tataris. However, the same was not true for those with Medicare or Medicaid. People with insurance through an employer had the greatest likelihood of receiving aspirin, but age and gender did not seem to matter.
While the reason for these disparities cannot be concluded, it is important to remember that there are reasons why someone may not be a candidate for aspirin therapy en route to the hospital. These include recent surgery, any type of bleeding disorder, gastric ulcers, a history of brain bleeds, or those that may have already taken aspirin or are on another platelet aggregate inhibitor. However, these cases only account for two-to-three percent of those that cannot safely receive aspirin, so there’s still a whole lot of people out there who are not receiving aspirin who should be.
Readers, what are your thoughts on this?