Survive a heart attack


Surviving a Heart Attack When You Are Alone

Did you know bad indigestion could be a sign you’re having a heart attack?

Most people know to call 911 if they experience severe chest pain, but chest discomfort isn’t always present when heart attack occurs. Call 911 if you suddenly experience chest pressure or tightness that radiates to your jaw or either arm, shortness of breath, nausea and vomiting with no explanation, says Duke cardiologist Christopher Granger, MD,

That message is particularly important for women, older people and people with diabetes, says Dr. Granger, because the typical chest pain may not occur. “It may simply be weakness or nausea or feeling poorly. If you suddenly feel any of those symptoms, seek immediate medical attention.”

People who are alone may minimize their symptoms, but it’s even more important for them to call 911 because it will get you better care faster.

“Paramedics can do an EKG, which will tell if there is a blockage or an artery that needs to be fixed,” he says. “They are very good at diagnosing a heart attack, and can get people to the best hospital as quickly as possible.”

A heart attack occurs when an artery becomes blocked and blood flow to the heart is interrupted. In contrast, cardiac arrest occurs when the heart stops beating, which stops the flow of blood. The person passes out and CPR becomes necessary.

Both events require immediate attention. “When the blood flow to the heart is interrupted, the tissue dies or becomes irreversibly damaged,” Dr. Granger says. In the case of cardiac arrest, “CPR can restore some degree of blood flow until emergency medical treatment arrives.”

While a heart attack can occur in anyone – with or without risk factors – your risk for heart attack increases with age, especially if you are age 50 and older.

You are also at increased risk if you are younger than 50 and have diabetes, smoke cigarettes, are overweight, have blocked arteries, high blood pressure, or a family history of these risk factors.

Regular check ups can identify problems that can lead to heart attack before they occur.

What can I do to avoid a heart attack or a stroke?

Online Q&A
Updated September 2015

Q: What can I do to avoid a heart attack or a stroke?

A: WHO estimates that more than 17.5 million people died of cardiovascular diseases such as heart attack or stroke in 2012. Contrary to popular belief, more than 3 out of 4 of these deaths occurred in low- and middle-income countries, and men and women were equally affected.

The good news, however, is that 80% of premature heart attacks and strokes are preventable. Healthy diet, regular physical activity, and not using tobacco products are the keys to prevention. Checking and controlling risk factors for heart disease and stroke such as high blood pressure, high cholesterol and high blood sugar or diabetes is also very important.

Eat a healthy diet: A balanced diet is crucial to a healthy heart and circulation system. This should include plenty of fruit and vegetables, whole grains, lean meat, fish and pulses with restricted salt, sugar and fat intake. Alcohol should also be used in moderation.

Take regular physical activity: At least 30 minutes of regular physical activity every day helps to maintain cardiovascular fitness; at least 60 minutes on most days of the week helps to maintain healthy weight.

Avoid tobacco use: Tobacco in every form is very harmful to health – cigarettes, cigars, pipes, or chewable tobacco. Exposure to second-hand tobacco smoke is also dangerous. The risk of heart attack and stroke starts to drop immediately after a person stops using tobacco products, and can drop by as much as half after 1 year.

Check and control your overall cardiovascular risk: An important aspect of preventing heart attacks and strokes is by providing treatment and counselling to individuals at high risk (those with a 10 year cardiovascular risk equal to or above 30%) and reducing their cardiovascular risk. A health worker can estimate your cardiovascular risk using simple risk charts and provide the appropriate advice for managing your risk factors.

  • Know your blood pressure: High blood pressure usually has no symptoms, but is one of the biggest causes of sudden stroke or heart attack. Have your blood pressure checked and know your numbers. If it is high, you will need to change your lifestyle to incorporate a healthy diet with less salt intake and increase physical activity, and may need medications to control your blood pressure.
  • Know your blood lipids: Raised blood cholesterol and abnormal blood lipids increase the risk of heart attacks and strokes. Blood cholesterol needs to be controlled through a healthy diet and, if necessary, by appropriate medications.
  • Know your blood sugar: Raised blood glucose (diabetes) increases the risk of heart attacks and strokes. If you have diabetes it is very important to control your blood pressure and blood sugar to minimize the risk.

