Heart Attack Warning Signs — and What to Do in the First Hour

Why the first hour matters

During a heart attack, a heart artery is suddenly blocked and the muscle it feeds begins to die. Doctors say 'time is muscle' — the sooner the artery is opened, usually by emergency angioplasty, the more of your heart is saved.

Many people lose precious hours because they think the pain is gas, acidity or tiredness. If in doubt, get checked.

Common warning signs

• Pressure, heaviness, tightness or burning in the centre of the chest lasting more than a few minutes
• Pain spreading to the left arm, both arms, jaw, neck, back or upper stomach
• Breathlessness, with or without chest pain
• Sudden cold sweat, nausea or vomiting
• Unexplained giddiness, extreme weakness or fainting

Signs that are easy to miss

Women, elderly people and people with diabetes often have milder or unusual symptoms — such as only breathlessness, tiredness, indigestion-like discomfort or back pain. Diabetes can blunt pain sensation, so a heart attack may feel surprisingly mild.

What to do immediately

• Call 108 for an ambulance, or get to the nearest hospital with a cath lab. Do not drive yourself.
• Stop all activity and sit or lie down in a comfortable position.
• If you are not allergic to aspirin and have not been told to avoid it, chewing a 300 mg aspirin may be advised — confirm with the emergency operator or doctor.
• If you have been prescribed sorbitrate/nitroglycerin, take it as directed.
• Keep your medicine list and previous reports (ECG, angiogram) ready for the doctors.

Never wait to 'see if it settles'. If chest pain lasts more than 5 minutes, treat it as an emergency.

After the emergency

Once your artery is opened, the focus moves to recovery and preventing another event — medicines, cardiac rehabilitation and control of risk factors. Dr. Senthilnathan's team will guide you through every step.