What is the purpose of life? Is it to live forever or just survive until death comes? What is happiness? Are there any pleasures other than food, water and sleep?
These are some of the questions that have been asked throughout history. However, science has answered them all. Science has come up with answers that can answer these questions for us today.
The human body is made up of various organs that perform different functions. Some of these organs include the heart, lungs, kidneys, liver and intestines. All these organs work together to keep our bodies alive. If one organ fails then we die because without oxygen or nutrients we cannot continue living.
When an organ stops working properly then other parts of the body suffer as well. For example if the heart stops beating then blood flow to vital organs such as the brain and eyes stop functioning too. Other symptoms of an organ failing include:
• Sudden dizziness or loss of balance (vertigo)
• Weakness or numbness in arm, leg or foot(dizzy spell)
• Nausea and vomiting (vomiting blood)
If you think you are experiencing any of these symptoms then you should seek medical attention immediately. Evidence shows that in developed countries, sudden cardiac arrest is the most common cause of death among young people. The only way to survive is to get CPR (cardiopulmonary resuscitation) and an AED (automated external defibrillator) as soon as possible. When a person suffers from a sudden cardiac arrest, their brain suffers an instant loss of oxygen and glucose.
This causes the brain to suffer massive and irreversible damage after just 4-6 minutes.
After this time period, most victims will be left in a coma or even die. The sooner CPR and an AED is used the higher are the chances of survival. Bystanders are often reluctant to perform CPR because they are afraid of hurting the victim. However, this is not true because rescuers are trained to press down on the middle of the victim’s chest to make sure they aren’t hurting them.
The only thing that can hurt the victim is doing nothing at all. The brain can only survive for a maximum of 10 minutes without oxygen and glucose before it starts to die. CPR can keep blood flowing to the victim’s brain and buy time until a defibrillator is used to shock the heart back into a normal rhythm. If CPR is not started within a few minutes then the brain is likely to suffer permanent damage and death will soon follow.
Defibrillation within 3-5 minutes of going into cardiac arrest can increase the chance of survival to more than 50%. If defibrillation is applied between 5-10 minutes after, then the chance of survival falls to less than 10%. After 10 minutes there is no chance of survival.
What happens if you suffer a heart attack?
When your heart beats it does so in a wave that goes from the top to the bottom. Imagine a lawn sprinkler and the way the water shoots out over the grass in a wave. A wave of pressure moves through your heart in the same way. When one part of your heart contracts (squeezing blood out) another part relaxes (letting blood in). This happens over and over again.
There are two main reasons why someone may suffer a heart attack. The first is that the heart can’t relax or contract properly. This is called a “cardiac arrhythmia” and is often triggered by an underlying condition like coronary heart disease (obstruction of the arteries) and diabetes. If someone has had any previous heart attacks, then they are more likely to suffer from this type of cardiac arrest.
The second is if the heart beats too fast. This can lead to the heart not being able to pump blood at a normal rate, and it is often caused by stress, anxiety or a drug overdose.
When someone suffers a heart attack they usually experience:
• Uncomfortable pressure, fullness, squeezing, or pain in the chest lasting more than a few minutes. Sometimes people mistake this feeling for indigestion or heartburn. They may also experience nausea, shortness of breath, sweating, and a cold feeling in their fingers and toes.
If you are experiencing these symptoms, immediately call an ambulance and ask for instructions on how to take the medication prescribed to you by your doctor. An ambulance should always be called if you think you are having a heart attack as it is better to over-react than under-react.
What are the warning signs of a heart attack?
Heart attacks can cause a range of different symptoms. The most common are:
Pain in the arms, back, neck, jaw or stomach
Shortness of breath, a feeling of being full, or nausea
Sweating and tiredness
If you experience any of these symptoms, especially the first three, call an ambulance immediately and ask for help.
What should I do if someone is having a heart attack?
The key to helping someone having a heart attack is to get the right help as quickly as possible and to keep them as still and comfortable as you can.
1. Call an ambulance immediately
2. If you are with someone who has been diagnosed with heart disease or has risk factors for a heart attack, have CPR training and are willing and able, you can give them 200mg of chewable aspirin.