How to manage having a heart attack when you are on your own.

The Heart of The Matter

According to the British Heart Foundation UK statistics, someone is taken to hospital with a heart attack every three minutes.

Many people will be on their own when they have a heart attack. It is vital to know how to help yourself if you are alone and think you’re having a heart attack.

More than 30,000 out of hospital cardiac arrests (when the heart stops beating sufficiently) occur in the UK every year.

Angina is discomfort caused by heart muscle complaining due to a reduced blood supply as blood tries to force its way through a narrowed artery.

A heart attack is when the narrowed artery becomes blocked or ruptures and heart muscle begins to die because of the lack of blood supply.

A cardiac arrest occurs when the heart stops being able to function adequately because of a heart attack or some other medical or trauma problem. The person will stop breathing and become unconscious and it necessary to give CPR, use a defibrillator and call an ambulance to give them a chance of recovery.

If You Are Experiencing Discomfort in your Chest, along your Left Arm or Jaw and Feel Seriously Ill and you are on your own:

Don’t try and drive yourself to A&E – call 999.

Phone a friend or member of your family and ask them to come and be with you.

If you have been prescribed GTN medication, take it now. GTN or Glyceryl Trinitrate is a fast-acting nitrate which widens the coronary arteries to improve the oxygen supply to the heart muscle and this should reduce the pain from an angina attack. It comes as a spray or tablet. It is taken under the tongue and takes effect within two to three minutes. (It might give you a headache)

If the GTN spray or tablet hasn’t helped within 5 minutes and you have been prescribed a 300 mg tablet of Aspirin – take it now.

Aspirin works by slowing the blood’s ability to clot, so during a heart attack, it stabilizes any blood clots that might have formed and reduces the likelihood of further ones forming.

Crush or chew the aspirin to get it into your blood stream faster. Only take a 300mg Aspirin if you have been prescribed it.

Unlock your front door and sit yourself down in the lazy W position, ideally propped comfortably against a wall or stable furniture.

Relax and avoid exerting yourself.

Keep yourself warm.

Aim to remain as calm as you can.

When the paramedics get to you they will start treatment immediately. Paramedics are trained to revive those suffering from heart attacks. They will quickly transfer you to hospital for treatment for the type of heart attack you have had. Each minute is vital to preventing long-term heart damage.

Know The Warning Signs Off By Heart

The symptoms of heart attacks vary widely. They differ between individuals, but also between men and women.

A heart attack can come on suddenly and be intense. Or it can start slowly and be mild. Some patients don’t experience any pain. Some people mistake a heart attack for indigestion or angina.

Those experiencing severe chest pain are more likely to call 999. Those experiencing less serious symptoms, don’t always seek immediate medical attention. However, responding rapidly when you suspect a heart attack can greatly improve your chances for survival and avoiding serious heart damage.

If you are uneasy about any symptoms, if you have symptoms bought on by exercise or exertion, or if you are woken up by symptoms or they come on at rest – you should always quickly seek medical help.

Classic Heart Attack Symptoms

The classic symptom of a heart attack is pain in the chest, especially in the centre, that lasts for a few minutes and comes and goes. This discomfort may feel like pressure, tightness, squeezing, or an aching sensation. The pain can radiate into the neck, arms, back, jaw, or stomach. It can manifest as pain or a general discomfort.

Men often experience a heart attack as chest pain.

However, post-menopausal women and anyone who is diabetic are far less likely to experience chest pain.

Whatever your symptoms, you will probably feel extremely unwell and are likely to be pale, clammy and light headed – listen to those symptoms and phone for help quickly.

