The head of RWJUH Rahway's emergency department tells when it's time to call 911.
What symptoms signal a heart attack—and what should you do about them? Michael A. Bernstein, MD, Medical Director at the Department of Emergency Medicine at Robert Wood Johnson University Hospital (RWJUH) Rahway, spells it out.
How can you tell if you’re having a heart attack?
Classic symptoms include a crushing pain around the center of your chest. Some people describe it as a “heaviness,” like there’s an elephant sitting on your chest. Associated symptoms are sweating, shortness of breath, dizziness, nausea and vomiting. However, there also can be subtle, atypical signs like vague weakness; discomfort elsewhere in the upper body, like the arms, back or neck; or just a sense that things don’t feel right.
What would indicate that subtle, easy-to-dismiss symptoms could be serious?
Usually, symptoms and feelings occur after you’ve performed an activity, or while you’re exerting yourself, as opposed to when you’re relaxed and watching TV. The cause of these abnormal feelings, which can vary, is that the heart is not getting enough blood.
What should you do if you think you may be having a heart attack?
Quickly getting a medical evaluation, and potentially an intervention, is paramount. If you’re in a metropolitan area—and that’s most places in our region—call 911. We have an incredible Emergency Response Team, and they’ll reach you in minutes.
Wouldn’t it be quicker to hop in a car?
Don’t get behind the wheel! You’d be putting yourself and everyone around you at risk. In fact, having someone else drive you could lose valuable time. If you call 911, the First Responders can begin an assessment and start the necessary treatment as soon as they reach you. They also can relay information to the hospital in close to real time. As soon as this is done, we can mobilize the Critical Care and Interventional Cardiology Team and be ready for you by the time you roll through the door.
What happens at the hospital? We evaluate you. If we don’t have clear answers from tests, we may hold you for observation. If you’re having a heart attack, you’re taken to the Cardiac Catheterization lab, where an interventional cardiologist working with a team of nurses and technicians accesses your cardiac arteries. Tools can remove the blockage causing the heart attack and install a stent to keep the artery open.
In the ED: Tests You May Get
Here are some of the tests you might be given to check for a heart attack.
EKG: An electrocardiogram. This records the heart’s electrical activity through small electrodes placed on the chest and is usually able to reveal the areas of the heart where blood flow is restricted.
Chest X-Ray: Imaging the chest helps rule out other conditions that could be causing chest pain.
Cardiac Enzymes: This blood test measures proteins in the blood, such as troponin, for levels that indicate cardiac muscle damage.
Echocardiogram: An ultrasound that shows a moving image of the beating heart to check for abnormal motion.
Cardiac Catheterization: You may need a cardiac catheterization. In the cardiac catheterization lab, a long, thin tube is inserted into an artery to check for signs of restricted blood flow.
Your heart doesn’t beat just for you. Get it checked. To learn more about expert cardiac care at RWJUH Rahway or to schedule an appointment with a cardiac specialist, visit www.rwjbh.org/rahwayheart.