Say: At the last session, we talked about the risk factors for heart disease.
Ask: Who remembers the risk factors that we can prevent or control? Note: Allow about 3 minutes for group members to respond.
Add the following risk factors if they are not said:
Overweight and obesity
High blood cholesterol
Not being physically active
High blood pressure
Ask: Would any of you like to share what you are doing to improve your heart health? Note: Allow about 2 minutes for group members to respond.
About This Session
Say: Heart disease develops over many years. Sometimes, despite our best efforts, heart disease can result in a heart attack. That is why it is important to know the warning signs of a heart attack and what to do if you experience them. In today's session, we will discuss these warning signs and the importance of taking quick action if you experience warning signs. By the end of this session, you will know:
How the heart functions
What a heart attack is
The importance of fast treatment for a heart attack
The warning signs of a heart attack
Why people delay in seeking help for a heart attack
The benefits of calling 9-1-1
Steps you can take now to help you survive a heart attack
Each year about 1.2 million people in the United States will have a heart attack, and about half of these people will die
About half of the people who die of a heart attack will die before they reach the hospital.
Say: To begin our session today, I would like to show a video about the importance of paying attention to heart attack warning signs.
Show the “Act in Time to Heart Attack Signs” video (14 minutes).
Say: Now that we have seen the video, let's talk about it.
What did you see in the video?
What did you hear in the video?
How did the video make you feel? Note: Allow about 5 minutes for group members to respond.
What Is a Heart Attack?
Say: In the video, you heard facts about heart attacks. Now let's talk about what a heart attack is and how one happens.
Show picture card 2.1.
Say: A normal artery allows blood to flow freely. A heart attack occurs when the blood supply going to a portion of the heart through one of the coronary arteries is blocked. Here's how this happens.
Heart disease, which can lead to a heart attack, develops over time. Fatty deposits build up on the inside of the coronary arteries. When this happens, the arteries become narrow, and not enough blood, oxygen, and nutrients get through to meet the needs of the heart.
The coronary arteries can become blocked, usually by a clot. When this happens, the blood flow is closed off and a heart attack begins.
If the blockage continues, part of the heart muscle will start to die.
When a heart attack occurs, medical treatment can restore the blood flow to the heart. This keeps the heart muscle from dying.
Treatments work best if given as soon as possible, within 1 hour after warning signs of a heart attack begin.
When a part of the heart muscle dies, nothing can be done to restore it.
Ask: Are there any questions about what happens during a heart attack? Note: Allow about 5 minutes for group members to answer.
Importance of Rapid Treatment for a Heart Attack
Treatments for heart attacks have improved over the years. Twenty years ago, not much could be done to stop a heart attack.
Today there are treatments that can open up the heart's arteries and restore blood flow.
“Clot-busting” medicines and other artery-opening treatments can break up the clots and quickly restore blood flow to the heart.
Show picture card 2.2.
There is also a treatment called angioplasty. A balloon is placed in the coronary artery and inflated to open the artery. This restores the blood flow.
Sometimes with angioplasty, doctors will insert a stent. A stent is a wire mesh tube that is used to open the artery.
The stent stays in the artery and keeps it open to improve blood flow to the heart.
These treatments should be given as soon as possible, within 1 hour after warning signs of a heart attack start.
The more heart muscle that is saved, the better chance a heart attack patient has of surviving and returning to a normal life.
What Are the Warning Signs of a Heart Attack?
Say: It is important to know how to recognize a heart attack. This activity should help you learn the warning signs of a heart attack.
Ask: What warning signs would make you think someone is having a heart attack? Note: Write group members' responses on a blackboard or on a large piece of paper taped to the wall.
Say: These are the warning signs most commonly reported by heart attack patients, both women and men.
Discomfort in the center of the chest that lasts more than a few minutes. It can feel like uncomfortable pressure, squeezing, fullness, or pain.