3. If you have n ambulance transport oxygen kit, give the patient some oxygen.
4. Position the patient to make them as comfortable as possible.
5. If they become unconscious, turn them on their side to help prevent them from vomiting and choking on it.
6.If the patient becomes unconscious, check to see if they are still breathing by placing your ear next to their mouth and nose. DO NOT look into their mouth.
7.If they are not breathing, perform CPR
Once an ambulance arrives:
1.answer all the paramedics questions honestly and clearly. If you don’t know the answer say so.
2. try and keep the patient calm and informed about what is happening.
3. The paramedic may give the patient an injection of a type of blood thinner to counteract the effects of a heart attack.
This should begin to ease their pain within ten minutes.
4. The paramedic may also give the patient oxygen and a drip to replace lost fluids.
5. The paramedic may also give the patient medication to control pain and other symptoms.
6. The paramedic may call for an aircraft to transfer the patient to hospital.
7. The paramedic will most likely send a doctor from the hospital to see you before you board the plane.
They will decide if you are medically fit to fly. If you have any doubts about your fitness to fly, tell the paramedic and they will make the decision.
8. You will be taken to hospital by helicopter if you are medically able to fly.
What should I do if I think my partner or relative has had a heart attack but the ambulance is a long way off?
If you are with someone who is having a heart attack and the ambulance is a long way away, here are some tips on what to do:
-Restrain them from doing any vigorous exercise or heavy lifting. If they smoke, ask them not to smoke.
-Encourage them to rest and keep them company. Talking is not a strain on the heart, but long periods of silence may be misinterpreted by the person as an indication that you are having a heart attack.
-Check if they are having doubts about their marriage or if they have just won or lost a large amount of money. These are common triggers for heart attacks, so try to reassure them that everything is going to be OK.
-Aspirin may help to break up blood clots that are occuring in the coronary arteries. Aspirin however, should not be given to people who are allergic to it or who have bleeding problems without medical supervision.
If you do not know whether the patient is allergic to aspirin or not, you can try giving them baby aspirin (81mg), as it is the smallest dose available over the counter and worth trying.
The patient should take one tablet every 6 hours. Maximum of 3 tablets in 24 hours. If there is no improvement after 3 tablets then the aspirin is not effective in this instance.
To help break up blood clots that have formed, you can also try the following treatments:
1. Place your ear on their chest and ask them to do the same so that you can listen for a certain type of heartbeat called an “Apex Beat”.
The normal lub-dub sound of the heart is not heard in patients who have had a heart attack due to the damage of the heart muscle. The apex beat can be hard to find sometimes, so keep trying until you hear a fluttering noise as the sound of the heartbeat.
2. Massage the person’s chest with firm pressure in the area just to the left of the beating pulse.
You can place your whole hand over the area and push hard as you go slowly up and down the area. Do it for at least 5 minutes.
3. Call emergency services and say, “I have a 14 year old boy who has been playing football and he suddenly clutched his chest, saying it hurt a lot.
He is now unconscious…”
What is acute coronary syndrome?
Acute coronary syndrome (or ACS for short) describes the events when the blood supply to a part of the heart is suddenly blocked by a blood clot or plaque. The most common type of ACS is ST Elevation Acute Coronary Syndrome (STEMI) when an area of the heart called the anterior wall or the septum is occluded. This leads to chest pain, shortness of breath and if left untreated, death.
Who gets acute coronary syndrome?
-Anyone with risk factors for heart disease can develop acute coronary syndrome.
-Some people get it without any risk factors.
-It is more common in men than women, and more common in older people.
What are the symptoms of acute coronary syndrome?
ST Elevation Acute Coronary Syndrome (STEMI) has the following symptoms:
-Severe substernal chest pain that lasts for more than 10 minutes. The pain may go away between heartbeats, but then suddenly comes back. It can feel like pressure, squeezing or burning in the chest.
-Pain in one or both arms, the back, neck, jaw or stomach.
-Shortness of breath
-Feeling of imminent death (this is rare)
Other types of acute coronary syndrome have the following symptoms:
-Unusual fatigue or weakness for no apparent reason.
-Feeling sick with nausea and vomiting.
-Diarrhoea or constipation.
