If someone near you is having a heart attack, call 911 immediately, help them sit down, and give them an aspirin to chew if they’re not allergic. Every minute matters. Bystander CPR started within two minutes of cardiac arrest increases the chance of survival by 81% compared to no CPR at all. Here’s exactly what to do.
Recognize the Signs
The classic heart attack symptom is chest pain or pressure, often described as tightness, squeezing, or a heavy weight. But heart attacks don’t always look like what you see in movies. Pain can radiate into the left arm, both arms, the jaw, neck, or back. Some people feel shortness of breath without any chest pain at all.
Women in particular often experience less obvious symptoms: unusual fatigue, nausea, vomiting, dizziness, lightheadedness, or pain in the upper abdomen. These symptoms may come on while resting or even during sleep. Because they’re vague, they’re frequently misinterpreted or dismissed. If something feels wrong, especially in combination (sweating plus nausea plus jaw pain, for example), treat it as a possible heart attack.
Call 911 First
This is the single most important thing you can do. Don’t wait to see if symptoms pass. Don’t drive the person to the hospital yourself unless there is absolutely no other option. Paramedics can begin treatment in the ambulance, and hospitals can prepare for the patient’s arrival when they know one is coming.
When you call, the dispatcher will walk you through what to do next. Stay on the line and follow their instructions. They may tell you to give aspirin, start CPR, or use a nearby defibrillator.
Help Them Into a Safe Position
Have the person sit down or lie down, whichever feels more comfortable. Both positions reduce the workload on the heart. Sitting on the floor is a good choice because if the person loses consciousness, you can quickly reposition them to start CPR. If they’re sitting upright, lean them against a wall or a sturdy piece of furniture for support.
Loosen any tight clothing around their neck or chest. Keep them as calm and still as possible. Physical exertion makes the heart work harder, which is the last thing you want during an attack.
Give Them Aspirin to Chew
If the person is conscious, not allergic to aspirin, and hasn’t been told by a doctor to avoid it, have them chew a regular aspirin. Chewing is important because it gets the medication into the bloodstream faster than swallowing whole. Use a plain, uncoated tablet if available, since coated aspirin doesn’t work as quickly during a heart attack.
Make a note of the time they took it. When paramedics arrive, tell them that aspirin was given and when.
What About Nitroglycerin
Some people with known heart conditions carry prescribed nitroglycerin tablets or spray. If the person has their own prescription and is conscious, you can help them take it. They should sit down first, because the medication can cause dizziness, lightheadedness, or fainting.
There is one critical safety issue: nitroglycerin should never be combined with medications for erectile dysfunction (such as sildenafil, tadalafil, or vardenafil). The combination can cause a dangerous drop in blood pressure. If you’re unsure whether the person takes one of these medications, mention it to the 911 dispatcher and let them advise you. Do not give someone else’s nitroglycerin to the patient. Only help them take their own prescribed medication.
If They Lose Consciousness, Start CPR
A heart attack can lead to cardiac arrest, where the heart stops beating effectively. If the person becomes unresponsive and isn’t breathing normally, begin chest compressions right away.
Place the heel of one hand on the center of their chest, put your other hand on top, and push hard and fast. Aim for a depth of at least 2 inches and a rate of 100 to 120 compressions per minute. That’s roughly the tempo of the song “Stayin’ Alive.” If you’re trained in CPR, give 30 compressions followed by two rescue breaths, then repeat. If you’re not trained, just keep doing compressions without stopping until help arrives. Hands-only CPR is far better than no CPR.
The timing here is critical. People who receive bystander CPR within two minutes of cardiac arrest are 95% more likely to survive without significant brain damage compared to those who receive no CPR. Even CPR started up to 10 minutes later still improves survival by 19%. But after 10 minutes with no CPR, the benefit disappears entirely. Don’t hesitate because you’re worried about doing it wrong. Imperfect CPR saves lives.
Use an AED If One Is Available
Automated external defibrillators are found in many public buildings, airports, gyms, and offices. If someone nearby can grab one while you do compressions, use it. AEDs are designed for untrained people. The machine gives clear voice instructions, analyzes the heart rhythm automatically, and only delivers a shock when it detects one is needed. You cannot accidentally shock someone who doesn’t need it.
Turn it on, attach the pads to the person’s bare chest as shown in the diagram on the pads, and follow the prompts. If the AED advises a shock, make sure no one is touching the person, then press the button. Resume CPR immediately after the shock.
Prepare for When Paramedics Arrive
While waiting for emergency services, gather a few things that will help paramedics treat the person faster. If you can, find any medications they take regularly and have them ready to hand over. Knowing what someone is prescribed tells paramedics a lot about their medical history in seconds. Also grab their phone, wallet, and keys so these items make it to the hospital.
When paramedics arrive, tell them what symptoms you observed and when they started, whether the person took aspirin or nitroglycerin (and at what time), and whether they lost consciousness at any point. Clear, specific information helps the medical team make faster decisions.
What Not to Do
- Don’t let them “wait it out.” Heart attacks cause progressive damage to the heart muscle. The longer treatment is delayed, the more tissue dies.
- Don’t let them walk around or exert themselves. Any physical effort increases the heart’s oxygen demand.
- Don’t give aspirin to someone who is allergic to it or who has been told by their doctor to avoid it.
- Don’t leave them alone. Their condition can change rapidly. Stay with them and monitor their breathing and consciousness until help arrives.