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Recognizing Heart Attack, Stroke, and Angina

Heart Attack Symptoms: What to Do

If you or someone near you has heart attack symptoms, don't wait for more than 5 minutes to call 911. Have someone else drive you to the emergency room only if you can't call 911 for some reason, experts say. Never drive yourself unless you have no other option.

"People need to understand that 911 gets you into the hospital in a really rapid manner," Daya says. "You bypass a lot of the process in the waiting area and you're immediately taken back."

Calling 911 is best because emergency medical personnel can start treatment, such as oxygen, heart medications, and pain relievers, as soon as they reach you. They can also alert the hospital to begin preparations for tests and treatment.

Before the ambulance arrives, here are other ways to help yourself or someone else having heart attack symptoms:

  • The patient should chew and swallow an aspirin.
  • The patient should stop all activity, lie still, and try to remain calm.
  • If the patient becomes unconscious, stops breathing, and doesn't respond to stimulation, such as shaking, he or she may be in cardiac arrest. In other words, the heart stops beating. If an automated external defibrillator (AED) is on hand, follow instructions on the device and use it immediately. The device can deliver an electrical shock that can restore normal heart rhythm and make the heart beat again. If the heart doesn't start beating, a trained person should begin cardiopulmonary resuscitation (CPR).
  • If the patient becomes unconscious, doesn't have a pulse, or isn't breathing, a trained person should perform CPR. If you're not CPR-trained, a 911 dispatcher may be able to talk you through the steps until help arrives.


A heart attack can be hard to distinguish from angina, which is temporary chest pain or pressure that happens when heart muscle isn't getting enough oxygen. Angina usually occurs because arteries that supply blood and oxygen to the heart have become narrowed or blocked. Strong emotion, physical exertion, hot and cold temperature extremes, or a heavy meal can trigger angina.

Symptoms include:

  • Pressure, pain, squeezing, or a sense of fullness in the center of the chest
  • Pain or discomfort in the shoulder, arm, back, neck, or jaw

If you have stable angina, symptoms usually happen with predictable triggers. They usually stop if you rest or take nitroglycerin that your doctor has prescribed. Follow your doctor's orders for when to call 911. For instance, patients are often instructed to take nitroglycerin pills within a certain amount of time and then call 911 if symptoms don't go away or if they get worse.

If you have unstable angina, the chest pain comes at unexpected times, even with little physical exertion. Symptoms don't go away with rest or medication. It can be hard to distinguish unstable angina from heart attack symptoms. If your chest pain doesn't improve after you've taken nitroglycerin, or if it worsens, call 911.

If you get chest pain for the first time, call 911. If you've never been prescribed nitroglycerin, don't take anyone else's, says Alfred Sacchetti, MD, an emergency physician and spokesman for the American College of Emergency Physicians.

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