Discomfort in one or both arms or the back, neck, jaw, or stomach
Shortness of breath, with or without chest discomfort
Nausea or feeling sick to their stomach
Say: The most common heart attack warning sign for men and women is chest pain or discomfort.
Men and women do not need to have all of the warning signs to be having a heart attack.
The warning signs mentioned are the most common ones, and most people experience more than one of them. Some signs can occur together. For example, chest discomfort often occurs with shortness of breath. Also, arm pain, sweating, and nausea may occur together.
Many people think that all heart attacks happen the way you see in soap operas or the movies — a person has crushing chest pain and falls to the floor. This is a myth. The reality is that not all heart attacks happen this way. Many heart attacks start slowly, with signs gradually getting stronger.
A heart attack often is not a sudden, deadly event. A variety of warning signs may signal that someone is in danger.
Sometimes the pain or discomfort is mild, and the signs may come and go.
Ask: What do you think are other reasons why people do not recognize when they are having a heart attack? Note: Allow about 5 minutes for group members to call out answers.
Add the following reasons if they are not mentioned.
People may confuse the warning signs of a heart attack with the symptoms of other diseases, such as asthma.
People may confuse heart attack signs with symptoms of a pulled muscle, indigestion, or the flu.
Some people do not believe they are at risk for having a heart attack. When they have warning signs, they ignore them or wait to see if the signs get worse before they call for help.
Delay Can Be Deadly
Say: People often wait too long before they seek medical care for the warning signs of a heart attack.
Some people wait 2 to 4 hours, or even a day or more, before getting help.
If you think a heart attack is happening, the most important thing to remember is this: Call 9-1-1 in 5 minutes or less.
Say: When people having heart attacks decide to seek help, they often do not call 9-1-1. Only half of all heart attack patients arrive at the hospital by ambulance.
Say: Let's go over how to take fast action when you think a heart attack is happening.
Ask a volunteer to read the handout aloud.
Ask: Think about yourself and your family — what might prevent you from calling 9-1-1 quickly if you think you are having a heart attack? Note: Allow about 5 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
Add these reasons if they are not mentioned.
They did not think their symptoms were severe enough.
They were unaware that calling 9-1-1 has many lifesaving advantages.
They thought driving themselves to the hospital would be faster.
They were concerned about being embarrassed when an emergency vehicle — ambulance or fire engine — showed up at their door.
They were concerned about the cost of the ambulance and medical care.
They were afraid of being embarrassed if the symptoms were a false alarm.
Say: If you are having a heart attack and you or someone else cannot call 9-1-1, have someone drive you to the hospital at once. Never drive yourself. You may pass out along the way, putting yourself and others in danger.
Say: It is easy to talk about what to do when a heart attack happens, but it is not so easy to take the right action if you or someone you know is actually having symptoms. Let's take time to act out different scenarios to prepare you for a real situation. Note: Ask for volunteers in the group to form three teams of two people each. Give each team one of the three different role plays in the “Fast Action Saves Lives: Role Plays” handout. Note: Ask the teams to take a few minutes to read the role play, decide who will play the characters, and think about what they will say. Then ask each team in turn to present their “drama” to the group.
Ask: Now that you have seen the three scenarios, what do you think is the main action you must take when someone is having the warning signs of a heart attack? Note: Allow a moment for group members to call out the answer. If no one gives the correct answer, say: The answer is to call 9-1-1 in 5 minutes or less.
The Role of Emergency Medical Services
Say: Our actors did a great job of showing us why it is important to call 9-1-1 right away. Calling 9-1-1 is like bringing the hospital emergency department to your door.
Ask: What are the benefits of calling emergency medical services? Note: Allow 3 minutes for group members to respond.
Add these answers if they are not mentioned.
Emergency personnel arrive fast and can start treatment right away. They may carry oxygen, heart medicine, pain relief medicine, aspirin, or other medications that can help in case of a heart attack.
In many locations, emergency personnel are linked to the hospital. They can send information about a patient's condition to the emergency department before the patient arrives at the hospital.
