Recognise the symptoms of a heart attack, distinguish it from cardiac arrest, and take the right immediate actions to save a life.
Heart disease kills more people globally than any other cause — approximately 17.9 million deaths annually. In many of those cases, the person experiencing the heart attack, or a bystander, failed to recognise the symptoms quickly enough. Early treatment dramatically improves outcomes: a heart artery reopened within 90 minutes of symptom onset preserves substantially more heart muscle than one reopened after several hours.
This guide covers how to recognise a heart attack, what distinguishes it from cardiac arrest, and exactly what to do in the critical first minutes.
These terms are often used interchangeably but describe very different medical events. The distinction matters because the immediate response is different.
| Feature | Heart Attack | Cardiac Arrest |
|---|---|---|
| What is happening | Blockage in a coronary artery — heart muscle is starved of oxygen | Heart stops pumping — no organised electrical activity |
| Consciousness | Patient is usually conscious and responsive | Patient is unresponsive |
| Breathing | Usually breathing normally | Not breathing or only gasping (agonal breaths) |
| Pulse | Present | Absent |
| Pain | Typically severe chest pain or pressure | May be preceded by chest pain if heart attack caused it |
| Immediate action | Call 999/911; aspirin; reassure; wait for ambulance | Call 999/911, CPR, AED |
| Can talk and describe symptoms | Yes | No |
A heart attack can progress to cardiac arrest if the arrhythmia that results from the blocked artery causes ventricular fibrillation. This is why a heart attack patient must never be left alone and why you should always have CPR and AED capability ready.
⚠️ If a heart attack patient loses consciousness and stops breathing normally — they have likely gone into cardiac arrest. Start CPR immediately and call for an AED.
The most widely recognised symptom is crushing chest pain or pressure, but heart attacks present in many ways:
Chest symptoms:
Radiating pain:
Accompanying symptoms:
Women are significantly more likely to experience heart attacks without classic chest pain. This has historically led to women's heart attacks being misdiagnosed — by both patients and clinicians — as anxiety, indigestion, or other conditions.
Women are more likely to report:
This does not mean women do not get classic chest pain — many do. But in the absence of it, the other symptoms listed above should still prompt an emergency call. When in doubt, call emergency services. A false alarm costs nothing. A missed heart attack can be fatal.
Call 999 (UK), 911 (USA), 112 (EU), or your local emergency number. Do not drive the patient to hospital yourself if an ambulance can reach you faster — paramedics can begin treatment en route, including clot-busting drugs and 12-lead ECG transmission to the hospital.
Tell the dispatcher:
Sit the patient down — ideally on the floor with their back against a wall, or on a chair. A semi-reclined position reduces strain on the heart. Do not allow them to walk around or exert themselves.
Aspirin inhibits platelet aggregation and can limit the size of the clot blocking the coronary artery. The AHA, BHF, and NHS all recommend 300 mg of aspirin to be chewed (not swallowed whole — chewing achieves faster absorption) as soon as possible if:
Use adult aspirin 300 mg. Regular-strength aspirin (325 mg in the USA) is equivalent. Enteric-coated aspirin is less suitable — if only coated is available, it should still be chewed.
Do not give aspirin if the patient is unconscious, has a known allergy, has been told specifically by a doctor not to take aspirin, or if you are unsure.
Stay with the patient. Talk calmly. Keep them warm and still. Monitor their level of consciousness and breathing every minute.
If the patient loses consciousness and stops breathing normally, begin CPR immediately. Cardiac arrest during a heart attack is survivable with prompt defibrillation — AEDs have the highest impact in these situations.
This is one of the most important questions in cardiac emergency response.
Call an ambulance rather than driving when:
Driving may be acceptable only if:
Ambulances are almost always preferable. UK ambulances carry 12-lead ECG equipment and can alert the cardiac catheterisation lab before arrival, so the team is ready when the patient arrives — dramatically reducing time to treatment.
Research shows that many heart attack patients experienced warning symptoms in the 24–72 hours beforehand — symptoms that, if acted on, could have led to earlier intervention:
These are symptoms of unstable angina — a pre-heart attack state that requires urgent medical evaluation. If you or someone you know experiences these, seek medical assessment the same day.
| Symptom / Situation | Action |
|---|---|
| Central chest pain > 20 min | Call 999/911 immediately |
| Chest pain with arm, jaw, or back pain | Call 999/911 |
| Shortness of breath + sweating + nausea | Call 999/911 — possible atypical heart attack |
| Patient wants to drive themselves | Do not allow it — call ambulance |
| Aspirin available, patient conscious, no allergy | Give 300 mg, chewed |
| Patient loses consciousness | Check for breathing, start CPR, call for AED |
| Patient appears to recover but symptoms returning | Do not cancel ambulance — symptoms can return suddenly |
| Women with fatigue/nausea/back pain | Treat as potential heart attack — call 999/911 |
Understanding risk factors helps identify when atypical symptoms deserve extra urgency:
Any person with multiple risk factors presenting with the symptoms above should be treated as a potential heart attack until proven otherwise. When in doubt — call.
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