Call 911 immediately. That single action is the most important thing you can do if someone is having a heart attack. Every minute without treatment increases the damage to heart muscle, and paramedics can begin life-saving care on the way to the hospital. Once you’ve made that call, there are several things you can do to help while waiting for emergency services to arrive.
Recognize the Symptoms
The classic sign is chest pain or pressure, often described as a squeezing or heavy sensation in the center of the chest. But heart attacks don’t always look the way they do in movies. Some people experience pain that radiates into the left arm, jaw, neck, or back. Shortness of breath, cold sweats, nausea, and lightheadedness are all common.
Women in particular often have symptoms that are easy to dismiss. Unusual fatigue, nausea, vomiting, dizziness, and back or jaw pain may occur without any chest pain at all, and these symptoms sometimes appear while resting or even during sleep. If something feels seriously wrong, trust that instinct. Don’t worry about causing a false alarm by calling 911.
What to Do Step by Step
Call 911 first. Do this before anything else. Don’t wait to see if symptoms improve, and don’t let the person convince you they’re fine. Denial is extremely common during heart attacks, and delay costs lives. Ideally, treatment should begin within 90 minutes of arriving at a hospital.
Help them sit or lie down. The goal is to reduce the workload on the heart and prevent a fall injury if they lose consciousness. Sitting on the floor with their back against a wall or sturdy furniture is a good option. It keeps them stable and makes it easier to reposition them for CPR if needed. If they’re alone, they should sit or lie down somewhere first responders can easily find them, like near the front door.
Loosen tight clothing. Undo belts, ties, collars, or anything restricting their chest or breathing.
Ask about prescribed medications. If the person takes nitroglycerin for a known heart condition, help them take it. The tablet goes under the tongue while they’re sitting down. Do not give them someone else’s prescription medication.
Consider aspirin if directed. Aspirin helps prevent blood clotting and can reduce heart damage during an attack. The 911 operator may tell you to have the person chew and swallow an aspirin (a full 325 mg tablet or a low-dose 81 mg tablet). Only do this if instructed by the operator or a physician, and only if the person isn’t allergic to aspirin. Don’t delay calling 911 in order to find aspirin. Call first.
Stay with them. Do not leave the person alone except to call for help. Keep them calm and reassured while you wait.
If They Become Unconscious
A heart attack can lead to cardiac arrest, where the heart stops beating effectively. If the person becomes unresponsive, isn’t breathing, or has no pulse, begin CPR right away. If two people are present, one should call 911 while the other starts compressions.
If you’re not trained in CPR, do hands-only CPR: push hard and fast on the center of the chest at a rate of 100 to 120 compressions per minute. That’s roughly the tempo of the song “Stayin’ Alive.” Press down at least 2 inches with each compression. Don’t stop until paramedics arrive or the person starts breathing again. If you are trained in CPR and confident in your skills, give 30 chest compressions followed by two rescue breaths, then repeat.
How to Use an AED
If the person is unconscious and an automated external defibrillator is nearby (many public buildings, gyms, airports, and offices have them), grab it and use it. You don’t need training. The machine talks you through every step.
Turn it on and follow the voice prompts. Remove clothing from the person’s chest and wipe it dry if needed. Place one adhesive pad on the upper right side of the chest and the other on the lower left side, a few inches below the armpit. The machine will analyze the heart rhythm automatically. When it tells you to, say “clear” loudly so nobody is touching the person, then press the shock button. Continue CPR between shocks as the AED instructs.
What Not to Do
- Don’t drive them to the hospital yourself. Paramedics carry equipment and medications that can begin treatment immediately. An ambulance is faster than your car in every way that matters.
- Don’t wait to see if symptoms pass. Heart muscle is dying with every minute of delay. “Let’s just see how you feel in 20 minutes” is one of the most dangerous things you can say.
- Don’t give food, water, or medication by mouth unless it’s their prescribed heart medication or aspirin recommended by a 911 operator.
- Don’t let embarrassment stop you from calling. If it turns out not to be a heart attack, that’s the best possible outcome. Emergency responders would far rather respond to a false alarm than arrive too late.
Why Speed Matters So Much
During a heart attack, a blocked artery cuts off blood flow to part of the heart muscle. The longer that blockage stays in place, the more muscle tissue dies permanently. Hospital teams aim to restore blood flow within 90 minutes of a patient’s arrival, but the clock starts the moment symptoms begin, not when the person walks through the door. Getting to a hospital quickly is the single biggest factor in survival and long-term recovery. People who receive treatment fast often walk away with minimal lasting damage. Those who wait hours may face heart failure or worse.
The most common reason people delay calling 911 is uncertainty. They’re not sure it’s really a heart attack. They don’t want to overreact. They think the discomfort will go away. If someone near you has symptoms that could be a heart attack, make the call. Let the professionals sort it out.