Patient Handout for Heart Attack
If you experience chest pain or other heart attack symptoms, call 9-1-1 immediately—do not drive yourself or have someone drive you to the hospital. 1
Recognizing Heart Attack Symptoms
Heart attack symptoms can include:
- Chest discomfort with or without radiation to the arm(s), back, neck, jaw, or upper abdomen
- Shortness of breath
- Weakness
- Sweating (diaphoresis)
- Nausea
- Lightheadedness 2
Important: Women and some patients may experience atypical symptoms, including unexplained shortness of breath without chest pain, which carries significant risk 2.
Immediate Actions During a Heart Attack
Step 1: Call 9-1-1 First
Call 9-1-1 within 5 minutes of symptom onset—do not wait to see if symptoms improve 1, 2. Ambulance transport is critical because:
- EMS providers can begin life-saving treatment immediately
- They can perform an ECG en route
- Hospitals receive advance notice to prepare 1
Step 2: Take Aspirin While Waiting
Chew 162-325 mg of aspirin (non-enteric coated) while waiting for the ambulance, unless you:
- Are allergic to aspirin
- Have active bleeding
- Have been told not to take aspirin by your doctor 1
Why this matters: Aspirin significantly decreases mortality from heart attack 1.
Step 3: Nitroglycerin (If Previously Prescribed)
If you have been prescribed nitroglycerin:
- Take 1 dose under the tongue when symptoms start
- If symptoms are not improved or worsening after 5 minutes, call 9-1-1 immediately (if not already called)
- Do not take more than 3 doses total, spaced 5 minutes apart 2, 3
Critical warning: Do not delay calling 9-1-1 to take multiple nitroglycerin doses 2.
Long-Term Medications After Heart Attack
You will need to take several medications indefinitely to prevent another heart attack. Never stop these medications without talking to your doctor first.
Daily Aspirin (Class I Recommendation)
- Dose: 75-162 mg daily
- Purpose: Prevents blood clots and reduces risk of death
- Continue indefinitely unless contraindicated 4
Beta-Blockers (Class I Recommendation)
- Purpose: Reduces heart workload, prevents abnormal rhythms, improves survival
- Start immediately and continue indefinitely
- Do not stop suddenly 4
ACE Inhibitors (Class I Recommendation)
- Purpose: Protects heart function, prevents heart failure, improves survival
- Especially important if you have:
- Reduced heart pumping function (ejection fraction <40%)
- Heart failure symptoms
- Diabetes
- High blood pressure
- Large heart attack (anterior wall) 4
Statin (Cholesterol-Lowering Drug)
- Goal: LDL cholesterol <100 mg/dL (ideally <70 mg/dL for very high-risk patients)
- Continue indefinitely regardless of cholesterol levels 4
Additional Medications (If Applicable)
- Clopidogrel: If you received a stent, take for at least 1 month (bare metal stent) or 3-12 months (drug-eluting stent) 4
- Aldosterone blocker: If ejection fraction ≤40% and you have heart failure or diabetes 4
Essential Lifestyle Changes (Class I Recommendations)
These lifestyle modifications are your first line of defense and are as important as medications 5:
1. Stop Smoking Immediately
- Quit all tobacco products
- Avoid secondhand smoke
- This is the single most important lifestyle change you can make 5
2. Physical Activity
- Minimum goal: 30 minutes of activity, 3-4 days per week
- Optimal goal: 30-60 minutes daily
- Activities: Walking, jogging, cycling, or other aerobic exercise
- Cardiac rehabilitation is strongly recommended—ask your doctor for a referral 4
3. Heart-Healthy Diet
- Eat fruits, vegetables, whole grains
- Choose low-fat or non-fat dairy products
- Eat fish regularly
- Include legumes (beans)
- Select lean meats and poultry
- Limit saturated fats and avoid trans fats (hydrogenated oils) 5
4. Weight Management
- Goal: Body Mass Index (BMI) 18.5-24.9 kg/m²
- Waist circumference goals:
- Women: <35 inches
- Men: <40 inches
- Balance calories consumed with calories burned 4
5. Blood Pressure Control
- Optimal: <120/80 mm Hg
- If ≥140/90 (or ≥130/80 with diabetes), medication is needed 5
6. Cholesterol Management
- Total cholesterol: <200 mg/dL
- LDL (bad cholesterol): <100 mg/dL
- HDL (good cholesterol): >50 mg/dL (women), >40 mg/dL (men)
- Triglycerides: <150 mg/dL 5
7. Diabetes Control (If Applicable)
- Goal: HbA1c <7%
- Maintain through diet, exercise, and medications as prescribed 4
Warning Signs to Seek Immediate Help
Call 9-1-1 immediately if you experience:
- Chest pain lasting >5 minutes despite nitroglycerin
- Chest pain that is more severe than usual
- New or worsening shortness of breath
- Pain that occurs with less activity than before
- Pain that now occurs at rest 6
Contact your doctor promptly if:
- Your angina pattern changes (more frequent, more severe, occurs with less effort)
- You develop new symptoms
- You have concerns about your medications 6
Follow-Up Care
Immediate Post-Discharge (Within 1-2 Weeks)
- See your cardiologist for medication review and symptom assessment
- Discuss cardiac rehabilitation enrollment 7
Ongoing Monitoring
- Regular cardiology appointments as scheduled
- Repeat echocardiogram in 6-12 weeks if heart function was reduced 7
- Monitor blood pressure, cholesterol, and blood sugar regularly
Cardiac Rehabilitation
Strongly recommended for all heart attack patients 4. Benefits include:
- Supervised exercise training
- Education about heart disease
- Support for lifestyle changes
- Improved survival and quality of life
Important Reminders
- Keep a list of all medications with doses and frequencies
- Carry nitroglycerin with you at all times if prescribed
- Wear medical alert identification indicating your heart condition
- Inform family members about heart attack symptoms and your action plan 2
- Attend all follow-up appointments—approximately 1 in 5 patients are readmitted within 30 days 7
Your survival and quality of life depend on taking medications as prescribed, making lifestyle changes, and seeking immediate help if symptoms return.