Heart Attack — What to Do

Recognising a Heart Attack

Heart attack symptoms vary between people. Not all heart attacks cause dramatic chest pain. Know all the signs:

What to Do — Step by Step

1. 1

   Call 999 Immediately

   Tell the operator you think someone is having a heart attack. Give your exact address. Stay on the line — the operator will guide you. An ambulance will be dispatched as a priority.

2. 2

   Sit or Lie Them Down Comfortably

   Help the person to sit or lie in the most comfortable position — usually sitting on the floor leaning against a wall, with knees bent. Do not let them walk around. Loosen any tight clothing.

3. 3

   Aspirin — If Available and Not Contraindicated

   If the person is not allergic to aspirin and is able to swallow, give them one adult aspirin (300mg) to chew slowly — not swallow whole. Do not give aspirin if the person is already on anticoagulants (warfarin, rivaroxaban) or if the 999 operator advises against it.

4. 4

   Stay with Them

   Stay with the person, keep them calm and reassured. Unlock the front door so paramedics can enter easily. Gather any medication they take to give to the paramedics.

5. 5

   If They Become Unconscious — Start CPR

   If the person becomes unresponsive and is not breathing normally, start CPR immediately. The 999 operator will guide you through this over the phone.

CPR — Basics

If the person is unconscious and not breathing normally:

1. Place the heel of your hand on the centre of their chest
2. Place your other hand on top and interlock your fingers
3. Press down firmly by 5–6cm, 30 times at a rate of 100–120 per minute (the beat of "Stayin' Alive" by the Bee Gees)
4. If trained in rescue breaths, give 2 rescue breaths after every 30 chest compressions
5. If not trained in rescue breaths, continue hands-only CPR at 30 compressions per minute without stopping
6. Continue until paramedics arrive or the person shows signs of life

Hands-only CPR (without rescue breaths) is effective for adults and should not be delayed due to uncertainty about technique.

Angina vs Heart Attack

Angina is chest pain caused by reduced blood flow to the heart — usually triggered by exertion and relieved by rest or GTN spray. A heart attack occurs when a coronary artery becomes completely blocked.

If the person has known angina:

• Give their GTN spray (1 puff under the tongue) and rest
• If pain does not improve within 5 minutes, give a second puff
• If pain has not improved 5 minutes after the second puff — call 999
• If pain is worse or different from their usual angina, or comes at rest — call 999 immediately