-Chest pain or discomfort that is not like the pain of a heart attack. It may feel like pressure, an ache or tightness, a burning sensation or stabbing pain. It may also occur just in one arm, the back, neck, jaw or stomach.
-Shortness of breath.
-Dizziness, blackouts or loss of consciousness.
-A fast or irregular heartbeat (heart palpitations).
-A cardiac arrest (one moment you’re fine, and then your heart stops beating).
-Generalised anxiety or nervousness.
-Other physical symptoms that don’t appear to have a cause such as fatigue, loss of energy, feeling unwell or body aches.
What causes acute coronary syndrome?
Acute coronary syndrome is caused by the blockage (occlusion) of the blood supply to part of the heart muscle. This is usually due to the development of a blood clot within the coronary arteries that supply blood to heart muscle. The most common cause of this is atheroma (in simple terms, plaques building up inside the walls of the arteries).
Atheroma is caused by the build up of a waxy substance called cholesterol and other materials inside the walls of arteries. It is not known why this process starts, but it is known that certain things in our diet can increase our risk of developing atheroma. These include:
-Diet high in saturated fat
-Poorly controlled diabetes
-Other things such as excessive alcohol and lack of exercise can also contribute to the development of atheroma.
What are the danger signs of acute coronary syndrome?
The symptoms listed above occur because the heart muscle is no longer getting enough blood, and begins to die as a result. This part of the heart then tries to make more blood, and this is where the ‘chest pain’ of a heart attack occurs. The area that has suffered will then begin to ache for quite a while after the original event.
If you have any of these symptoms then it is very important to seek medical attention immediately:
-Severe pain or discomfort in the chest.
-Pain under the sternum which spreads to the left arm.
-Pain in the centre of the chest which may spread to the neck, jaw or left arm.
-Unexplained nausea and vomiting.
-Severe pain in the upper abdominal area, sometimes spreading to the back.
-Pain in the upper back, sometimes spreading to the arm.
-Unexplained shortness of breath.
-Rapid or irregular heartbeat.
-General feeling of impending doom or unusual fatigue (even if you feel quite well).
-Other possible symptoms include low blood pressure, dizziness, fainting, sweating and a slow heart rate.
First aid of acute coronary syndrome:
If you think someone is having a heart attack you should seek medical help immediately. Before this however, you should try to calm them and make them comfortable. While waiting for medical assistance, you should also try to keep them as still as possible. If the person is unconscious, place them in the “SAH” position:
-If they are lying on their back, turn them on their side.
-If they are lying on their side, turn them onto their back.
-If they are unconscious, check that they’re not choking on their tongue or pennies and roll them onto their back.
You should never:
-Try to do CPR on someone who is unconcious and not breathing.
-Try to move a person who is in pain, as this may disrupt blood clots which could result in a life threatening situation.
-Give the person anything to eat or drink.
-Put your hands behind their head or under their neck.
Remember that giving first aid to someone who is suffering a heart attack is extremely difficult and it is important to get them proper medical attention as soon as possible. If you are uncertain, always seek medical help.
The death of a patient with acute coronary syndrome is caused by lack of oxygen to the brain and vital organs. The oxygen deprivation is a result of the build up of plaque in the arteries which reduce the blood flow to these areas. Without proper treatment, the person may die.
If the patient survives the initial heart attack, it is important that they make lifestyle changes and seek medical attention to prevent a second heart attack or a stroke.
When a heart attack occurs in younger people it is usually due to arterial plaque build up over many years which gradually reduces blood flow to vital organs.
Most deaths caused by heart attacks occur within an hour of the onset of chest pain.
Acute coronary syndrome is a very common reason for hospital admissions and is the leading cause of death in most developed countries.
It can affect anyone but it is more common in older people and those who smoke, have high blood pressure or a family history of heart disease. Other risk factors include diabetes, obesity, lipoprotein abnormalities, excess alcohol consumption and lack of exercise.
There are two types of plaque which can build up in the arteries, fatty and fibrous. Fatty plaque is less likely to cause a blockage than fibrous plaque which is the result of inflammation in the walls of the arteries.
A heart attack occurs when blood flow to an area of heart muscle is reduced or cut off completely due to a blockage caused by fatty or fibrous plaque rupture or closure of a section of an artery causing thrombosis.
The smaller arteries of the heart undergo a great deal of strain during contraction and expansion due to the constant pumping action required to keep blood flowing around the body. With normal aging, the inside wall of these arteries begins to develop deposits of fatty substances (atheroma).
These fatty substances stay in place for many years before rupturing and causing a blockage which severely restricts blood flow or even completely blocks it. This then deprives the heart muscle of oxygen and causes pain. If the blood flow is not restored quickly enough, permanent damage can be caused to the heart muscle.
The two main types of heart attack are:
The most common form of heart attack is caused by the closure of a coronary artery or one of its branches due to the rupture or narrowing of an atheroma.
Fatty materials that have broken away from the atheroma deposit suddenly clot and block the artery. This is known as an thrombosis.
A heart attack can also be caused by a blood clot breaking away from an atheroma and then traveling through (or being carried through) a small artery until it gets stuck in a larger artery, completely blocking the flow of blood through that artery. This is known as an embolism.
Most heart attacks in Western societies are caused by clots.
Atherosclerosis, the hardening of the arteries, is the underlying cause of most heart attacks.
The immediate cause of death in a heart attack is ultimately loss of blood supply to part of the heart, which causes the muscle cells to die after a few minutes of oxygen deprivation. If the blood flow is quickly restored, this permanent loss of cells can be prevented. Since the heart is a muscle, its cells do not normally die unless they don’t receive enough oxygen for a length of time.
When blood flow to the heart is interrupted, oxygen supply is cut off and after only a few minutes, cells start dying. This process of cell death can be temporarily prevented if an emergency treatment with a thrombolytic agent is given within 3 hours of the first symptoms appearing.
These emergency treatment options are a common medication such as streptokinase or tissue plasminogen activator, which quickly dissolve or break up the blood clots. If the person is treated within 3 hours of the first symptoms, this will also restore normal blood flow to the heart, and can prevent any permanent heart damage.
Following a heart attack, long term treatment with drugs such as statins to reduce the chance of a future heart attack or stroke is usually recommended, and also efforts to lose weight if your weight is more than 10% higher than it should be for your height (this is known as hypertension or being overweight).
Your doctor may also prescribe blood thinning medication such as warfarin to prevent further blood clots from forming.
Also, lifestyle changes such as quitting smoking and physical exercise can be beneficial.
Coronary artery disease is the most common cause of death in the developed world. It is the leading cause of death worldwide.
In 2013, 11.5 million deaths (or 17.3% of all deaths) were due to Coronary heart disease.
Risk factors of coronary artery disease include:
Several other conditions are also associated with coronary heart disease:
People with inflammatory bowel disease such as Crohn’s disease and ulcerative colitis have a higher risk of coronary heart disease.
The disease was first described in 1628 by a French physician, Ambrose Pare, who described the symptoms. Over the next three centuries, knowledge and treatment of the disease steadily advanced. In 1717 the English physician Thomas Burnett confirmed for the first time that the symptoms were due to narrowed arteries rather than excess blood. In 1798 the English surgeon John Aikin is regarded as diagnosing the first case of pericarditis (inflammation of the sac surrounding the heart) though this was not widely recognised until the 1870s.
In 1910 a connection between narrowed arteries and chest pain was made by a German physician, Ernest von Krueger. He also noted that the pain could be relieved by resting, and was made worse by activity.
In 1953 an American, Willis Noble, described the medical condition of typical chest pain due to angina in a scientific paper.
In 1974 the coronary angiogram was invented, which provided visual images of the inside of blood vessels. This led to the discovery ofulpheroles, and the development and improvement of treatments for angina.
Other significant dates:
Society and culture:
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Rewire your brain: Think your way to a better life by S Aamodt, S Wang – 2009 – Bloomsbury Publishing USA
Lift More and Perform Better Using Mental Intention by S Blechman – advancedmolecularlabs.com
Buddha’s brain: The practical neuroscience of happiness, love, and wisdom by G Small – 2003 – Hachette Books
Flicker: Your brain on movies by JB Arden – 2010 – books.google.com
You Are Not Your Brain: The 4-Step Solution for Changing Bad Habits, Ending Unhealthy Thinking, and Taki ng Control of Your Life by A McCubbin – breakingmuscle.com