– By Dr. Erik SteeleA heart attack occurs when blood flow to a section of heart muscle becomes blocked. If the flow of blood isn’t restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.Heart attack is a leading killer of both men and women in the United States. But fortunately, today there are excellent treatments for heart attack that can save lives and prevent disabilities. Treatment is most effective when started within 1 hour of the beginning of symptoms. If you think you or someone you’re with is having a heart attack, call 9-1-1 right away.Heart attacks occur most often as a result of a condition called coronary artery disease (CAD). In CAD, a fatty material called plaque builds up over many years on the inside walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery. Heart With Muscle Damage and a Blocked ArteryDuring a heart attack, if the blockage in the coronary artery isn’t treated quickly, the heart muscle will begin to die and be replaced by scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems. Severe problems linked to heart attack can include heart failure and life-threatening arrhythmias (irregular heartbeats). Heart failure is a condition in which the heart can’t pump enough blood throughout the body. Ventricular fibrillation is a serious arrhythmia that can cause death if not treated quickly.Get Help QuicklyActing fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment is most effective when started within 1 hour of the beginning of symptoms. The most common heart attack signs and symptoms are:Chest discomfort or pain-uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that can be mild or strong. This discomfort or pain lasts more than a few minutes or goes away and comes back.Upper body discomfort in one or both arms, the back, neck, jaw, or stomach. Shortness of breath may occur with or before chest discomfort. Other signs include nausea (feeling sick to your stomach), vomiting, lightheadedness or fainting, or breaking out in a cold sweat. If you think you or someone you know may be having a heart attack:Call 9-1-1 within a few minutes-5 at the most-of the start of symptoms. If your symptoms stop completely in less than 5 minutes, still call your doctor. Only take an ambulance to the hospital. Going in a private car can delay treatment. Take a nitroglycerin pill if your doctor has prescribed this type of medicine. Each year, about 1.1 million people in the United States have heart attacks, and almost half of them die. CAD, which often results in a heart attack, is the leading killer of both men and women in the United States. Many more people could recover from heart attacks if they got help faster. Of the people who die from heart attacks, about half die within an hour of the first symptoms and before they reach the hospital.From 6/23/09The Organ Donation Process – By Dr. Joan PellegriniThere is extensive information available about how to become an organ and tissue donor. Most of us by now know that there are 100,000 people in the US waiting for a life-saving organ transplant. We even make it easy in the State of Maine by allowing you to designate yourself as a donor when you get or renew your driver’s license. However, there is almost no information out there about what this might mean for your loved ones if the time comes for them to be notified that you are a potential organ donor.The vast majority of organ donors sign a declaration card without knowing exactly what this will mean for their family and loved ones if in fact something tragic really does happen to them. I very much want everyone to be an organ donor but I also want donors and their families to be well-informed about the processes that will take place. Once you sign an organ donor card, please tell your family about your wishes. Then, tell them what might happen if you are a potential donor. Our local resource is the New England Organ Bank (www.neob.org or 800-446-6362). Their website does not have this type of information but you may call them with questions. Alternatively, you may print this page to help you discuss this with your family.Many of us think that if we are an organ donor, then our organs will be taken as soon as we die. Unfortunately, if your heart is not beating, then the doctors will not be able to use your organs. You may still be a bone and tissue donor though. In order for you to donate organs, your heart and lungs must still be alive in order to keep your organs alive.Most organ donors have had a sudden illness such as a stroke or heart attack or have been critically injured. If this were to happen to you, before approaching your family about donating your organs, the doctors usually first determine that your brain is dead and there is no chance for recovery. In order for your organs to be donated, the doctors and nurses must keep your heart and lungs alive on a breathing machine in the intensive care unit. Your illness or injury may not be visible and so you may look very much alive to your loved ones. Because you may look “OK”, the news will be even more difficult for your family to understand. Your family will be devastated by the bad news and this would be a terrible time for them to learn that you wish to be an organ donor in the event of your death.Organ donation does not happen immediately after it is determined that you are a potential donor. In fact, it may take 12-24 hours or even more. The reason for this is that the organ procurement organization (OPO) must review your medical history and do lab tests to look for reasons why they may not be able to use your organs. Some of these tests take hours for the results to come back. Also, some of these tests are actual procedures that take some time to be done (cardiac catheterization, bronchoscopy, tissue biopsies to name a few). Once your organs are found to be transplantable, the OPO must then match them to people on the waiting list who have your same blood type and tissue characteristics. Coordinating this effort takes time.Steps that you should take:Decide to be an organ and tissue donor.Let your family and loved ones know about your wishes.Tell your family that if something terrible were to happen to you, the doctors and nurses will help them to understand what is happening.If the medical team determines that your illness is likely nonsurviveable, they will discuss organ donation with your family.If you become an organ donor, the team will need several hours to coordinate this effort. The medical team will spend quite a bit of time with your family to help them understand the process.