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Heart Attack and Occupational Therapy

What is a heart attack? How to tell if someone has a heart attack?
How can you reduce your risk of having a heart attack? What treatments are there for a heart attack?
What is the role of occupational therapy in heart recovery?
Cardiopulmonary Resuscitation


What is a heart attack?


A heart attack, also known as a myocardial infarction, is a severe medical emergency that occurs when the blood flow to a part of the heart is blocked, causing damage to the heart muscle. The most common cause of heart attack is a blockage in one or more coronary arteries, which supply blood to the heart.


During a heart attack, the heart muscle does not receive enough oxygen and nutrients, which can cause the heart to stop functioning correctly. This can lead to severe complications, such as heart failure or arrhythmias (abnormal heart rhythms).

How to tell if someone has a heart attack?

If you think someone has a heart attack, it is crucial to seek medical attention immediately. The most common symptoms of a heart attack include the following:

Chest pain or discomfort: This is often described as a feeling of pressure, tightness, or squeezing in the chest. The pain may also radiate to the arms, neck, jaw, or back.


Shortness of breath: Difficulty breathing or shortness of breath may occur, even when the person is not physically active.


Nausea and vomiting: Some people may experience nausea and vomiting during a heart attack.


Sweating: Excessive sweating, especially if accompanied by chest pain, may signify a heart attack.


Fatigue: Some people may feel unusually tired or weak before or during a heart attack.




It is important to note that heart attack symptoms can vary from person to person, and not everyone will experience the same symptoms. Some people may have only mild symptoms, while others may have no symptoms at all. If you suspect someone has a heart attack, do not wait for all the symptoms to appear. Call emergency medical services immediately. Every minute counts in a heart attack, as prompt treatment can reduce the risk of complications and improve the chances of a full recovery.



Each year, over 60,000 Canadians will suffer their first heart attack.


How can you reduce your risk of having a heart attack?


There are several steps that you can take to reduce your risk of having a heart attack:


Eat a healthy diet: A diet that is high in fruits, vegetables, whole grains, and lean proteins, and low in saturated and trans fats, can help lower your risk of heart disease.

Exercise regularly: Regular physical activity can help lower your blood pressure, improve cholesterol levels, and reduce your risk of heart disease. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.


Quit smoking: Smoking and tobacco use can damage your heart and blood vessels, leading to a higher risk of a heart attack. If you smoke, quitting is one of the best things you can do for your heart health.


Control your blood pressure: High blood pressure puts extra strain on your heart and can increase your risk of a heart attack. Lifestyle changes such as eating a healthy diet, exercising regularly, and quitting smoking can help lower your blood pressure.


Manage diabetes: If you have diabetes, it is essential to control your blood sugar levels to reduce your heart attack risk. This may involve taking medications, eating a healthy diet, and exercising regularly.



Control your cholesterol: High cholesterol levels can increase your risk of heart disease. Lifestyle changes such as eating a healthy diet, exercising regularly, and quitting smoking can help lower your cholesterol levels.


Reduce stress: Chronic stress can raise your blood pressure and increase your risk of a heart attack. Engaging in stress-reducing activities such as exercise, meditation, or therapy can help lower your risk.


By making these lifestyle changes, you can significantly reduce your risk of heart attack and improve your overall health. Work with your healthcare provider to determine the best strategies for reducing your risk of a heart attack.

What treatments are there for a heart attack?


Treatment for a heart attack may include:


Medications to dissolve the blood clot: One of the main goals of treatment for a heart attack is to restore blood flow to the heart. This may involve administering medications that can help dissolve the blood clot blocking the blood flow. These medications, known as thrombolytics, can be given through a vein (intravenously) or a catheter (a thin, flexible tube) inserted into the artery near the blockage.


Coronary angioplasty: This procedure involves inserting a catheter with a small balloon on the end into the blocked coronary artery and inflating the balloon to widen the artery and restore blood flow to the heart. A stent (a small mesh tube) may also be placed in the artery to help keep it open.



Every 22 minutes a Canadian woman dies of a heart attack. Most of those deaths are preventable - CBC News



Coronary artery bypass surgery involves creating a bypass around the blocked coronary artery using a blood vessel taken from another part of the body (such as the chest or leg). The bypass allows blood to flow around the blockage and reach the heart muscle.


Other medications: In addition to medications to dissolve the blood clot, people who have had a heart attack may also be given medications to help prevent further heart attacks, such as aspirin, blood thinners, and cholesterol-lowering drugs.


What is the role of occupational therapy in heart recovery?


Occupational therapy plays a crucial role in heart attack recovery by helping individuals regain skills and independence in their daily lives. Heart attacks can affect a person's ability to perform activities of daily living (ADLs), such as bathing, dressing, and eating, and instrumental ADLs (IADLs), such as managing finances and taking medication. Occupational therapists work with heart attack survivors to help them recover these skills and adapt to any physical, cognitive, or emotional changes resulting from the heart attack.


Some specific ways that an occupational therapist may be able to help an individual who has had a heart attack include:

  1. Assessing physical and cognitive abilities: Occupational therapists can assess an individual's physical and cognitive abilities after a heart attack to determine what activities they can perform safely and any areas that need improvement.

  2. Developing a treatment plan: Based on the assessment, the occupational therapist can work with the patient to develop a treatment plan that addresses any physical or cognitive limitations and helps the patient progress towards their goals.

  3. Teaching energy conservation techniques (see below for additional details): It is common for individuals to tire more quickly after a heart attack. Occupational therapists can teach patients techniques to conserve energy and pace themselves during activities to avoid overexertion.

  4. Providing education on heart-healthy habits: Occupational therapists can provide education on heart-healthy habits, such as healthy diet, exercise, and stress management, to help prevent future heart attacks.

