What to do if someone has a heart attack

Written by: 
Dr Sheena Meredith

What to do if you suspect a heart attack?  What’s the best action while awaiting an ambulance?

The most important action when someone has a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. is to get medical help as fast as possible. It’s vital not to waste time – early intervention can prevent permanent damage to the heart muscleTissue made up of cells that can contract to bring about movement. and may be life-saving. 

People who receive treatment within the first 60 minutes of the onset of symptoms treble their chances of surviving a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. [1] Yet many people delay seeking help. 

  • They may wonder whether the pain is indigestionDiscomfort after eating., and wait to see whether it will pass
  • They may hesitate to trouble the doctor, especially at night or over the weekend or during a holiday
  • They may be away from home and unsure how to summon medical help, or embarrassed to make a fuss because they are with strangers.

Yet this is one of the few situations where seconds really do count. Any sudden or severe chest pain – your own or someone else’s - should be treated as a possible heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. until proven otherwise. 

Don’t delay: call an ambulance straight away.

Could it be a heart attack?

What if I already have angina?

What can I do to help someone until the ambulance arrives?

What should I do if I’m on my own?

Could it be a heart attack?

It’s important to remember that not all heart attacks display classic symptoms. A person will not necessarily abruptly clutch his or her chest in agony – the sort of scene you often see in the movies or on television. 

Sometimes the pain is mild to begin with and gradually gets worse. Sometimes other symptoms are more prominent. These may include:

  • A sensation of pressure or discomfort in the chest
  • Pain or pressure in the upper abdomenThe part of the body that contains the stomach, intestines, liver, gallbladder and other organs., jaw or arms
  • Breathlessness with nausea or vomiting
  • Sweating, feeling clammy
  • Feeling dizzy or faint, losing consciousness
  • A strong sense of impending doom.

As many as one in three people who have a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. don’t have typical chest pain. [2] 

Women, older people and those with diabetes or heart failureFailure of the heart to pump adequately. are especially likely to have little or no pain with a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. – and so may delay calling for help. [2] 

If you or anyone around you develops chest pain or any of the symptoms listed above, never wait more than 5 minutes before calling for emergency medical help.

What if I already get angina?

If you have anginaA central chest pain caused by insufficient oxygen supply to the heart. and you aren’t sure whether this is anginaA central chest pain caused by insufficient oxygen supply to the heart. or a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction., look for the following features that could indicate a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.:

  • Pain that comes on in unusual circumstances - at rest, for example
  • Pain that doesn’t go away as usual when you sit down
  • Pain that doesn’t respond rapidly to your usual medication
  • Pain accompanied by other symptoms such as breathlessness, sweating or nausea.

If you’re in any doubt as to whether it’s anginaA central chest pain caused by insufficient oxygen supply to the heart. or a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction., don’t delay: call an ambulance straight away.

What can I do to help someone until the ambulance arrives?

  • Make the person comfortable – help him or her to sit or lie down. Stay with the person until help arrives and offer reassurance. Activity or strong emotions could put further stressRelating to injury or concern. on the person’s heart
  • Help the person to take one standard aspirin tablet, if one is readily available (as long as he or she is not allergic to aspirin or taking anti-inflammatoryAny drug that suppresses inflammation or anti-clotting drugs). Suggest that the person chews the tablet rather than swallowing it, to help the drug reach the bloodstream faster
  • Note how much time has passed since the symptoms started. This information may be helpful to the medical staff
  • Gather the person’s medications to send into hospital with him or her
  • Don’t give the person food or drink, other than sips of plain water
  • Be prepared for the person to vomit. If he or she is not fully conscious, turn the person’s head to the side to keep the airway open
  • If the person collapses and you can’t find a pulse, give cardiopulmonary resuscitationEmergency life support, with artificial respiration and cardiac massage. if you know how to do this.

What should I do if I’m on my own?

  • Try not to panic
  • Call for medical help, make sure the front door is open, then sit or lie down
  • If possible, ask a neighbour to wait with you until the ambulance arrive
  • If you can find one easily and can take it without problems, chew a standard aspirin tablet – but don’t wander around searching for one
  • Don’t have anything to eat or drink, in case you need an anaestheticA medication that reduces sensation. when you get to hospital.
References: 

1. ‘About Heart Attacks’. British Heart Foundation. http://www.2minutes.org.uk/aboutAttacks.htm

2. Prevalence, clinical characteristics, and mortality among patients with myocardial infarctionDeath of an area of heart muscle due to poor blood supply. presenting without chest pain. Canto JG, Shlipak MG, Rogers WJ et al. JAMA. 2000 Jun 28;283(24):3223-9.