Two heart attacks, what is the difference, read it and you will understand

Doctor’s knowledge: If you have sudden chest pain that does not subside and you suspect your myocardial infarction, call 120!

But many people said that waiting for 120 ambulance was too time-consuming. Some even said that by the time 120 ambulance arrived, the patient was already dead.

So what is the difference between driving to the hospital and calling 120 when a heart attack occurs? After reading these two cases today, everyone will understand clearly.

Last Thursday we rescued two patients with myocardial infarction. The conditions of their illness were basically the same, but the results were vastly different.

Case 1:
The patient, a 52-year-old male, had sudden chest pain for 1 hour and his home was about 30 minutes away from the hospital.
One hour after the onset of the disease, he felt extremely uncomfortable and asked his family to drive him to the hospital.
The family helped and dragged the patient down from the third floor and into a private car.

(Sudden myocardial infarction, blocked heart vessels, myocardial necrosis, the heart needs absolute rest, and you cannot move around at this time. The best or only way is to lie down or sit well and let the heart rest. Any movement will increase the burden on the heart and aggravate the condition.)

On the way to the hospital, about 15 minutes after getting on the car, the patient suddenly had convulsions in his limbs and lost consciousness. The patient's family members kept pinching his Ren Zhong point, patting his arms, and beating his chest.

(When our heart stops beating, there are two situations: one is ventricular fibrillation, which requires electric shock defibrillation, and the other is cardiac arrest, which requires chest compression and cardiopulmonary resuscitation. Other rescue efforts are futile.)

When the patient's family drove to the hospital and called the emergency doctor to come and see the patient, the patient was not well. The emergency doctor ran to the car and determined that the patient had lost consciousness and the aorta had disappeared. At the same time, other staff had already pushed the stretcher and defibrillator to the car. Everyone lifted the patient onto the stretcher. The defibrillator showed that the patient's electrocardiogram was a straight line, so there was no need for electric shock defibrillation, only chest compression and cardiopulmonary resuscitation.
It took the patient 30 minutes from the time he decided to go to the hospital to the time he arrived at the hospital.

(After the heart stops beating, if rescue can be done immediately, the hope of survival will increase. The longer the delay, the closer to death. Generally speaking, if there is no CPR for more than 4 minutes after the heart stops beating, the brain will die. If there is no CPR for more than 8 minutes, even a god cannot save the person.)

While performing resuscitation, the patient was pushed into the emergency room and continued with the rescue.

After continuous rescue, the patient's vital signs such as heartbeat and breathing did not recover, and the patient was declared clinically dead.

We can assume that the patient did not suffer from ventricular fibrillation or cardiac arrest on the way and arrived at the hospital safely after 30 minutes.

At this time, the emergency room doctor will ask about the medical history, do an electrocardiogram, draw blood for tests, measure blood pressure, etc. If low blood pressure is found, the blood pressure will be raised. After the electrocardiogram is done, if it is a myocardial infarction, 300 mg of aspirin and 180 mg of ticagrelor will be given immediately, and a cardiology consultation will be called.

This time is usually within 10 minutes. After the cardiologist arrives, it will take another 5-10 minutes to confirm that the blood vessels need to be opened. It will then take at least 15-20 minutes to start the catheterization room.

It takes about 30-40 minutes before the patient can be sent to the catheterization room for surgery.

That is to say, even if everything goes well when you go to the hospital on your own, it will still take 60-70 minutes from leaving the house to getting on the operating table.

Case 2:
The patient, a 54-year-old male, had sudden chest pain for 1 hour and his home was about 30 minutes away from the hospital.

One hour after the onset of the disease, he felt that his condition had worsened and asked his family to call 120.

After the 120 ambulance arrived, they measured the patient's blood pressure and found it was low, so they gave him dopamine to increase blood pressure. After an electrocardiogram showed acute myocardial infarction, they immediately gave him 300 mg of aspirin and 180 mg of ticagrelor orally. The patient was carried to the 120 ambulance.

(After the 120 doctors arrive, they can find many problems, especially low blood pressure, which can be immediately raised; if myocardial infarction is confirmed, drug treatment can be given immediately.)

About 15 minutes after getting on the ambulance, the patient also experienced convulsions in his limbs and lost consciousness. The ECG monitor indicated ventricular fibrillation. The doctor immediately delivered an electric defibrillator, and the patient's heart resumed normal beating and consciousness was restored.

Because when the 120 doctor confirmed that the patient had myocardial infarction, he notified the hospital to activate the catheterization room, and the patient had already taken preoperative medications, so the patient arrived at the hospital 25 minutes after being on the 120 car and was sent to the operating room.

After the patient's blood vessels were opened, he was sent to the intensive care unit and his condition is stable.

(It took the patient 50 minutes from dialing 120 to arriving at the hospital, because the 120 ambulance is faster and does not have to wait for red lights. On the surface, calling 120 takes a little longer than going to the hospital on your own. But the time it takes for 120 to arrive at the patient's home is 25 minutes after calling 120, which is 5 minutes less than the time it takes for the patient to go to the hospital on his own.)

In other words, it took 50 minutes from the time the patient called 120 to the time the patient was safely sent to the operating table. The total time was still less than the time taken by the patient mentioned above.

So overall, calling 120 is not a waste of time.

The features of 120 are not available when driving by yourself:

1. If 120 detects hypotension in a patient, they will immediately give him/her blood pressure-raising treatment; if they detect hypertension in a patient, they will give him/her blood pressure-lowering treatment;

2. Once the patient was diagnosed with myocardial infarction, aspirin and other drugs were immediately given, and the chest pain center was contacted to activate the catheterization room, saving the patient a lot of time that would have been spent going to the hospital on their own.

3. 120 has a defibrillator, which can save the patient's life after detecting ventricular fibrillation. It is impossible for the patient to drive on his own.

4. 120 has emergency doctors who can perform chest compressions and cardiopulmonary resuscitation if the heart stops beating to improve the survival rate.

Someone will definitely ask, what should we do if the patient’s heart stops beating at home when the ambulance has not arrived yet?

At this time, you can only perform chest compressions and CPR, there is no other way. Under the same conditions, think about whether the success rate of CPR is higher at home or in a private car on the road (can CPR be performed in the back seat of a private car? This is still a question!).

In short, if chest pain persists and myocardial infarction is suspected, call 120 immediately! It can increase the chance of survival!