  5. Assisting with returning to work (see below for additional details): For patients who can return to work, occupational therapists can help with transitioning back to work, including providing accommodations and helping patients develop strategies to manage their energy levels while at work.

Overall, occupational therapy can be an important part of recovery for individuals who have had a heart attack, helping them regain their independence and return to their normal daily activities.


What are some strategies for energy conservation?


Energy conservation techniques can be helpful for individuals who tire easily after a heart attack or other medical conditions. Some strategies for conserving energy include pacing, simplifying tasks and prioritizing tasks.



Pacing is a strategy that involves managing your activity levels to conserve energy and prevent fatigue. It involves setting goals for your daily activities and balancing periods of activity with rest. There are several ways to implement pacing:


  1. Set realistic goals for your daily activities, and break them up into smaller, manageable tasks.

  2. Alternate periods of activity with periods of rest. For example, you might work for 15-30 minutes, then take a short break to rest or relax.

  3. Gradually increase your activity levels over time rather than trying to do too much too quickly.

  4. Monitor your energy levels and listen to your body. If you feel tired or experiencing discomfort, take a break or modify your activity level.


Simplifying tasks is another strategy that can help conserve energy and prevent fatigue. It can be helpful to simplify tasks to make them more manageable and less physically or mentally demanding. Break tasks down into smaller, more manageable steps. For example, you might focus on cleaning one room at a time instead of cleaning the entire house at once. Use assistive devices or technology to make tasks easier. For example, use a long-handled dustpan and brush to avoid bending over, or use a computer or tablet to write letters instead of writing by hand.



91,524 people in Canada died of heart conditions, stroke or vascular cognitive impairment in 2016. - Heart and Stroke


Prioritizing tasks is a strategy that can help conserve energy by allowing you to focus on the most critical tasks first, save less important ones for later, or delegate them to someone else.


When you prioritize tasks, you can:

  1. Avoid wasting energy on tasks that are not important or necessary.

  2. Focus on tasks that are most important and have the most significant impact on your life.

  3. Avoid multitasking, which can be mentally and physically draining. Instead, focus on one task at a time.

By incorporating these strategies into your daily routine, you can help conserve your energy and manage the effects of your heart attack more effectively.

What is a gradual return to work plan, and how do occupational therapists help create one?

A gradual return to work plan is a plan that outlines the steps that an individual will take to return to work after a period of absence due to a medical condition, such as a heart attack. The plan may include specific recommendations for accommodations, modified duties, and a gradual increase in hours and responsibilities.


Occupational therapists can play a crucial role in helping individuals create a gradual return to work plan. They can assess an individual's physical and cognitive abilities and provide recommendations for accommodations and modified duties that will allow the person to return to work safely. They may also work with the individual to develop strategies for managing physical and mental fatigue and provide education on heart-healthy habits to help prevent future heart attacks.

In addition, occupational therapists can collaborate with the individual's employer and other healthcare professionals to ensure that the return to work plan is realistic and achievable and that the necessary supports are in place to help the individual succeed.

Overall, a gradual return to work plan can help individuals transition back to work safely and sustainably while minimizing the risk of further health complications. It is essential to work closely with your healthcare team and employer to develop a plan that meets your needs and goals.



Cardiopulmonary Resuscitation


Cardiopulmonary resuscitation (CPR) is a lifesaving technique that can help a person whose heart has stopped beating. If you are trained in CPR and see someone unconscious and not breathing, you should begin CPR immediately.




Here are the steps to performing CPR:

  1. Call for emergency medical help. If you have access to a phone, call 911 or your local emergency number. If you don't have a phone, ask someone else to call for help or go to a nearby phone to call for help.

  2. Check for signs of life. Tap the person on the shoulder and shout, "Are you okay?" If there is no response, check for breathing by tilting the person's head back and looking for chest movement.

  3. If the person is not breathing, begin CPR. Position yourself so that you are kneeling beside the person with your hands on the person's chest.

  4. Place the heel of one hand on the person's breastbone, just above the nipple line. Place the heel of your other hand on top of the first hand.

  5. Interlock your fingers and keep them off the person's chest.

  6. Use your upper body weight (not just your arms) to give compressions at least 2 inches (5 centimetres) deep and deliver at least 100 compressions per minute.

  7. After 30 compressions, open the person's airway by tilting the head back and lifting the chin with one hand. Pinch the person's nose shut and give two breaths into the person's mouth. Each breath should take about one second.

  8. Continue CPR, giving 30 compressions followed by two breaths, until emergency medical help arrives or the person begins to show signs of life, such as breathing on their own or moving.

It's important to remember that CPR should only be performed on a person who is unconscious and not breathing. If the person is conscious and breathing, do not try to give CPR. Instead, call for emergency medical help and follow any instructions given by the operator. If you are not trained in CPR, it is still important to call for emergency medical help as soon as possible. While waiting for the ambulance to arrive, you can help the person by staying with them and providing comfort and support.




References



American Red Cross Training Services. (n.d.). CPR Steps | Perform CPR. Red Cross. https://www.redcross.org/take-a-class/cpr/performing-cpr/cpr-steps


British Heart Foundation. (n.d.). Occupational therapist. https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/a-medical-who-is-who/occupational-therapist


CBC News. https://www.cbc.ca/news/health/womens-heart-health-advocacy-1.6593599


Connected by the numbers. (n.d.). Heart and Stroke Foundation of Canada. https://www.heartandstroke.ca/articles/connected-by-the-numbers


Heart Attack Symptoms, Risk Factors, and Recovery | cdc.gov. (2022, July 12). Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/heart_attack.htm


What is a Heart Attack? (2022, December 7). www.heart.org. https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks