2020 American Heart Association Guidelines for CPR and ECC

These guidelines are based on the most current and comprehensive review of resuscitation science, systems, protocols, and education.

heart attack happens about every 40 seconds in the U.S., and the most common heart attack is caused by a complete blockage in a coronary artery, called ST-elevation myocardial infarction (STEMI). STEMI patients are most often treated with PCI, also known as angioplasty with stent, in which a catheter with a deflated balloon is inserted into the narrowed heart artery. Subsequently, the balloon is inflated, which clears the obstruction and restores blood flow. A stent is then inserted to keep the artery open.




“We know the time to opening the blocked coronary artery with PCI in heart attack patients is an important indicator for how a patient does after their heart attack. There are two measures for this time. One is symptom-to-balloon time, which is before the patient arrives to the hospital after symptoms start, to when that patient has a PCI; second is door-to-balloon time, the time from hospital arrival to PCI,” said study author Gregg W. Stone, M.D., director of academic affairs at Mount Sinai Heart Health System in New York City. “We focused on heart attack size, or damage, with both time measures and found symptom-to-balloon time was by far the more important.”

“During the peaks of the COVID-19 pandemic, hospitals are reporting fewer people coming into the emergency room for heart attack and stroke symptoms – indicating people aren’t calling 911, or they are delaying or avoiding critical care,” Elkind said. “This concerns us because we know it’s very unlikely that there are fewer heart attacks or strokes occurring. These new findings emphasize just how crucial it is to call 911 at the first sign of a heart attack or stroke – because getting quick treatment can be the difference between life and death. As we have been urging even during the COVID-19 pandemic, don’t die of doubt. Call 911 as soon as possible.”


Co-authors are Björn Redfors, M.D., Ph.D.; Reza Mohebi, M.D.; Gennaro Giustino, M.D.; Shmuel Chen, M.D., Ph.D.; Harry P. Selker, M.D., M.S.P.H.; Holger Thiele, M.D.; Manesh R. Patel, M.D.; James E. Udelson, M.D.; E. Magnus Ohman, M.D.; Ingo Eitel, M.D.; Christopher B. Granger, M.D.; Akiko Maehara, M.D.; Ziad A. Ali, M.D., D.Phil.; Ori Ben-Yehuda, M.D. Author disclosures are in the manuscript. The researchers reported no funding sources for this study.


AHA Heart attack warning-signs infographic 2021

Common heart attack warning signs:

  1. Pain or discomfort in chest
  2. Lightheadedness, nausea, or vomiting
  3. Jaw, neck or back pain
  4. Discomfort or pain in arm or shoulder
  5. Shortness of breath

Learn more at Heart.org/HeartAttack

copyright American Heart Association 2021

Smoking directly linked to a higher risk of subarachnoid hemorrhage

Stroke Journal Report

Research Highlights:

  • The relationship between smoking and risk of a serious type of bleeding stroke called subarachnoid hemorrhage (SAH) appeared to be linear, with risk of SAH increasing significantly among people considered heavy smokers.
  • People with genetic variants that predisposed them to smoking behaviors have an increased risk of SAH by more than 60%.
  • DALLAS, Jan. 14, 2021 — Adults who smoke or who are genetically predisposed to smoking behaviors are more likely to experience a serious type of stroke called subarachnoid hemorrhage (SAH),
  • hemorageaccording to new research published today in Stroke, a journal of the American Stroke Association, a division of the American Heart Association. The results of this study provide important evidence that there is a causal link between smoking and the risk of SAH.