Taylor Leddin McMaster (Host): Hello listeners and thanks for tuning into Well Within Reach podcast brought to you by Riverside Healthcare. I'm your host, Taylor Leddin McMaster, and joining me today is Al Ponton, Riverside's Emergency Medical Services Manager. Al's here today to talk about early heart attack care. Thanks so much for joining us.

Al Ponton, MSN, RN, Paramedic: Yeah, thank you, Taylor, for having me.

Taylor Leddin McMaster (Host): Before we get into today's episode, we're going to take a quick break for a message about MyChart.

MyChart ad: Healthcare can be confusing, but thanks to your My Riverside MyChart, you can easily manage not only your care, but your family's as well. With a single click, your My Riverside MyChart lets you stay well connected to the same information your provider sees. You can view your health history, get test results, request prescription refills, pay your bill or make an appointment.

Manage your care from anywhere, your laptop, phone, or tablet. Learn more and enroll today at riversidemychart.org. 

Host: And we're back with Al Ponton to talk about early heart attack care. So first Al, can you tell us how long you've been with Riverside and what you do in your role with EMS?

Al Ponton, MSN, RN, Paramedic: Yeah. I've been at Riverside 34 years. And my role here as the EMS System Manager, I've been in that role for 14 years. And my role as the EMS System Manager is I oversee the daily operations of our EMS system. We oversee 26 departments including one correctional facility, the Kankakee County Jail, and then we have two 9-1-1 centers that I oversee. I oversee the planning, the coordination and evaluation of emergency medical services. In addition, I ensure that the federal and state regulatory compliances are available for our departments and that we're following those compliance rules.

I manage resources, implementing training programs, process initial EMS license, relicense EMS providers, improve response efficiency to enhance patient care, implement training. I oversee our paramedic program, our EMT program at Kankakee Community College, and we also have some EMT programs that we do at fire departments that I oversee.

Host: Oh, that's fantastic. That's all incredibly important work, so thank you for what you do for the community. That's awesome. So talking about our topic, what exactly does early heart attack care mean, and why is it so critical for individuals to recognize the signs early on?

Al Ponton, MSN, RN, Paramedic: The concept of the early heart attack care or EHAC, if you ever kind of name that, it gained prominence in the late 1980s and early 1990s with the Society of Chest Pain Centers, establishing an EHAC program in 1998, to aim to prevent ultimately death and disability from heart disease.

Host: Okay. Okay. So what are some of the more common signs and symptoms of a heart attack that people should be aware of?

Al Ponton, MSN, RN, Paramedic: Yeah. Symptoms of a heart attack can differ from person to person, and it's also gender specific between males and females. The typical signs of a heart attack may include chest discomfort or pressure lasting more than a few minutes or a recurring pain that radiates in somebody's arm, jaw, their neck, their back. They might have some shortness of breath. They might also complain of nausea, vomiting, some fatigue. They might complain of some cool clammy skin.

But most importantly, recognizing these signs and symptoms early, is critical because prompt medical intervention could prevent heart damage, improve survival rates, and reduce complications. And educating individuals about EHAC or early heart attack care encourages seeking medical help quickly, which can subsequently improve their outcomes.

Host: Okay. That's all really good to know. And that kind of leads into our next question, which is how can individuals differentiate between general chest discomfort or if they feel heartburn or something, or to potential heart attack symptoms. Like if they're like me and they think, oh my gosh, something's wrong with any discomfort, how can they delineate between the two?

Al Ponton, MSN, RN, Paramedic: Yeah, again, it really goes back to that heart attack symptoms that we just went over and making sure that people are looking for that. Whereas general chest pain or muscular chest pain or acid reflux, patients often experience sharp or localized pain, often worse seen with movement or touch.

Patients might complain of burning sensation to the chest, or more commonly known as acid reflux possibly. With non-cardiac chest pain, the pain and discomfort often improves with rest or positioning or taking antacids. But in doubt it's always safest to call and seek medical attention and call 9-1-1 and go to Riverside ER as early as intervention saves lives.

Host: Yeah, absolutely. What are some of the typical misconceptions or misunderstandings that people might have when it comes to recognizing heart attack symptoms early?

Al Ponton, MSN, RN, Paramedic: When you look at that, Taylor, there's a lot of different misconceptions out there. There are several of them and one is really that heart attacks always cause severe pain, and the reality is, some heart attacks cause mild discomfort or pressure rather than intense pain that most people experience, especially in women or diabetic patients.

Another misconception we hear a lot of times, only older adults have a heart attack, right? We hear that a lot. We're young, we're healthy, we're not going to have a heart attack. But really the reality is that heart attack can happen at any age. And our risk of a heart attack increases with our age and younger individuals can also experience heart attacks due to the factors like stress, smoking, being overweight, or maybe possibly having some underlying cardiac condition.

