Category: Health & Safety
Recognizing a Heart Attack or Stroke
A heart attack and a stroke are different medical emergencies, but both happen when blood flow to vital tissue is interrupted. During a heart attack, part of the heart muscle may not receive enough blood. During a stroke, part of the brain may lose its blood supply or bleeding may occur inside the brain.
Both conditions require immediate treatment. The longer blood flow is interrupted, the greater the risk of permanent damage, disability, or death.
Symptoms are not always dramatic. A heart attack may begin with mild pressure, indigestion-like discomfort, unusual fatigue, or shortness of breath. A stroke may cause subtle speech changes, sudden confusion, imbalance, or vision problems.
Call 911 when either condition may be occurring. Do not wait for the symptoms to become severe or attempt to drive the person to the hospital yourself.
Recognizing a Heart Attack
A heart attack occurs when blood flow through one or more coronary arteries becomes blocked or severely reduced. Without enough blood and oxygen, the affected heart muscle begins to suffer damage.
Some heart attacks cause sudden, severe symptoms. Others begin gradually and may come and go.
Common Heart Attack Warning Signs
Possible symptoms include:
- Pressure, squeezing, fullness, heaviness, tightness, or pain in the center of the chest
- Chest discomfort that lasts more than a few minutes
- Chest discomfort that goes away and returns
- Pain or discomfort in one or both arms
- Shoulder pain
- Back pain
- Neck pain
- Jaw pain
- Upper-abdominal or stomach discomfort
- Shortness of breath
- A cold sweat
- Nausea or vomiting
- Lightheadedness
- Fainting
- A rapid or irregular heartbeat
- Sudden weakness
- Unusual fatigue
- A sense that something is seriously wrong
A person does not need to have every symptom. Chest pain may be mild or absent.
The American Heart Association advises calling 911 for possible heart attack symptoms even when you are unsure. American Heart Association: Heart Attack Warning Signs
What Chest Discomfort May Feel Like
Heart attack discomfort is not always a sharp pain.
A person may describe it as:
- Pressure
- Squeezing
- Tightness
- Heaviness
- Burning
- Fullness
- An aching sensation
- Indigestion
- A band around the chest
- An elephant sitting on the chest
The discomfort may spread from the chest to an arm, the shoulders, back, neck, jaw, or upper abdomen.
Do not dismiss symptoms because they are not severe or because the person uses the word discomfort instead of pain.
Less-Obvious Heart Attack Symptoms
Some people experience symptoms that are easier to mistake for another condition, including:
- Unusual or extreme tiredness
- Shortness of breath without chest pain
- Nausea
- Vomiting
- Dizziness
- Jaw or back pain
- Upper-abdominal discomfort
- Sleep disturbance
- Sudden weakness
- Anxiety or a feeling of doom
Women, older adults, and people with diabetes may be more likely to experience less-obvious symptoms, although anyone can have them.
Women’s most common heart attack symptom is still chest pain or discomfort, but shortness of breath, nausea, vomiting, back or shoulder pain, and unusual fatigue may also occur.
Heartburn or a Heart Attack?
Heartburn may cause burning discomfort behind the breastbone, often after eating or while lying down. Heart attack symptoms can also feel like indigestion or burning.
It may be impossible to tell the difference at home.
Call 911 when discomfort:
- Is new or unusual
- Is accompanied by shortness of breath
- Spreads to an arm, back, neck, or jaw
- Occurs with sweating, nausea, dizziness, or weakness
- Begins during physical activity
- Does not improve as expected
- Feels different from the person’s usual heartburn
- Occurs in someone with heart disease or significant risk factors
Do not take an antacid and wait to see whether the problem goes away when a heart attack is possible.
Heart Attack Versus Cardiac Arrest
A heart attack and cardiac arrest are not the same.
During a heart attack, the person is often awake and breathing, although the condition may lead to cardiac arrest.
During cardiac arrest, the heart suddenly stops pumping effectively. The person:
- Collapses
- Becomes unresponsive
- Does not breathe normally
- May gasp or make irregular sounds
Cardiac arrest requires immediate CPR and use of an AED.
If someone with possible heart attack symptoms becomes unresponsive:
- Call 911.
- Check for normal breathing.
- Begin CPR when the person is not breathing normally.
- Send someone to get an AED.
- Use the AED as soon as possible.
- Continue until emergency responders take over.
What to Do for a Possible Heart Attack
Call 911 Immediately
Do not wait for the person’s doctor to call back. Do not drive to an urgent care center. Do not wait to see whether rest or medication makes the symptoms disappear.
Tell the dispatcher:
“I think this person may be having a heart attack.”
