If someone near you is having a heart attack, call 911 immediately. Every minute matters: hospitals aim to open the blocked artery within 90 minutes of first medical contact, so the clock starts the moment you make that call. While you wait for paramedics, there are several things you can do to improve the person’s chances.
Call 911 Before Anything Else
This is the single most important step. Paramedics can begin treatment in the ambulance, and the hospital can prepare for the patient before they arrive. If two people are present, one should call 911 while the other stays with the person.
Don’t drive the person to the hospital unless an ambulance absolutely cannot reach you. Emergency crews carry equipment and medications that can stabilize someone mid-transport. If driving is the only option, have someone else drive so the person can stay still and you can monitor them. The person experiencing the heart attack should never drive themselves.
Help Them Into a Safe Position
Have the person sit down or lie down, whichever feels more comfortable. The goal is to reduce the workload on the heart and eliminate any risk of a fall injury if they lose consciousness. Sitting on the floor with their back against a wall works well. It keeps them supported and makes it easier to reposition them for CPR if their condition worsens.
If you’re the one having the heart attack and you’re alone, get to a spot where first responders can easily find you. Sit or lie near an unlocked door if possible, and stay on the phone with 911.
Give Aspirin if Appropriate
Aspirin slows blood clotting, which can limit the damage a heart attack does to the heart muscle. The American Heart Association recommends that alert adults with nontraumatic chest pain chew and swallow 162 to 325 milligrams of aspirin. Chewing gets it into the bloodstream faster than swallowing whole.
Do not give aspirin if the person:
- Has an aspirin allergy or is allergic to similar painkillers like ibuprofen
- Has been told by a doctor not to take aspirin
- Has a known bleeding disorder or stomach ulcer
- Is under 16 years old
Call 911 first, then deal with the aspirin. Don’t delay the emergency call to search for medication. If you’re unsure whether aspirin is safe, the 911 operator can guide you.
If They Have Nitroglycerin
Some people with a history of heart problems carry a prescribed nitroglycerin tablet or spray. If the person has their own prescription and is conscious, help them take one dose under the tongue. They can repeat a dose every five minutes, up to three doses total, if chest pain continues.
Do not give someone else’s nitroglycerin to the person. Nitroglycerin lowers blood pressure, and it can be dangerous for someone whose blood pressure is already low or who has recently taken medication for erectile dysfunction.
Know When to Start CPR
A heart attack and cardiac arrest are not the same thing, but a heart attack can trigger cardiac arrest. During a heart attack, the heart is still beating but part of it isn’t getting blood. In cardiac arrest, the heart stops beating entirely. The person collapses, becomes unresponsive, and stops breathing or only gasps.
If the person becomes unresponsive and stops breathing normally, start CPR immediately. Push hard and fast on the center of the chest, about two inches deep, at a rate of 100 to 120 compressions per minute. If you’re not trained in rescue breathing, hands-only CPR (chest compressions without mouth-to-mouth) still dramatically improves survival.
If an automated external defibrillator (AED) is nearby, use it. These devices are designed for untrained bystanders. They give clear voice instructions, analyze the heart rhythm, and only deliver a shock when it’s needed and safe. You cannot accidentally harm someone with an AED. Keep doing CPR between shocks until paramedics arrive.
Recognizing a Heart Attack
The classic sign is crushing chest pain or pressure, often described as feeling like something heavy is sitting on the chest. But heart attacks don’t always look like the movies. Pain can spread to the arms, neck, jaw, or back. Shortness of breath, cold sweats, nausea, and lightheadedness are all common.
Women are more likely to experience symptoms that don’t match the textbook picture. Unusual fatigue, nausea, vomiting, dizziness, and pain in the upper abdomen or back are frequently reported in women, and these symptoms can appear during rest or even sleep. Many women dismiss these signs because they don’t feel like “typical” heart attack symptoms. If something feels seriously wrong, treat it as an emergency.
What Not to Do
Don’t let the person talk you out of calling 911. People having a heart attack often downplay their symptoms or insist they’ll be fine. Heart muscle begins dying within minutes of losing blood supply, and the damage becomes permanent without treatment. It’s always better to call and be wrong than to wait and be right.
Don’t have the person walk around or exert themselves. Any physical activity increases the heart’s demand for oxygen, which is exactly what a blocked artery can’t deliver. Keep them still and calm. Loosen any tight clothing around the neck and chest.
Don’t give them anything to eat or drink besides aspirin (if appropriate). They may need a procedure soon after arriving at the hospital, and having food in the stomach can complicate that. Don’t offer water unless they need it to help swallow the aspirin.
What Happens at the Hospital
Once paramedics arrive, they’ll likely run an EKG in the ambulance to check the heart’s electrical activity. If the EKG confirms a serious heart attack (called a STEMI), the hospital team will be waiting to open the blocked artery when the patient rolls through the door. The clinical target is to have the artery open within 90 minutes of first medical contact.
For the person having the heart attack, this typically means being taken to a procedure room where doctors thread a thin tube through a blood vessel in the wrist or groin to reach the blockage. A small balloon opens the artery, and a stent (a tiny mesh tube) holds it open. Most people are awake but sedated during this procedure. Recovery in the hospital usually takes a few days, depending on how much damage occurred before the artery was reopened.
This is why calling 911 fast matters so much. The less time the heart goes without blood flow, the less muscle dies, and the better the long-term outcome. People who get treated quickly often recover well enough to return to their normal activities within weeks.