Heart attack: First aid

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A heart attack occurs when one or more arteries supplying your heart with blood and oxygen become blocked. This loss of blood flow injures your heart muscle. A heart attack generally causes chest pain for longer than 15 minutes, but it can also be silent and have no symptoms at all.

About half the people who suffer a heart attack have warning symptoms hours, days or weeks in advance. The earliest predictor of an attack may be recurrent chest pain that’s triggered by exertion and relieved by rest.

The American Heart Association lists these warning signs and symptoms of a heart attack. Be aware that you may not have all of them and that symptoms may come and go.

* Uncomfortable pressure, fullness or squeezing pain in the center of your chest, lasting more than a few minutes
* Pain spreading to your shoulders, neck or arms
* Lightheadedness, fainting, sweating, nausea or shortness of breath

If you suspect a heart attack, even if it feels like indigestion, act immediately:

1. Call 911 or emergency medical assistance. The operator contacts the emergency medical services (EMS) system. In areas without 911 service, call the emergency medical response system. It’s usually better to call these emergency numbers first. Calling your doctor may add unnecessary time. When you call, describe symptoms such as severe shortness of breath or chest pain. This ensures a priority dispatch of EMS responders (paramedics) trained in basic and advanced cardiac life support. Most EMS units carry a portable defibrillator, a device that restores normal heart rhythm by delivering Electrical shocks. Defibrillators can be critical to early successful treatment and survival. Many police and fire rescue units also carry defibrillators and may respond before an ambulance does.
2. Begin Cardiopulmonary resuscitation (CPR). If the person you’re calling about is unconscious, an emergency dispatcher may advise you to begin emergency treatment. If you’re not trained in emergency procedures, doctors recommend skipping mouth-to-mouth rescue breathing and proceeding directly to chest compression. The reason is that if you’re distracted by trying to perform unfamiliar breathing techniques, valuable lifesaving minutes might be lost for the person who needs help. The most important thing you can do is to proceed directly to chest compression to move blood to vital organs, particularly the brain and heart. If you’re trained in emergency procedures, it’s important to do both mouth-to-mouth rescue breathing and chest compression.
3. Decide on the fastest method of transportation. A dispatcher automatically notifies the closest well-equipped EMS unit. Ideally, EMS responders should reach you within 4 to 5 minutes. If you live in a rural or large metropolitan area, however, you may get to the hospital faster by having someone drive you. Don’t drive yourself!
4. Go to the nearest emergency cardiac care facility. Identify in advance the nearest center staffed 24 hours a day with doctors trained to provide emergency cardiac care.
5. Chew aspirin. Aspirin inhibits blood clotting, which helps maintain blood flow through a narrowed artery. If you think you’re having a heart attack, take one regular-strength aspirin and chew it to speed absorption. Avoid aspirin if you are allergic to it or if you have bleeding problems. Don’t delay calling for emergency help just because you’ve taken aspirin. Aspirin alone won’t treat your heart attack.

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