Understanding Cardiac Arrest, Heart Attacks, and the Power of Mental Health

0:00 Speaker 1: Welcome to the Healthy, Wealthy and Wise podcast with Dr William Chokta, MDJD. Our mission is to empower you with the knowledge and the tools you need to thrive in all aspects of your lives. Join us now as we discuss everything from nutrition and exercise to money management and personal growth. Dr Chokta will provide insightful advice on how to improve your physical and financial health, as well as your emotional and mental well-being. Whether you're looking to boost your energy levels, unlock financial freedom or cultivate a more positive mindset, we've got you covered.

0:41 Get ready to become the best version of yourself? So let's get started. Here's Dr William Chokta, MDJD. Speaker 2: Welcome to the Leadership Masterclass. We're going to talk about cardiac arrest and heart attack this morning. We're delighted to have you with us, so let's get started. I believe life is about being of service to others. I believe knowledge is power. I believe leaders can change the world. Today we're going to talk about a very important topic And, as always, i'd like to give you an outline. The outline lets you know what we're going to talk about, and the other purpose of the outline is to let you know that when we're just about done. So first I wanted, as always, to suggest to you let's do what to have you think like doctors, and if you think like doctors, then some of this stuff will make sense to you as we go through this presentation. Next, we're going to talk about the common causes of death in this country. Take a distinction between cardiac arrest and heart attack, and we'll end with a discussion about cardiopulmonary resuscitation.

1:53 So by the time we start talking about CPR, you know that I'm just about done. I realize that you're very busy people and we're absolutely delighted to have you join us on this journey and to spare some of your very valuable time with us. The most common cause of death in this country are heart disease, cancer and trauma. Heart disease , cancer and trauma. We're going to concentrate on heart disease for the time that we have together And we can divide heart disease into two main areas, the most serious parts of heart disease, and that is heart attack and cardiac arrest. Now, you've heard of both of them, but we're going to break it down to distinguish between the two, because sometimes people get them confused. So let's talk about heart attack. Heart attack is when. Well, let me back up, the heart is a muscle that sits in the middle of the chest and is connected through the other parts of the body through very, very large blood vessels. The heart basically works by having blood supplied to it, to those muscles, so that those muscles can pump regularly and efficiently to move blood around to all the different parts of the body. So it's a very, very important part, a very, very obviously important organ in the body, and to do that, the heart must be supplied with the blood

3:24 , supplied through what's called the coronary arteries, or the heart arteries, if you will. These arteries. They go throughout the heart and they supply the muscle with oxygen, with blood, through red blood cells. That allows it to do its work and pump the blood throughout the body. So a heart attack in essence means that there is a blockage, either complete or partial, of those arteries that supply blood to the heart. Let me say that again a heart attack is a blockage, partial or complete, of those arteries we call them coronary arteries that supply blood to the heart. And what happens is that as that blockage becomes more and more and more complete, less and less blood gets to the heart muscles. The heart then cannot function as it normally should and a heart attack may very well ensue. So but we were always taught And this dates back to what's called the Fremenheim study, which is many, many years ago I graduated from medical school in 1973. This is long before that But basically the Fremenheim study told us that when someone is having a heart attack, they would have the primary symptoms include a crushing substernal chest pain that radiated to the left arm, a crushing substernal chest pain,

4:57 a pain in the middle of the chest that was very, very hard, very, very strong, and that then radiated, or moved, if you will , around and down the left arm. Occasionally it could be associated with nausea. But the crushing substernal chest pain was absolutely a major factor in diagnosing this particular condition And that it usually occurred in men, usually in middle age, the elderly men sometimes, who were slightly overweight, and that obviously was important to get these individuals to a hospital so they could be treated immediately. So in effect, the heart attack is basically a plumbing problem. It's a good way to think about it, in other words as a blockage of blood supply to the heart via its coronary artery vessels And so as a result of this blockage either partial or complete, let's say complete blockage blood cannot get to the muscle of the heart and the heart then cannot pump in, the heart goes into a failure or just stops many times Frequently. It's not uncommon that these symptoms of the heart attack could be gradual, maybe discomfort, which then may increase in time depending on level of exertions and depending on the patient's prior medical condition. But the presentations were pretty specific. But there was one

6:29 problem with the presentation for the heart attack And the Fremenhem study, which was, as I said, was the main source of information about this is that the Fremenhem study did not include women. The Fremenhem study again, remember this was probably in the 50s and the 60s, if not before the 70s, and back in those days a lot of the large studies did not include women At least this one did not And the heart attack was primarily considered, primarily a male disease And, as a result, treatment and therapy and education was based on that.

7:13 What was discovered subsequently was that when women have a heart attack, that they don't proceed through the classic Fremenhem study process, that many times women may not have the crushing sub-sternal chest pain that radiates to the left arm, that indeed they may come in with nausea, they may come in with a bad case of indigestion or extreme fatigue, they may have some chest pain, but it might be in the lower chest of the upper abdomen And, as a result, there's a whole area of quality healthcare that has occurred in the last 50 years.

