What should be done if someone is suspected of having a heart attack?

Immediate Actions for Suspected Heart Attack

If someone is suspected of having a heart attack, immediately call emergency services (9-1-1) rather than transporting the person yourself to a healthcare facility. 1

Recognition of Heart Attack Symptoms

Heart attack symptoms that require immediate attention include:

• Chest pain or discomfort
• Pain or discomfort in the jaw, neck, or back
• Pain or discomfort in the arms or shoulder
• Feeling weak, lightheaded, or faint
• Shortness of breath

Step-by-Step Response Protocol

1. Call Emergency Services

• Call 9-1-1 immediately when heart attack symptoms are suspected 1
• Do not delay by trying to transport the person yourself 1
• Emergency services provide the fastest route to appropriate care and can begin treatment en route

2. Aspirin Administration

• While waiting for EMS to arrive, a person with chest pain suggestive of heart attack may take aspirin if they have no allergy or contraindication (such as recent bleeding) 1
• Recommended dose: 162-325 mg, preferably non-enteric coated (chewed) for faster absorption 1
• If uncertain whether the chest pain is cardiac in origin, do not encourage aspirin use 1

3. Nitroglycerin Use (if previously prescribed)

• If the person has been prescribed nitroglycerin previously:
  • Take only 1 dose of sublingual nitroglycerin initially 1
  • If pain is unimproved or worsening 5 minutes after taking nitroglycerin, call 9-1-1 immediately 1
  • For those with chronic stable angina who experience significant improvement with one dose, it may be appropriate to repeat nitroglycerin every 5 minutes for a maximum of 3 doses, but still call 9-1-1 if symptoms don't completely resolve 1

4. Position the Person

• Place the person in a comfortable position, typically supine if there is evidence of shock 1
• If there's no evidence of trauma, raising the feet about 6-12 inches may be considered while waiting for EMS 1
• Do not raise the feet if movement or position causes pain 1

Hospital Care

Once emergency services arrive, they will:

• Provide immediate assessment
• Administer oxygen if needed
• Begin cardiac monitoring
• Transport to an appropriate facility with a predetermined chest pain protocol 1

At the hospital:

• The person should be evaluated immediately with an ECG within 10 minutes of arrival 1
• For confirmed heart attacks, thrombolytic treatment should be administered within 90 minutes of contacting medical services (the "call-to-needle time") 1

Common Pitfalls to Avoid

1. Delaying the call to emergency services - Many people wait too long before calling 9-1-1, significantly reducing survival chances 2, 3

2. Self-transportation to the hospital - This delays critical care and prevents pre-hospital interventions 1

3. Taking multiple nitroglycerin doses before calling for help - This creates dangerous delays in receiving proper care 1

4. Dismissing symptoms as indigestion or anxiety - Heart attack symptoms can be subtle, especially in women, elderly, and people with diabetes 1

5. Failing to recognize atypical symptoms - Not all heart attacks present with dramatic chest pain; symptoms can include shortness of breath, nausea, or unusual fatigue 1

The timely recognition of heart attack symptoms and immediate action by calling emergency services are crucial for survival and limiting heart damage. Studies show that treatment within the first hour of symptom onset can save significantly more lives than treatment delayed by even a few hours 1.