Another misconception I think we hear a lot is pain is always to the left side of our chest, right? We hear that quite often. And the reality is pain can radiate to the right side, to our jaw, to our back, our right side of our chest. So when we really look at that, it could be all over our body. So we can never ignore those types of symptoms, especially if they don't go away.

I've always taken care of patients who told me they, they couldn't have a heart attack because the symptoms would go away and really with a heart attack, those symptoms may come and go, but that doesn't mean that the heart isn't in distress. Ignoring intermittent warning signs can be dangerous. Another big misconception is that only men have classic heart attack symptoms.

While that might be true to some degree, women often experience different or more subtle symptoms such as the nausea, the dizziness, the extreme fatigue or discomfort, rather than that sharp chest pain that a lot of people say that they have when they're having a heart attack. But most importantly, recognizing these misconceptions can help individuals take in early symptoms more seriously and seek prompt medical care.

Host: Yeah, that's really interesting because I think unless you've personally experienced it or witnessed it, like you kind of just lean towards what you've seen in movies and stuff where it's always very dramatic and, you know, falling out of a chair kind of thing. And so what you're saying is it can be much more subtle than that.

And so it's good to have the awareness of what those symptoms look like so that you can acknowledge it and get interventional help. That's, really important.

Al Ponton, MSN, RN, Paramedic: Yeah, absolutely. Absolutely.

Host: Well, awesome. Before we continue our conversation, we're going to take a moment to talk about the importance of primary care.

At Riverside Healthcare, your primary care provider is dedicated to being in your corner, helping you and your family stay healthy and thrive. Find the right primary care provider for you at Riversidehealthcare.org/acceptingnew. From annual screenings to well checks and everything in between, having a primary care provider that you can trust makes all the difference.

We are back talking about early heart attack care, signs and symptoms and all of that with Al Ponton. So what are some of the key risk factors for heart attacks and how can people mitigate those risks? I know we talked about some of the causes, but what are some of the mitigation tools and lifestyle changes?

Al Ponton, MSN, RN, Paramedic: So heart attacks are often linked to a combination of lifestyles. There's also medical and genetic factors that play into a role with our heart and heart attack. While some risks cannot be changed, many can be managed through lifestyle adjustments and medication interventions. We often look at educating individuals on modifiable risk factors or risk factors that we can control right, as individuals.

Take for example, high blood pressure. Controlling that through low sodium diets, our regular exercises, and taking our prescribed medication if needed. And we also look at high cholesterol. That's another factor that plays into possibly having a heart attack. And again, reduce the amount of saturated fat that we take into our food, increase our fiber in our diet.

And again, it goes back to that exercise regularly. You think about that often, right? We have to exercise, exercises our heart too. And I hate to say this, but a lot of times that's smoking, people that smoke, by quitting smoking simply reduces your heart attack risk within months.

And so it's really a key factor, for that. Diabetes is another one. Managing our blood sugars, through diet, medication and lifestyle changes could help reduce your chances of having a heart disease later in life. And many Americans suffer from a poor diet. A lot of people do. And with that, we need to avoid excessive processed foods.

Our sugars and our unhealthy fats. Focus on whole foods, lean proteins and healthy fat foods. Limit intake of alcohol to moderate levels. Most recent research shows that recommended daily consumption of alcohol is one drink per day for women and two for men. That we have those chronic stress is important too, and trying to reduce our stress.

But on the flip side, there's also some non-modifiable risk factors that can't be changed, but can be managed. Think about our age. As we get older, our risk factor increases with our age, particularly after age 45 for men and 55 for women. Or possibly having a family history is another non-modifiable risk factor.

If you have a history of chest disease in close relatives increases your risk in this situation, making lifestyle changes are even more crucial at that point. Another non-modifiable risk factor is gender. We talked about that earlier a little bit, and men have a higher risk at a younger age, but postmenopausal women, they also face an increased risk of having heart disease later in life.

But when talking about lifestyle changes and how they may play a role, absolutely. One studies shows that making heart healthy lifestyle choices can significantly reduce your risk of having a heart attack, even in individuals genetic predisposed. A combination of regular exercise and nutritious diet, stress management and avoiding smoking can cut heart attack risk rates by over 80%. So making these changes early and maintaining them can improve heart health and overall wellbeing.

Host: 80% is a staggering number.

Al Ponton, MSN, RN, Paramedic: Yeah.

Host: Well I want to take a minute to, you mentioned cutting smoking out of lifestyle choices. We do have a smoking cessation program at Riverside that's taking place. It's a quarterly program, so if you want more information about that, go to riversidehealthcare.org and search our events and you could sign up to learn more about smoking cessation.

