How to respond to cardiac events during natural disasters

People with existing heart conditions are more vulnerable to cardiac episodes when natural disasters occur, according to the Philippine Heart Association (PHA). 

“In disasters what happens is, siyempre, the normal reaction is matatakot tayo, panic, everything. So that can create stress sa atin. Stress hormones are not good, and stress hormones can actually cause tachycardia or bibilis yung heartbeat natin, tataas ang blood pressure, and this can trigger a cascade of events leading to, number one, pwede mag-heart attack. Number two, mag-shoot up ang blood pressure,” PHA president Dr. Walid Amil said in an interview with GMA News Online.

(In disasters, what happens is, of course, the normal reaction that we will get scared, panic, and everything. So that can create stress for us. Stress hormones are not good, and stress hormones can actually cause tachycardia, or a very fast heartbeat, increasing blood pressure, and this can trigger a cascade of events leading to, number one, a possible heart attack, and number two, a shoot-up in blood pressure.)

“Pwede mag-cause ito ng stroke or yung mga tawag namin doon heart failure,” he added.

(This can cause a stroke or what we call heart failure.)

The Philippine Statistics Authority reported that ischemic heart diseases were the leading causes of death in the country from January to November 2024, tallying up to 106,088 cases, or 19.3% of the total deaths during the period. 

While there were no actual data pertaining to how many cardiac episodes occur in disasters, Amil said that doctors have noticed an increasing trend of cardiac events during or after disasters.

'Time is gold'

Time is crucial when responding to a cardiac episode, according to Amil.

“Yung sa cardiac arrest kasi, time is gold as we call it. Time is gold. So a few seconds lang will really matter,” he said.

(For cardiac arrest, time is gold, as we call it. Time is gold, so just a few seconds will really matter.)

A patient may die if no action is taken within five minutes.

“Well [para maging] brain dead actually, 5 minutes minsan wala na yan… That's the golden period na dapat magkaroon ka ng CPR, and yung chances of surviving yun within that 5 minutes mas mataas.  After that, mababa na yung chances,” he said.

(Well, [for a patient to turn] brain dead actually, they’re already gone in around 5 minutes… That’s the golden period where you have to have CPR, and your chances of surviving it within those 5 minutes are higher. After that, the chances become low.)

“Very important [to note] na time is really an important parameter dito. Kailangan agad-agad mabigyan mo ng tamang CPR,” he added.

(It’s very important [to note] that time is a really important parameter here. You need to provide the correct CPR immediately.)

But how do you know if a person is experiencing a heart attack?

The first sign is a fainting or suddenly collapsing patient.

“Before you say cardiac arrest siya, you have to check also kung responsive pa ba so gigisingin mo. Kung unresponsive, tingnan mo kung nagbe-breathing, humihinga pa ba siya. Kung wala, tingnan mo ang last, which would be pulso,” Amil said.

(Before you can say it’s a cardiac arrest, you have to check also if the patient is still responsive; you have to wake them up. If they’re unresponsive, then see if they’re still breathing. If not, the last thing you need to check would be the pulse.)

“Kakapain mo yung dito sa my neck area, itong malaking ugat natin, sa carotid artery. Kung walang pulso, then you can safely say, cardiac arrest ito,” he added.

(You have to check the neck area for a big vein, the carotid artery. If there’s no pulse, you can safely say it’s a cardiac arrest.)

Once confirmed, the immediate action should be starting CPR, or cardiopulmonary resuscitation, and calling for help.

“Dapat yung chest compression should be at least 2 inches deep, tapos up to 120 compressions in a minute, tapos kailangan medyo straight ang arms mo,” he said.

(The chest compression should be at least 2 inches deep, and up to 120 compressions in a minute, and your arms must be straight.)

An automated external defibrillator (AED), a portable device that utilizes electric shock to help a patient's heart return to normal rhythm, is another option.

Still, it is important to have more people know how to properly conduct a successful CPR.

“Ang ating mga estudyante, ating mga first responders, tinuturuan namin ang barangay health centers kasi very crucial… Tinuturo natin ito all over the country, the proper method of doing it,” Amil said.

(We teach our students, first responders, and barangay health centers because it’s very crucial… We teach this all over the country, the proper method of doing it.)

“I think major urban centers are probably medyo capable, but if you go to the provinces, siyempre talaga, obviously parang kulang talaga. Yung ating usually naman ang first aid, yung mga first response is sa health center, so we have to equip them na maging certified sila, yung capable to do the CPR… of course, [i-provide] yung mga equipment, yung mga AEDs,” he said.

(I think the major urban centers are probably kind of capable, but if you go to the provinces, there would obviously be an observable gap. Usually our first aid and first response would be the health center, so we have to equip them so they will be certified and capable to do the CPR… and of course, [providing] the equipment, AEDs too.)

In addition to CPR, Amil said that it was crucial for patients to always have access to their maintenance medicine.

He also advised the public to prepare go-bags for emergencies and to manage their stress during disaster events.

“I think very important yung preparation. I think the national government and the private sector should go hand-in-hand to prepare the public in terms of education and information… Kailangan siguro i-capacitate yung ating staff sa health centers, and kung meron yung mga first aid medications for heart attack and for stroke, kailangan meron tayong naka-ready," Amil said. 

(I think preparation is very important. I think the national government and the private sector should go hand-in-hand to prepare the public in terms of education and information… We probably should capacitate the staff of our health centers, and if there are first aid medications for heart attack and stroke, we need to have them ready.)

“Siguro i-educate natin [ang tao on] how to handle cardiac emergencies, which I think as I speak mukhang wala pa tayo dyan sa people sa mga health centers,” he added.

(I think we should educate natin [the people on] how to handle cardiac emergencies, which I think as I speak is not yet available to the people in health centers.) — VBL, GMA Integrated News