University of Iowa Health Science Relations and
Richard Kerber, MD
Professor of Internal Medicine
First Published: 2000
Last Revised: October 2004
Peer Review Status: Internally Peer Reviewed

If there's any question to call 911 when you experience a chest pain--do so, says a University of Iowa heart specialist.

You might save a few dollars by doing nothing, but you also might be risking your life.

"At least half of all deaths that result from heart attacks are due to rhythm disturbances," says Dr. Richard Kerber, professor of internal medicine in the UI Carver College of Medicine. "And rhythm disturbances typically occur in the first few minutes to first few hours of a heart attack."

These disturbances can be promptly treated if the victim is taken to a hospital. If left untreated, they can be lethal, Kerber says.

In the normal heart, tiny electrical centers--called pacemakers--send rhythmic electrical signals through the heart. These signals cause the heart muscle to contract, or "beat," about 70 to 80 times a minute.

When a person is having a heart attack, cells other than pacemakers may send electrical signals through the heart muscle so that it no longer beats with a normal rhythm.

If enough cells do this and the rhythm becomes disturbed enough, the heart will not beat at all , but will just quiver ineffectively. This is called ventricular fibrillation.

Unless this is corrected rapidly, the person might die, he says.

"If the heart isn't beating effectively, the brain can't get blood flow. And if the brain is deprived of blood flow for longer than four minutes, it will begin to die.

"So you have four minutes to save a life, and that's not very long."

Kerber says the best way to take care of the problem is to prevent it.

"If the person is taken to the hospital quickly, drugs can be given that will prevent the rhythm disturbances from getting underway.

"If a rhythm disturbance does occur, it can be treated by an electrical shock known as defibrillation. This shock will wipe out all the abnormal rhythms and allow a normal rhythm to restore itself."

Kerber says defibrillation can be performed by well-equipped emergency medical personnel who are called to the scene of a heart attack. They will attach electrical monitoring equipment, administer appropriate medication, and transport you to a hospital.

So if you suspect that you might be having a heart attack, call 911 immediately--it may be well worth the money.