Heart attack patients who are brought by ambulance receive faster treatment than patients who have someone drive them to the hospital.
Your heart may stop beating during a heart attack. Emergency personnel carry equipment to restart the heart if that happens. Note: Most communities have the 9-1-1 system. However, if your community does not, say: The best way to get the care you need is to call the local emergency medical number. In our community, that number is:
Say: It is a good idea to plan ahead for who will take care of your family in an emergency. Emergency personnel will usually contact a relative or friend to make arrangements, if necessary.
Ask: What would you plan to do if you suddenly had to go to the hospital in an ambulance? Note: Allow about 5 minutes for group members to discuss their answers.
How To Plan Ahead
Say: We have learned a lot today about heart attacks and what to do if one happens. Here's the good news: Planning ahead with your family can help you survive a heart attack. Here are things you can do now to prepare for a possible heart attack.
Show picture card 2.4.
Say: You now know the warning signs for a heart attack. Talk to your family and friends about these signs and the importance of calling 9-1-1 right away.
Show picture card 2.5.
Say: You and other adults in your family should talk to your doctor about your risk of a heart attack and how to lower it.
Say: You and your family should have a plan of action in case of an emergency. This plan should include an emergency card. This card gives health care providers the information they need to know about you in case of an emergency. Let's look at your emergency card. The emergency card includes the following information:
Name, relationship, and phone number of emergency contacts who should be called if you have to go to the hospital
Emergency numbers in your area
Name and phone number of your doctor or clinic
Your health conditions
Any other important information
Make a copy for all adults in your family and encourage them to fill it out.
Ask for volunteers to tell you how they would explain the importance of making a survival plan to their family members.
Ask group members to tell you how they would make sure that all of their family members (such as a grandparent, spouse, or uncle) know what to do in case of a heart attack. Note: Allow 2 or 3 minutes for group members to respond.
More Information – Aspirin: Take With Caution
A person who is thinking about using aspirin to treat or prevent heart problems should talk to a doctor first. If the doctor thinks that aspirin is a good choice, it is important to take the correct dose.
If a person has had a heart attack or stroke, aspirin can help lower the risk of a second one. It can also help keep arteries open in persons who have had heart surgery. It has also been shown that healthy women who take a low dose of aspirin every other day may prevent a first stroke. Aspirin may also prevent a first heart attack in women over the age of 65.
Tender Care for a Happy Heart
Say: After you finish preparing your emergency card, try some of these actions to lift up your heart.
Say: You have learned a lot today about how to be prepared if a heart attack happens. Now let's think about how you can practice what you have learned. Please think of one change you can make. This will be your pledge for the week.
Say: Be specific about what you plan to do, how you plan to do it, and when you will start. Here are some examples:
Within the next week, I will think about what to do if a heart attack happens at home, at work, in the middle of the night, or in other situations.
I will talk with family and friends within the next week about the heart attack warning signs and the need to call 9-1-1 right away.
I will make an appointment within the next month to talk to my doctor about my heart attack risk. Note: Allow 5 minutes for group members to think of a pledge.
Say: Would anyone like to share his or her pledge with the group? Note: Write down pledge ideas on the blackboard or on a large piece of paper taped to the wall.
(Optional)Say: A personal value is a quality that you consider valuable or important. Personal values can help you make changes in your everyday life to improve your health. Today, the value is serenity. Serenity helps you stay calm, even when you face problems or worries. It can help you manage stress and anger, which are two things that can bring about a heart attack. Note: Ask the group members to share how serenity, or another personal value, can help them keep their pledge. Allow 3 minutes for group members to share their ideas.
Say: We will talk about how you did with your pledge at the next session.
Information on this page is taken from the English print version of “Your Heart, Your Life, A Community Health Worker's Manual.” U.S. Department of Health and Human Services, National Institutes of Health, National Heart Lung and Blood Institute, NIH Publication No. 08-3674, Originally Printed 1999, Revised May 2008.