According to CDC released statistics, the leading cause of death in the United States was heart disease, with nearly 700,000 reported heart attack-caused deaths in 2020 alone. When arteries leading to the heart are obstructed by plaque, a buildup of fats, and cholesterol, the arterial blood flow is slowed. This sequence of events is known as atherosclerotic cardiovascular disease, which affects about 7.2% of Americans. The plaque, as it continues to build upon itself, has a high probability to rupture, and break off of the arterial wall, forming a clot, and clogging coronary arteries. When the blood flow to the heart is completely blocked, the tissue is unable to get oxygen and begins to die. This is known as a myocardial infarction, or more commonly, a heart attack.
The symptoms associated with a heart attack can range dramatically from mild and hardly noticeable, to severe and fatal. Angina or chest pain that can present as bad indigestion, tightness, pressure, a dull ache, or sharp pain is the most common symptom of a heart attack. Others include breaking a cold sweat; a stabbing pain in the left arm, then spreading to the shoulder, neck, back, right arm, and at times, the abdomen; fatigue ranging in severity; dizziness and lightheadedness, which may cause one to fall or pass out; shortness of breath; and nausea, which is most common in women. Women’s symptoms are atypical and can be very brief, to the point that a full cardiac arrest is commonly the first symptom that is recognized as something out of the ordinary.
Now, you may ask “What can I do?” if you observe someone presenting these symptoms, or if they are unconscious and you believe they may have suffered a heart attack. The first step, whether they are conscious or unconscious, is to immediately call 911, and listen to the instructions given by the operator. Only with paramedics on the way can you proceed to the next steps, as emergency care is vital for the patient’s survival and time is of the essence in order to prevent as much damage to the heart as possible. If the patient is conscious, the next step is to have them sit down, or remain sitting. Then ask if they take any prescribed medication, such as nitroglycerin. It is necessary to not leave them alone, give them anything by mouth (other than prescribed medication if applicable), or allow them to talk you out of calling 911 by downplaying their symptoms. If the patient is unconcious or falls unconscious before the paramedics arrive, immediately check their breathing and their pulse. If neither is able to be found, this means that the patient has gone into sudden cardiac arrest as a result of the heart attack. The heart has stopped, and blood is not being circulated throughout the body, so the brain, nor any other organ or system is being oxygenated. It is imperative that CPR is performed whilst waiting for the ambulance. If an automated external defibrillator (AED) is available in this situation, follow the instructions provided on the machine.
If you observe yourself having symptoms consistent with a heart attack, and you are alone, your best option is to call 911 immediately. The operator will stay on the line with you until the paramedics arrive, and will instruct you on how to proceed with the situation until they do. It is possible that the 911 operator may instruct you to chew a full dose of aspirin, a common blood thinner, as it gets into the blood system faster than swallowing the dosage, in order to keep blood from clotting and attempt to reduce damage to the heart. If you have been told by your medical provider to never take aspirin, do not take it even in the event of a heart attack, as it may cause more harm to the heart and cause you to go into cardiac arrest.
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