Provide:
- The address
- The person’s age
- Symptoms
- When symptoms began
- Whether the person is awake
- Whether the person is breathing normally
- Known heart conditions
- Medications already taken
Emergency medical professionals can begin evaluation and treatment before reaching the hospital. They can also alert the hospital so the appropriate team is ready.
Keep the Person Still
Have the person stop all activity and rest in a comfortable position.
Many people prefer to sit upright with their back supported. Loosen tight clothing and keep the area calm.
Do not allow the person to:
- Walk around
- Climb stairs
- Drive
- Continue exercising
- Finish a household task
- Take a shower
- Search extensively for paperwork
Unnecessary activity increases the heart’s demand for oxygen.
Aspirin During a Possible Heart Attack
Call 911 before giving aspirin.
The dispatcher may recommend that the person chew aspirin after checking for reasons it may be unsafe, such as:
- An aspirin allergy
- Active bleeding
- A known bleeding disorder
- Instructions from a healthcare professional not to take aspirin
- Symptoms that may represent a stroke
- Another medical risk
Do not take aspirin and wait for it to relieve the symptoms. Do not give aspirin automatically when you are unsure whether the emergency is a heart attack or stroke.
The American Heart Association specifically advises calling 911 first and taking aspirin only when the dispatcher or a qualified healthcare professional recommends it. Aspirin is not advised for a suspected stroke because some strokes involve bleeding. American Heart Association: Aspirin During a Heart Attack or Stroke
Prescribed Nitroglycerin
If the person has prescribed nitroglycerin for chest pain, help them follow their personal treatment plan.
Do not:
- Give them someone else’s nitroglycerin.
- Give more than prescribed.
- Use an expired or unidentified medication.
- Delay calling 911 while waiting for it to work.
Tell the dispatcher and emergency responders what medication was taken and when.
Recognizing a Stroke
A stroke occurs when blood flow to part of the brain is blocked or when a blood vessel in or around the brain ruptures.
A clot-blocked stroke is called an ischemic stroke. A bleeding stroke is called a hemorrhagic stroke. The symptoms can be similar, and brain imaging is needed to determine which type is occurring.
Because the treatments differ, do not attempt to diagnose the type of stroke or give aspirin on your own.
Remember B.E. F.A.S.T.
What to Do for a Possible Stroke
Keep the Person Safe
Have the person sit or lie down in a safe position.
Do not allow them to:
- Walk without assistance
- Drive
- Eat
- Drink
- Take pills by mouth
- Go to sleep without emergency evaluation
- “Wait it out”
A stroke may interfere with swallowing, increasing the risk of choking.
If the person vomits or becomes unconscious while breathing normally, turn them onto their side when it can be done safely.
If they stop breathing normally, begin CPR and use an AED.
Do Not Give Aspirin
Do not give aspirin during a suspected stroke unless a qualified emergency professional specifically directs you to do so.
Some strokes are caused by bleeding in the brain. Aspirin can make bleeding worse.
Hospital imaging is needed to determine whether the stroke resulted from a clot or bleeding.
Do Not Give Food, Drink, or Medication
A stroke may weaken the muscles used for swallowing. The person could choke or inhale material into the lungs.
Do not give:
- Water
- Food
- Aspirin
- Blood-pressure medication
- Diabetes medication
- Other pills
Follow instructions from the 911 dispatcher.
Do Not Attempt to Lower Blood Pressure
Blood pressure is often high during a stroke. Do not give an extra dose of blood-pressure medication unless an emergency medical professional specifically instructs you to do so.
A sudden reduction in blood pressure may reduce blood flow to the brain.
Record the blood-pressure reading if it is already available, but do not delay calling 911 to find a monitor.
Why Calling 911 Is Better Than Driving
Calling an ambulance does more than provide transportation.
Emergency medical professionals may:
- Assess breathing and circulation
- Perform an electrocardiogram
- Begin treatment
- Monitor heart rhythm
- Manage cardiac arrest
- Check blood sugar
- Recognize stroke symptoms
- Choose an appropriate hospital
- Alert the hospital before arrival
A person can become unconscious or stop breathing during the drive. The driver may also be distracted, frightened, or delayed by traffic and parking.
Do not drive yourself when experiencing possible heart attack or stroke symptoms.
If You Are Alone
If you develop symptoms:
- Call 911 immediately.
- Unlock the door when you can do so safely.
- Sit or lie down.
- Keep the phone on speaker.
- Follow the dispatcher’s instructions.
- Do not drive.
- Do not walk outside to wait for the ambulance.
- Keep prescribed emergency information nearby.
Contacting a neighbor or family member can be helpful, but do not call them before calling 911.
Preparing for Emergency Responders
If another person is available, ask them to:
- Unlock the door.
- Turn on outside lights.
- Secure pets.
- Clear a path.
