Heart Attack Response

Most Common

• Chest pressure/squeezing: Center of chest, lasts more than few minutes, or goes away and comes back. "Elephant sitting on chest."
• Radiating pain: Spreads to shoulders, neck, jaw, arms (especially left), back, even teeth.
• Shortness of breath: With or without chest discomfort.
• Cold sweat: Sudden sweating, often with pale/clammy skin.
• Nausea/vomiting: May feel like indigestion.
• Lightheadedness: Dizziness, feeling faint.
• Unusual fatigue: Sudden extreme tiredness.

Not all symptoms occur in every heart attack. Some people have mild symptoms, some have severe. Any combination is concerning.

Women's Symptoms (Often Different)

Women more likely to have "atypical" symptoms WITHOUT classic chest pain:

• Unusual fatigue: For days or weeks before (often dismissed)
• Sleep disturbance: Inability to sleep, unusual tiredness
• Indigestion/nausea: May be dismissed as stomach issue
• Back or jaw pain: Without chest pain
• Shortness of breath: Without obvious cause
• Anxiety: Sense of doom, impending death
• Cold sweat: With any of above

Women's heart attacks are often missed because symptoms are less obvious. Take any unusual combination of symptoms seriously.

Silent Heart Attacks

20-30% of heart attacks have minimal or no symptoms, especially in diabetics and elderly. May only be detected later by EKG. Any unexplained sudden fatigue, shortness of breath, or weakness in at-risk individuals should prompt medical evaluation.

Step by Step

1. Call 911 IMMEDIATELY - Don't wait. Don't drive yourself. Ambulance can start treatment en route and alert hospital.
2. Chew aspirin: One regular aspirin (325mg) OR two baby aspirin (162mg total). CHEW and swallow - works faster than swallowing whole.
3. Sit or lie down: Rest. Don't move around. Reduce heart's oxygen demand.
4. Unlock door: So EMS can enter.
5. Stay calm: Anxiety increases heart rate and oxygen demand.
6. If nitroglycerin prescribed: Take as directed (usually 1 tablet under tongue, can repeat every 5 min up to 3 doses if still having symptoms).
7. Be ready for CPR: If person becomes unresponsive and not breathing normally, begin CPR.

Aspirin Protocol

• Dose: 162-325mg (one regular aspirin or two baby aspirin)
• Method: CHEW then swallow. Faster absorption through mouth and stomach.
• Why: Aspirin inhibits platelets, helps prevent clot from growing.

If uncertain about aspirin, call 911 and ask dispatcher. Generally, benefit outweighs risk in suspected heart attack.

Heart Attack (Myocardial Infarction)

Blockage in coronary artery reduces blood flow to heart muscle. Heart usually still beating. Muscle is being damaged but person is conscious. Treatment: Hospital, catheterization, stent, or clot-busting drugs.

Cardiac Arrest

Heart's electrical system malfunctions. Heart stops pumping effectively (may quiver = ventricular fibrillation, or stop completely). Person collapses, unresponsive, not breathing or gasping only. Treatment: CPR + defibrillator (AED).

Heart attack can PROGRESS to cardiac arrest. This is why you stay with the person and monitor.

Signs of Cardiac Arrest

• Sudden collapse
• Unresponsive to voice or touch
• Not breathing or only gasping
• No pulse (if trained to check - don't delay CPR searching)

Response

1. Call 911 (or point at specific person to call)
2. Begin CPR: Push hard and fast in center of chest, 100-120 compressions/minute
3. Send someone for AED if available nearby
4. Use AED immediately when it arrives - follow voice prompts
5. Continue CPR until help arrives or person wakes up

Don't stop CPR except to use AED or when help takes over. Switch rescuers every 2 minutes if possible to maintain quality compressions.

Major Risk Factors

• High blood pressure: Damages arteries over time
• High cholesterol: Builds plaque in arteries
• Smoking: Damages blood vessels, reduces oxygen
• Diabetes: Increases risk 2-4x
• Obesity: Increases other risk factors
• Physical inactivity: Weakens heart muscle
• Family history: Father/brother before 55, mother/sister before 65
• Age: Men 45+, women 55+
• Stress: Chronic stress contributes
• Alcohol: Excessive consumption

Prevention

• Control blood pressure: Below 120/80 ideal, below 140/90 acceptable
• Control cholesterol: LDL under 100 (under 70 if high risk)
• Don't smoke: Or quit - risk drops 50% within 1 year
• Exercise: 150 min/week moderate or 75 min/week vigorous
• Healthy diet: Vegetables, fruits, whole grains, lean protein, limit saturated fat
• Maintain healthy weight: BMI 18.5-24.9
• Manage stress: Chronic stress contributes
• Limit alcohol: 1/day women, 2/day men maximum
• Take medications: As prescribed for BP, cholesterol, diabetes

Stable Angina

Chest pain with exertion, relieved by rest or nitroglycerin. Predictable pattern. Heart muscle not damaged but artery is narrowed. Warning sign.

Unstable Angina

Chest pain at rest, new onset, worsening pattern, or not relieved by nitroglycerin. EMERGENCY - may be heart attack or about to be. Same response as heart attack.

Post-Heart Attack

• Cardiac rehabilitation: Supervised exercise, education, support
• Medications: Aspirin, beta blockers, ACE inhibitors, statins typically prescribed
• Lifestyle changes: Diet, exercise, stress management
• Monitor mental health: Depression common after heart attack
• Follow-up: Regular cardiology appointments

Many people live years after heart attack with proper treatment and lifestyle changes. 25% of heart attacks are repeat events - prevention is critical.

Heart Attack Kit

• Aspirin (regular 325mg - check expiration annually)
• Nitroglycerin (if prescribed - replace every 6 months)
• Phone/way to call 911
• List of medications and medical history

Source: Aspirin anywhere. Nitroglycerin prescription only. Medical alert bracelet recommended for heart conditions.