If you think someone is having a heart attack
- Call your emergency number now. Do not wait to see if it passes, and do not drive to hospital.
- Sit or lie down in whatever position is most comfortable, usually sitting with knees bent.
- Chew an aspirin (300 mg in many countries, 325 mg in the US, or as the dispatcher advises), unless you are allergic or have been told not to take it.
- Unlock the door and stay on the phone with the dispatcher.
- If the person collapses and is not breathing normally, start CPR and ask someone to find a defibrillator (AED).
Every minute matters. Treatment to reopen a blocked artery works best when it starts early.
The common warning signs
- Chest pain or discomfort: pressure, squeezing, tightness, fullness or pain in the centre of the chest, lasting more than a few minutes or coming and going. It is not always severe.
- Pain spreading to one or both arms, the neck, jaw, back or stomach.
- Shortness of breath, with or without chest discomfort.
- Cold sweat.
- Nausea or vomiting.
- Light-headedness or dizziness.
- A sense of anxiety or that something is badly wrong.
Symptoms can differ
Chest pain is the most common symptom in both men and women. But women, older adults and people with diabetes are more likely to also have, or to have mainly:
- Shortness of breath.
- Nausea, vomiting or indigestion-like pain.
- Back, jaw or neck pain.
- Unusual, extreme tiredness, sometimes for days beforehand.
- Dizziness.
These can be mistaken for flu, heartburn or stress, so people delay calling for help. If symptoms are sudden, unexplained and worrying, call anyway. Emergency services would rather check and find nothing.
Heart attack, cardiac arrest and stroke: the differences
| Heart attack | Cardiac arrest | Stroke | |
|---|---|---|---|
| What happens | A blocked artery cuts blood flow to part of the heart muscle | The heart suddenly stops pumping effectively, usually due to an electrical problem | Blood flow to part of the brain is blocked or a vessel bleeds |
| Person is | Usually awake and talking | Unconscious, not breathing normally | Usually awake, may be confused |
| Key signs | Chest pain, breathlessness, sweating | Collapse, no response | Face drooping, arm weakness, speech problems |
| What to do | Call emergency services, rest, aspirin if advised | Call emergency services, CPR, use an AED | Call emergency services; note the time symptoms began |
A heart attack can lead to cardiac arrest, which is why it is important to stay with the person.
How to do hands-only CPR
If someone collapses, does not respond and is not breathing normally:
- Call emergency services and put the phone on speaker. Send someone for an AED if there is one nearby.
- Kneel beside them, place the heel of one hand in the centre of the chest, with your other hand on top.
- Push hard and fast: about 5 to 6 cm deep, at 100 to 120 compressions a minute (roughly the beat of the song "Stayin' Alive").
- Let the chest rise fully between compressions.
- Keep going until help arrives or an AED tells you to stop. Switch with someone else every two minutes if you can.
- Use the AED as soon as it arrives. Switch it on and follow its spoken instructions.
Dispatchers will coach you through CPR on the phone. A CPR course, often free or low-cost through organisations such as the Red Cross or Red Crescent, builds confidence.
Lowering your risk
Most heart attacks are linked to risk factors you can influence:
- Blood pressure: see how to lower blood pressure naturally.
- Cholesterol: see how to lower cholesterol.
- Smoking: quitting is one of the most effective changes at any age.
- Diabetes: keep blood sugar in your target range.
- Activity: aim for about 150 minutes a week of moderate exercise. Walking counts; see the benefits of walking.
- Weight, diet and alcohol.
Family history and age also matter. Regular health checks find problems before they cause symptoms.
After a heart attack
Recovery usually includes medicines, a cardiac rehabilitation programme of supervised exercise and education, and lifestyle changes. Cardiac rehab is strongly linked to better recovery, so attend if it is offered.
Key takeaways
- Chest pain or pressure, spreading pain, breathlessness and a cold sweat are classic signs.
- Women, older adults and people with diabetes may have less typical symptoms.
- Call an ambulance immediately; do not drive.
- If someone collapses and is not breathing normally, start CPR and get an AED.
This article is general information, not medical advice. In an emergency, call your local emergency number.