Following former prime minister Naftali Bennett’s heart attack on Sunday, what are the warning signs of a heart attack, and how should one be treated until the Magen David Adom (MDA) team arrives?
A heart attack, or in medical terms, a myocardial infarction, occurs when one of the coronary arteries that supply the heart muscle is suddenly blocked, usually by a blood clot. The blockage prevents oxygen from reaching the area of the heart muscle served by that artery, and the longer the blockage lasts, the greater the irreversible damage to the heart tissue.
This process can lead to cardiac pump failure and sudden death if not treated quickly.
Bennett likely experienced the classic signs: chest pain or pressure, sometimes radiating to the left shoulder, neck, or back, extreme weakness, shortness of breath, and cold sweat – symptoms that can be mistaken for low blood pressure or exhaustion, but actually indicate a severe and life-threatening cardiac event.
Thanks to the quick response of medical teams, Bennett was rushed to the emergency room, diagnosed with an acute cardiac event, and immediately taken for catheterization.
The catheterization procedure allows doctors to locate the blockage in the coronary arteries and open it, usually with a balloon (angioplasty), followed by the insertion of a stent to keep the artery open. This is a life-saving treatment, especially when performed within the critical window – the first six hours after the symptoms appear.
Annually, some 10,000 Israelis suffer a heart attack and are taken to hospital. Approximately an additional 3,000 do not reach the hospital in time and die at home, due to delays in recognizing the signs. Only about 60% of patients arrive within six hours, which is the time frame in which irreversible damage to the heart can still be prevented. The success of treatment largely depends on early detection and immediate medical attention.
The warning signs of a heart attack include, as mentioned, pressure or pain in the center of the chest – sometimes as a feeling of heaviness, burning, or tightness – which may radiate to the neck, lower jaw, shoulder, or left arm.
Additional symptoms include shortness of breath, cold sweat, nausea, vomiting, unusual fatigue, and sometimes even fainting or a feeling of severe anxiety. In women, the symptoms may be less typical, such as upper back pain or fatigue only.
If you suspect a heart attack, do not wait.
MDA must be called immediately by dialing 101. Until medical staff arrive, the patient should be seated or laid down in a comfortable position and asked to avoid any exertion. It is forbidden to stand up or walk, not even to go to the bathroom. Any movement may worsen the damage. If Aspirin tablets are at hand (and the patient is not allergic), chewing a 300-mg. pill can delay clot formation.
In the event of unconsciousness, begin CPR (Cardiopulmonary Resuscitation) immediately, including chest compressions at a rate of 100–120 per minute, and call for help. For those at high risk, such as individuals with heart disease, diabetes, high blood pressure, or a family history of heart attacks, it is recommended that household members become familiar with basic CPR procedures.
In-hospital treatment
In the hospital, an initial diagnosis is made using an ECG/EKG (electrocardiogram), which examines the electrical activity of the heart, along with blood tests that measure levels of enzymes released when the heart muscle is damaged: mainly CPK (process capability check) and troponin protein test. An increase in these values, combined with clinical symptoms and ECG findings, confirms the diagnosis.
Treatment depends on arrival time: If the patient arrives early, he or she undergoes immediate catheterization in the catheterization lab. If catheterization is temporarily not possible, clot-dissolving medication may be administered. The quicker the treatment, the lower the risk of permanent heart damage
After hospitalization, the patient begins a cardiac rehabilitation process. This includes supervised physical activity, a low-fat diet, managing diabetes and blood pressure, anti-coagulation medication, and psychological support to reduce stress. In many cases, this is a long journey, but it is essential for full recovery.