For pities sake don't ignore chest pain.

[Sapphire Silk]

Ashen in what what?

It's the word used to describe the blue grey color people turn when they go into shock. It's a common skin finding (along with diaphoresis, or sweats) in people having heart attacks.

Trust me, we'd rather transport someone who "thinks" they might be having heart issues than transport a body. When in doubt, call the emergency line.

Amen to that! Please review the Sticky's on this: when in doubt, call the doc or call 911. If you wonder if you should call 911, odds are you should.

My grandmother didn't want my dad to call 911 when she was having a heart attack because it wasn't like what she'd seen on tv or read about in magazines - ex. terrible crushing pain in the chest with shooting pains down the left arm. IIRC hers was a pressure in the chest that spread out to both arms. She survived it and was a bit POd to find out that the only descriptions of heart attacks out there are what is most common for men not women.

Women often have what's referred to as "atypical" chest pain, which might not even be in the chest. Men can have unusual symptoms as well. Remember, the heart exists in 3 dimensions: top bottom front and back. Where the pain refers from depends a lot on what part of the heart is dying (blockages of blood to heart and the accompanying lack of oxygen is what causes heart attacks).

Women often have upper left shoulder pain. I've seen men with this as well; one fellow, fairly young, was walked into our ER because the medics mistook his symptoms for simple back strain (the lack of a mechanism of injury was a major missed red flag). Less than a minute after he arrived, he coded and died.

The chest has a back as well as a front. When it comes to anything between the neck and the belly button, I tend to think heart first until proven otherwise.

Years ago, I had a patient walk into triage. At first I couldn't quite tell what his complaint was because he was having trouble talking, but he was sweaty and clearly in pain. I tried taking vitals and getting demographic info, but couldn't. He acted like he was having a seizure and I realized I needed to get him to the back.

He was grey by the time I had him on a stretcher, and as soon as he got on there, he arrested. While the team was coding him, his family arrived and told us he'd been having chest pain all day but refused to come to the hospital.

He didn't make it.

The doc wanted a nurse to with her to break the news to the family. Since I triaged him, I went.

The first question out of their mouths when she broke the news was, "If the nurse had gotten back faster, wouldn't he have lived?"



Doc: No. By the time he got here it was already too late. The damage to his heart was already done. I'm very sorry for your loss.

I really appreciated her candor with the family and that she had my back. I was shaken myself, and blaming myself for not moving faster. She later explained to me that nothing I could have done would have helped. He just should have come to the hospital sooner. End of story.

[Rapscallion]

Doc: No. By the time he got here it was already too late. The damage to his heart was already done. I'm very sorry for your loss.

I like that doctor. Just saying.

Rapscallion

[Cia]

Luckily for my grandma Dad called 911 anyways, he said it's better to be safe than sorry and he'd rather pay for an ambulance ride to find out it's indigestion than not to and find his mother dead the next day.

[Mishi]

My brother-in-law came over to chat/debrief the other day because one of his close friends had had a heart attack. He was freaked, because "she's only 20!". Yes, she is, but she also takes a lot of (illegal) drugs, is overweight, smokes, has a poor diet and is on the Pill. "But drugs don't cause heart attacks!"

[kansasgal]

I went to the hospital late in 2012 because I had chest pain that radiated to my jaw and my arm. I have never seen people move that quickly when I said I thought I was having a heart attack..just sayin, I had about 6 people attaching things to me. It ended up being my neck (I have a spinal injury on my neck) which radiated the pain, but it was a scary thing. I would rather go and have it be nothing serious then stay home and die.

[Blue Ginger]

Luckily for my grandma Dad called 911 anyways, he said it's better to be safe than sorry and he'd rather pay for an ambulance ride to find out it's indigestion than not to and find his mother dead the next day.

Yep, I generally err on the side of caution too.

When I finished Year 12, I spent my schoolies week at my Gran's house 3 hours from home. Saturday arvo, she tells me her left shoulder is sore. Now for Gran to say she is sore means she is in a fair bit of pain. Stubborn country women . So we ring up her one of her friends to drive us to the hospital.

10 minutes later we are in the tiny emergency room and she is complaining she 'didn't want to make a fuss' while one of the nurses is getting the town doctor. The doc got as far as 'What brings you' when Gran had a heart attack.

I can only thank the gods that we took her to the hospital when we did. While she lives in the same street as the ambo station, they were not on duty that week. The nearest ambo's would have taken 40 minutes to get to us.

A week later she had another one while a friend was visiting. This time the ambo's were there in a minute. 1 ran to her house, while the other got the car started to drive 5 house lengths.
2 weeks after that she had a triple by-pass.

She is still going strong at 89 years young. And the running family joke is if she has another heart attack on me, I'll kill her.

[Sapphire Silk]

My brother-in-law came over to chat/debrief the other day because one of his close friends had had a heart attack. He was freaked, because "she's only 20!". Yes, she is, but she also takes a lot of (illegal) drugs, is overweight, smokes, has a poor diet and is on the Pill. "But drugs don't cause heart attacks!"

The hell they don't. Meth and cocaine are both well known vasoconstrictors, meaning the arteries tighten and become narrower becasue of the effect of the drug. This in effect cuts off blood to the heart, and that can and does cause heart attacks and death.

[dalesys]

The hell they don't. Meth and cocaine are both well known vasoconstrictors, meaning the arteries tighten and become narrower becasue of the effect of the drug. This in effect cuts off blood to the heart, and that can and does cause heart attacks and death.

Not exactly news. Santayana was right. "Those who cannot remember the past are condemned to repeat it"

Canned Heat - Amphetamine Annie (1968)

This is a song with a message - I want you to heed my warning
I wanna tell you all a story about this chick I know
They call her "Amphetamine Annie", she's always shovelling snow
I sat her down and told her, I told her crystal clear
"I don't mind you getting high but there's one thing you should fear"
"Your mind might think its flying, baby, on those little pills
But you ought to know it's dying, 'cause: Speed kills"

But Annie kept on speeding, her health was getting poor
She saw things in the window, she heard things at the door
Her mind was like a grinding mill, her lips were cracked and sore
Her skin was turning yellow, I just couldn't take it no more
She thought her mind was flying on those little pills
She didn't know it was going down fast, 'cause: Speed kills

Well I sat her down and told her, I told her one more time
"The whole wide human race has taken far too much methedrine"
She said "I don't care what a Limey says, I've got to get it on
I'm not here to just see no man who come from across the pond
She wouldn't heed my warning, Lord, she wouldn't hear what I said
Now she's in the graveyard, and she's

Awfully dead

[Mishi]

The hell they don't. Meth and cocaine are both well known vasoconstrictors, meaning the arteries tighten and become narrower becasue of the effect of the drug. This in effect cuts off blood to the heart, and that can and does cause heart attacks and death.

I know that, and you know that, but explaining it to a very stubborn addict is nigh on impossible. I just wish there was more education about it.