7:56 To improve the quality of treatment for heart disease in women Because it was finally realized that the presentation and the approach and the effect of heart disease in women was different from that of men, and to provide quality care for women who have heart disease, particularly progressing to a heart attack, you have to understand what the methodology is in women and the presentation , the signs and symptoms. So a very, very important change or growth in healthcare that women are not like men 100% in the way they present with a heart attack. Not too long ago. That was a situation in one of our national pastimes, football, where a particular football player was playing in a game very aggressively, was hit and immediately fell to the ground and his heart stomped, immediately, fell to the ground and they noticed he did not have a pulse And so it concluded. The conclusion was immediately that he had a cardiac arrest. So we just talked earlier about the heart attack. That's a plumbing problem. Remember we talked about how the arteries and vessels to the muscle were narrowed or blocked completely and the heart then stops beating . But in this situation the heart stops immediately after

9:30 this traumatic hit. And so what we're talking about secondly here is a cardiac arrest, and a cardiac arrest is not a plumbing problem like heart attack. Cardiac arrest is an electrical problem. Electrical problem Because another part of the anatomy of the heart, in addition to the muscle and the blood supply, it is an electrical unit that there's an electrical charge that starts in this sinoatrial node, the SA node, that spreads its electrocurrent throughout the heart, that allows the muscle to contract and expand as needed and depending on the supply needed by the body. So the heart is a very complex organ and it's more than just the muscle, but it's also an electrical unit . So if you do something, if you interrupt that electrical flow, that heart will immediately stop or certainly begin to function in a way that is not productive. Sometimes it may go into what we call ventricular fibrillation, where the big ventricles of the heart do not pump adequately, but just sort of quiver, if you will, and with that quivering blood does not get around to other parts of the body and the patient is in extreme condition And if intervention does not occur, that patient could die and certainly could very well become brain dead. What we know is that obviously the most sensitive organ in the body to

11:03 blood loss, among others, is the brain, and usually you have about three to four minutes to get that going again, if indeed that's what has occurred, and this was what happened with Mr Hemlin. So let's summarize what we just said here Heart attack is the plumbing problem. The arteries are clogged up so that blood that normally would go to the heart muscle cannot adequately get there in sufficient quantities. Pneumatic arrest is an electrical problem . After a traumatic blow to the heart, for whatever reason, the electrical system is disrupted And because of that disruption the current does not go to the muscle the heart muscle properly and the muscle is the heart is then rendered inadequate in terms of fulfilling its role in getting blood supply to the rest of the body. So what can you do ? Let's say you're in an area, let's say you're walking through an airport and you have time to catch your plane, and in the area is a little crowded and a lot of people moving back and forth, and all of a sudden there's a person walking who begins to slow, let's say an elderly person, and they're sort of grabbing their chest and they immediately fall in the middle of the airport area. You then go up to them and you say

12:36 something, along with other people, to them, and they're not responsive. And you touch them, you feel for a pulse and you do not feel a pulse. This is where cardiopulmonary resuscitation comes in and basically many of you already know this, but I'm going to go over it anyway. This is where you start cardiopulmonary resuscitation. You've seen it on television and what you do is that you first would have someone call 911, if you're not by yourself and you would then lean over the person, be 90 degrees to them and put your the palm of your hand in the middle of their chest bone we call it the sternum about halfway down and middle of the chest, at 90 degrees, and you do 30 compressions and two breaths . Now, some people just do the compression, some people are uncomfortable doing the breaths, that's okay, but it's important to do the compressions after you've called. I had someone to call 911, if you're able to. So cardiopulmonary resuscitation involves 30 compressions, two breaths, 30 to two, and it's very important to do that. If it is a child, then you would do I was, depending on the age of the child, but a very small child you could do 15 compressions to one breath. The most important thing is the call

14:09 911. If, on the other hand, in addition to all of that, you are in an area that has what's called a detribulator and more and more detribulators being placed in public areas now, particularly in airports and other places stores, large stores, malls Usually these are things on the wall with bright colors and they'll say AED and that stands for automated external detribulator. If you see that, you can open that up and basically that's the way where you can actually shock the heart to start electrical activity. So let me go over this again. You're in the airport, you observe a person fall and become unconscious and appears that they may very well have had a cardiac arrest. After you evaluate them, you call 911. If there's someone with you they can help you. If there's no one with you and you believe this person is unresponsive, you cannot fill a pulse, then it's appropriate to start cardiopulmonary resuscitation 30 compressions to two breaths. So let's summarize what we just said. Heart disease is the most common cause of death in the United States. Two of the most common types of heart disease they call death are heart attacks and cardiac arrests. Men differ from women with heart attacks in that women don't have the classic crutch and substernal chest pain with pain that radiates down the left arm.

