If you or a loved one has heart disease, heart attack prevention and treatment are very important subjects. Your physician may have recommended taking a low dose aspirin each day to avoid heart attack. You may have heard that you can increase your chances of survival during a heart attack by taking aspirin. But how?

Imagine that you are sitting watching TV with your spouse. You begin to sense that your chest is heavy. It feels as though someone is tightening wide steel bands around you. You shift positions, but the feeling remains. You take a few deep breaths and try to relax, thinking it is stress. The pain begins to spread to your jaw and shoulder. You mention it to your spouse, who turns to look at you, dashes to the phone to call for an ambulance, and returns with an aspirin. "For your heart attack," says your spouse. Why?

How can aspirin help in heart attack?

A heart attack is an active, ongoing event. It is not something that begins and ends in five minutes. You can limit the damage done to your heart and body during this ongoing event by taking action immediately after the heart attack begins. Calling emergency services is one action step. Taking aspirin is a second action step.

Paramedics will arrive quickly when you call 911. They will give you oxygen and medication for your heart attack. They will monitor your blood pressure and heart rhythm to try to prevent heart attack complications. They will rush you to the emergency room of the nearest hospital.

Once you reach the Emergency Room, doctors and nurses will hurry to perform an EKG and blood tests to confirm or refute a heart attack diagnosis. If you are having a heart attack, doctors will usually try to open the blocked artery with angioplasty, a stent, or a drug.

But why take aspirin? If they are going to use all of these modern "miracle-workers" on you, how can aspirin help in heart attack?

Aspirin has been found to slow down platelets. Platelets are microscopic blood cells your body uses to trigger blood clotting. If you cut your finger, blood begins to flow from the cut. Immediately, platelets move to the cut finger and cause the blood to clot. If you were to take aspirin the moment you cut your finger, you would slow down the movement of platelets. The blood would continue to flow freely for a longer time.

You would need only a tiny amount of aspirin to slow down every tiny platelet in your bloodstream. You would have to take it quickly, though. The clotting of blood would increase minute by minute, so the sooner you took the aspirin, the better your chances of keeping the finger bleeding.

Of course, this would be foolish action in the case of a cut finger. You want the finger to stop bleeding. You want the blood to clot.

In heart attack, however, you do not want the blood to clot. The reason for most heart attacks is the rupture of plaque in a coronary artery. When the rupture occurs, the body senses injury and calls for platelets. The platelets hurry to trigger a blood clot, just as they will in a cut finger. As minutes pass, the clot grows larger and larger. It grows until it completely blocks the artery. Blood can no longer flow to the part of the heart served by that artery. Blood can no longer carry oxygen to the heart. Without oxygen, that part of the heart begins to die. The heart attack runs its course.

If aspirin is taken in the first few minutes of an attack, you slow down the rush of platelets, just as in our example of the cut finger. You make it more difficult for the blood to clot. You keep the blood flowing, carrying vital oxygen to the heart. You limit the risk of heart attack damage.

1. QUICKLY: The most important thing is to take aspirin immediately if you sense you may be having a heart attack. Aspirin needs nearly 15 minutes to fully slow platelets. Get it into your blood stream quickly.

2. AMOUNT: Take one 325 mg. of aspirin for heart attack. Do not take two or three in hopes of getting better results. A smaller dose is actually more helpful than a larger dose.

3. TYPE: The aspirin must not be enteric-coated. The coating is added to keep aspirin from dissolving too quickly in your stomach. For heart attack, you want it to dissolve as quickly as possible. Even when chewed, enteric-coated aspirin have been found to dissolve too slowly. So be sure you always have at hand non-coated 325 mg. aspirin tablets.

4. CHEW: It is very important that you CHEW the aspirin. Do not swallow it whole. CHEW the aspirin at least 30 seconds before swallowing it. Chewing will reduce the tablet to small particles, ready for digestion. It will also stimulate saliva, which will start the digestion. CHEW.

In the October 1997 issue of "Circulation," the American Heart Association (AHA) journal, it was reported that up to 10,000 more people annually could survive heart attack simply by chewing one 325 milligram aspirin tablet at the first chest pain or other heart attack symptom. Be prepared.