So how can individuals and communities be better educated about the importance of early heart attack care?  

Al Ponton, MSN, RN, Paramedic: Raising awareness is most important. And we're raising that awareness about early heart attack symptoms and need for prompt action can save lives. There are many different ways one can better educate and be educated in it.

One that I am proud of is how Riverside offers free heart scans in February for patients who have a Riverside Primary care physician. I think that's one of the greatest things that we have in our community that Riverside offers for us. In addition, we offer traditional CPR classes and hands-only CPR for the community members, and that comes through the EMS office.

By calling the EMS office, I can go out and have our paramedics also CPR instructors, go out and do some training to help with that. Social media also plays a big role. Television, radio, education, and early heart attack care can reach a much broader arena by that and encourage individuals to become CPR certified. Integrate healthcare education into schools, curriculums, and employers offering and promoting workplace wellness programs that include heart attack risk screening. Really, by implementing these strategies, both individuals and communities can take a proactive approach to heart attack prevention and early intervention.

Host: You mentioned CPR certification, which leads right into our next question. What is the importance or the connection between those two and what should a bystander do in a situation of someone having a heart attack?

Al Ponton, MSN, RN, Paramedic: CPR is really important. It's really important for heart attack survival, especially if the person goes into cardiac arrest where they lose their pulse and they are not able to breathe.

And immediate CPR helps maintaining their blood circulation to vital organs until professional medical help arrives, significantly increase in survival chances. For the bystanders, what they can do is really if somebody's having a heart attack, if the person is conscious and showing a heart attack symptoms, they need to call 9-1-1 immediately.

 Keep the person calm, loosen some of their tight clothing. If their patient has aspirin or there's the aspirin available and the patient's not allergic to aspirin, or they don't have a history of a gastrointestinal bleed, go ahead and administer the aspirin. A lot of times our 9-1-1 operators will advise the bystanders that are calling to go ahead and administer the aspirin before EMS arrives, especially for the condition till EMS arrive and always be prepared as a bystander to perform CPR if that individual did lose their pulse. And if the person does lose their pulse and go unresponsive, immediately calling 9-1-1 is the most important thing and starting CPR right away and using an AED if available. And if the bystander doesn't know CPR, the 9-1-1 telecommunicator will be able to instruct the bystander on the phone of how to perform CPR.

And again, the most important either one, is that the heart attack can quickly lead to cardiac arrest, and every minute without CPR reduces survival chances by seven to 10%.

Host: Wow. Okay. well, I'm going to get my CPR certification for sure now. This has inspired me to finally do that. Why is it so important to seek help immediately if someone suspects they're having a heart attack? You kind of already answered this, but if there's any more to that point.

Al Ponton, MSN, RN, Paramedic: Yeah. If somebody suspects they're having a heart attack, getting medical help immediately can be a difference between life and death.

Host: Mm-hmm.

Al Ponton, MSN, RN, Paramedic: Here's why. Calling 9-1-1, and getting to Riverside Medical Center immediately can help prevent heart damage. It reduces our risk of them going into cardiac arrest, and it increases their survival chances. Remember, our time is our muscle.

Host: That again leads into our next question, which is these all kind of tie together is quick action during a heart attack, both on the patient side and the bystander side. How does that tie to recovery outcomes?

Al Ponton, MSN, RN, Paramedic: You have to act immediately, especially if you think you're having a heart attack. Calling 9-1-1, getting to Riverside ER immediately is the most important thing to do. Especially if you're suspecting you're having that heart attack. The faster a heart attack is treated, the better survival rate, recovery, and long-term heart function.

Kind of think about this, delaying every 30 minutes can significantly increase damage and risk to our heart. So call the 9-1-1 immediately, if you're having a heart attack, symptoms appear. Time is muscle, and time saves lives.

Host: Well that's fantastic Al. That's really good information. Was there anything else you wanted listeners to know on the subject?

Al Ponton, MSN, RN, Paramedic: Yeah. Learn CPR. Recognize those early signs of a heart attack, acting fast, every minute counts and living a healthy heart lifestyle can save lives and including your own. And remember, Riverside Medical Center is a nationally certified chest pain center, part of our heart and vascular Institute providing rapid diagnosis and comprehensive treatment for our heart attacks, including angioplasty, stenting. And we are the only hospital locally that are able to do open heart surgery.  

Host: Yeah. So that's something to keep in mind. Definitely take advantage in February of those free screenings. But even if it's not February, schedule an appointment. Get checked out. Because like you said, intervention could save your life.

So thank you so much for your time and insight. I appreciate it. And thank you for tuning into the Well Within Reach podcast. To learn more about Heart Care and the Riverside Heart and Vascular Institute, go to my rhc.net/heart.