15:38 Women may present with any number of symptoms. So one has to have a high index of suspicion as to whether a woman is having a heart attack when you see them or evaluate them. Cardiac arrest, on the other hand, is completely different. This will be something that's very dramatic, that will happen immediately, and the person will go from being conscious to being unconscious many times. There you have Menistor Act and if you're comfortable with CPR cardiopulmonary resuscitation, cold 911, have someone call 911, do cardiopulmonary resuscitation 30 compressions to two breaths and continue that until you get assistance or until the patient responds. I would recommend, if you do not have formal CPR training, that you get the CPR training. Usually It's given in schools, many times in churches, the fire department or adult education areas. It's just something good to have just training this good to have because you never know My basic principles And remember what I said. When I get to my basic principles, i'm just about done. My first basic principle is that God is in charge. I am a physician, but I am a physician of faith, and God has been very important to me in my journey throughout life in terms of dealing with different issues and trying to make a difference

17:09 in the world. My second principle is I have no bad days. I decided I learned a number of years ago that whether my day was good or bad was completely up to me. So, with that being the case, i decided that I had had enough bad days and I did not want any more. So I don't have. I have good days and I have great days, but I don't have bad days. Number three don't sweat the small stuff, and most stuff is small. I have also learned that usually if something happens in my throughout my day that appears to be important or traumatic or stressful, that most of times it's never as stressful as I think it is or as important as I think it might be, and usually I can take a more deliberate approach and resolve whatever that issue is. Number four forgiveness is therapy. If someone does something in my perception that I consider to be negative or disruptive or inappropriate, i have learned to forgive them. And not only does forgiveness remove that as an issue for me, I have found that it is absolutely therapeutic And I certainly recommend that to you in the appropriate circumstances. And finally, everything is a relationship And relationships are based on mutual respect, mutual trust and good communication, and it does not matter what type of relationship it is A husband, wife, work relationship, parent,

18:43 child, colleague, colleague If you're able to provide or create mutual respect, mutual trust and good communication, then you will have a very, a number of very good relationships throughout life and will be happy and less stressful as a result. I want to go over a very important area that has to do with cardiac disease, and this may seem a little strange to you , but remember, the body is one unit all together, and all the different parts of the body work together, and so I want to close with a brief discussion about stress management. Stress is one of those things that occurs to us every single day, but we don't pay much attention to it, but yet it's an important part of our lives, and not only is it an important part of our mental life, it's also an important part of our cardiac life. Okay, so one of the things I want to have you to keep in mind that throughout your daily life, it is okay to say no. I have noticed in my practice over the last 15 years that many patients who came to see me and who were stressed were frequently individuals who had difficulty saying no. No means no. You can say it with a smile, you can say it with a hug, but it still means no. What it does is it gives the individual, it gives you the opportunity to have some control over your life

20:17 , instead of always allowing others to dictate what you do and when you do it, and you would be amazed at how having just a small amount of control will be beneficial. So learn how to say no. Remember that the mind is divided into the ego and the superego. The ego is basically responsible for wanting certain things for the individual, and the ego really doesn't care about anybody else. The ego is the rational part of the mind. It's the part of the mind that tells you whether something that you want to do is reasonable or not, and the superego is the right and wrong part of the mind. I would encourage you to remember those three different parts of your mind and to utilize them at all times. One of the things that we know is that what we believe affects how we think, and how we think affects how we feel, and how we feel affects how we act.

21:19 So if you find yourself constantly stressed, it may be something that stems back from your belief system, many of those beliefs that may have started in childhood or early adulthood. I would suggest to you to go back and evaluate a circumstance or an encounter, if you will, that may have been negative or you perceived as negative, and see if it's based on some old belief that you've had for many years. Many times when you do that, you will find out that that belief is no longer tenable and you can change it or get rid of it. And finally, i want to end up with the word think. Before you speak And certainly our parents would tell us that, but think about it in terms of a mnemonic, to some extent The teeth. Before you speak, make sure that what you think is true about something or some circumstance. Before you speak, make sure that what you think is helpful. Before you speak, make sure that what you think is inspiring And make sure that what you are going to say is necessary. And finally, before you speak, make sure that what you're going to say is kind. If you're able to do all those things, you're able to release your own personal power, be less stressed and be less inclined to having serious

22:51 cardiac pathology. Final comment Thank you so much for coming and being a part of this podcast . Please share it with your friends and remember be the change you want to see in the world. Have a wonderful day. Speaker 1: Thanks for listening to the Healthy, wealthy and Wise Podcast with Dr William Choctaw , mdjd. We hope you enjoyed this episode on mental health matters And if you found this episode helpful, you can support and subscribe to the podcast on your favorite podcast platform with the keywords Dr William Choctaw And you've got it. This will help ensure that you don't miss any future episodes. And then take the next step of action and share it with your family, friends and all your coworkers. They'll be glad you did So. Until the next time, live your best possible life the best possible way.