- Gather the medication list.
- Locate identification and medical information.
- Note symptom timing.
- Meet the ambulance.
Do not delay care while searching for paperwork.
Helpful Resources: Browse CPR & Emergency Response Supplies for products, equipment, services, or supplies related to this section.
Information to Provide
Tell responders:
- When symptoms began
- The last-known-well time
- What the person was doing
- Which symptoms appeared first
- Whether symptoms changed
- Medical conditions
- Current medications
- Blood-thinning medication
- Allergies
- Previous heart attack, stroke, or TIA
- Recent surgery, injury, or bleeding
- Any aspirin or nitroglycerin taken
Bring medication bottles when doing so is quick and practical.
Conditions That May Look Similar
Other problems may cause chest pain, weakness, confusion, or speech changes. These include:
- Acid reflux
- Anxiety or panic
- Low blood sugar
- Migraine
- Seizure
- Fainting
- Medication effects
- Infection
- Inner-ear problems
- Muscle or rib injuries
- Blood clots in the lungs
- Aortic emergencies
Do not attempt to rule out a heart attack or stroke at home. Even medical professionals may need electrocardiograms, blood tests, brain imaging, or other testing to determine the cause.
A false alarm is safer than missing a time-sensitive emergency.
Risk Factors
Knowing risk factors can increase awareness, but a person can have a heart attack or stroke without obvious risks.
Possible shared risk factors include:
- High blood pressure
- High cholesterol
- Diabetes
- Smoking
- Heart disease
- Atrial fibrillation
- Obesity
- Physical inactivity
- Family history
- Sleep apnea
- Increasing age
- Previous heart attack, stroke, or TIA
- Certain blood-clotting conditions
Do not dismiss symptoms because the person is young, active, or appears healthy. Heart attacks and strokes can occur at any age.
After Emergency Treatment
After a heart attack, stroke, or TIA:
- Follow the discharge plan.
- Take medication exactly as prescribed.
- Attend follow-up appointments.
- Participate in recommended rehabilitation.
- Ask about activity and driving restrictions.
- Learn the warning signs of another event.
- Address blood pressure, cholesterol, diabetes, and other risks.
- Keep emergency information accessible.
- Update family members and caregivers on the plan.
Do not stop heart, blood-pressure, cholesterol, blood-thinning, or stroke-prevention medication without speaking with the prescribing professional.
Common Mistakes to Avoid
Try not to:
- Wait for symptoms to become severe.
- Assume mild discomfort cannot be a heart attack.
- Assume indigestion is harmless without considering other symptoms.
- Drive the person to the hospital.
- Call a doctor or family member before calling 911.
- Give aspirin before calling 911.
- Give aspirin during a possible stroke.
- Give food, drink, or pills to someone with stroke symptoms.
- Allow the person to walk around.
- Let the person “sleep it off.”
- Cancel emergency help when symptoms improve.
- Ignore symptoms because the person is young.
- Assume heart attack symptoms are the same for everyone.
- Delay care while searching for insurance information.
- Attempt to lower blood pressure during a suspected stroke.
- Leave the person alone.
A Simple Emergency Checklist
When a heart attack or stroke may be occurring:
- Stop all activity.
- Call 911 immediately.
- Describe the symptoms clearly.
- Note when symptoms began.
- For stroke, record the last-known-well time.
- Keep the person sitting or lying safely.
- Do not allow them to drive or walk around.
- Do not give food or drink.
- Give aspirin only if the dispatcher or qualified professional recommends it.
- Never give aspirin automatically for a possible stroke.
- Monitor breathing and responsiveness.
- Begin CPR if the person becomes unresponsive and is not breathing normally.
- Use an AED as soon as one becomes available.
- Continue until emergency responders take over.
Heart attacks and strokes do not always look dramatic. A few mild or sudden symptoms may be the only warning. When something suggests a heart attack or stroke, call 911 and let emergency professionals determine the cause.
Suggested Guides
- Understanding CPR & How to Use an AED
- Calling 911 & Explaining the Emergency
- What to Do When Someone Faints
- Recognizing When a Problem Is an Emergency
- Choosing Between Your Doctor, Urgent Care & the Emergency Room
- Understanding a Diagnosis & Treatment Plan
Important Health & Safety Notice
The information in this guide is provided for general educational purposes only. Independence Answers is not a medical provider, and this content is not a substitute for professional medical advice, diagnosis, treatment, or supervision. Always follow the instructions of your doctor, pharmacist, or other qualified healthcare professional, especially if you have a medical condition, take medication, or are unsure whether an action is safe for you.
Do not ignore or delay seeking professional care because of something you read here. If you believe someone may be experiencing a serious or life-threatening emergency, call 911 or your local emergency number immediately.