Non-Classical Heart Attack Symptoms

Women, post-menopausal women, the elderly and those suffering from diabetes may develop non-classical heart attack symptoms. These include:

  • Nausea, indigestion, heartburn, or abdominal pain
  • Shortness of breath
  • Breaking out in a sweat
  • Feeling lightheaded or dizzy
Two Urban Myths To Ignore
Cough CPR

Cough CPR is often suggested on social media as a response if you think you’re having a heart attack and are alone.

It suggests that breathing deeply and coughing vigorously can squeeze the heart and keep the blood circulating. The squeezing pressure on the heart also helps it regain normal rhythm.

However, there is no medical evidence to support ‘cough CPR’ and many experts are dubious as to how it might work.

Water and cayenne pepper

Another urban myth for heart attacks is to drink a glass of water with a spoonful of cayenne pepper in it. Supporters suggest cayenne pepper is a stimulant capable of increasing the heart rate and carrying blood all over the body, rebalancing circulation.

There is no proof, however, that cayenne pepper is useful when taken at the start of a heart attack. Furthermore, it isn’t clear how capsaicin interacts with aspirin when taken during a heart attack.

Aspirin however has been proved to be helpful.

Ways to decrease your risk of having a heart attack

The World Health Organisation cites eight risk key factors: alcohol use, tobacco use, high blood pressure, high body mass index, high cholesterol, high blood glucose, low fruit and vegetable intake, and physical inactivity. These account for a whopping 61% of all cardiovascular deaths and over three quarters of all CHD, making this the leading cause of death worldwide. Stress also plays a role.

Not all heart attack risk factors are in our control; such as ageing, heredity and gender – men are still at higher risk.

Fortunately, there are some factors you can control to reduce your risk of having a heart attack:

  • Stop smoking and minimize exposure to second-hand smoke.
  • Control high blood cholesterol and high blood pressure by making changes to your diet, lose weight, take medication.
  • Take daily exercise.
  • Limit your alcohol consumption.
  • Eat a healthy and balanced diet, rich in vitamins and minerals.
  • Monitor your weight and try and lose weight if you’re overweight or obese.
  • Diabetics should manage their blood sugar and stick to their treatment plans.
  • Reduce stress in your life with relaxation techniques such as deep breathing or yoga or try talking therapies.

First Aid for Life is a multi-award-winning, fully regulated first aid training provider. Our trainers are highly experienced medical, health and emergency services professionals who will tailor the training to your needs. Courses for groups or individuals at our venue or yours.

First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.

How to Stop a Heart Attack

Most of the time, heart attacks start slowly with just mild discomfort and pain, giving warning signs before they strike. If you experience any of the following symptoms, call 911 or ask someone to call 911 immediately.

These could be signs of a heart attack:

  • Discomfort in the chest, especially the center, that lasts more than a few minutes or comes and goes. The discomfort may feel like heaviness, fullness, squeezing, or pain.
  • Discomfort in the upper body parts such as the arms, back, neck, jaw, or stomach. This may feel like pain or general discomfort.
  • Shortness of breath. This may come with or without chest discomfort.
  • Unusual sensations such as a cold sweat, nausea, vomiting, lightheadedness, or dizziness. Women are more likely than men to experience these kinds of symptoms.

1. Have someone call an ambulance

If others are around, tell them to stay with you until emergency medical services (EMS) workers arrive. Calling 911 is usually the fastest way to get emergency care, as opposed to asking someone to drive you to a hospital in their car. EMS workers are trained to revive people experiencing heart attacks and can also transport you to the hospital for rapid care.

If you’re in a public space such as a store, school, library, or workplace, there’s a good chance there’s a defibrillator on hand.

A defibrillator is the kind of device EMS workers use to revive people who are experiencing heart attacks. If you’re still conscious at the onset of your heart attack, instruct someone nearby to find the closest defibrillator. Defibrillators come with easy-to-use instructions, so it’s possible for a non-EMS worker to revive you if the heart attack strikes.

2. Take aspirin

When you’re still conscious, take a normal dose of aspirin (325 milligrams) if you have one on hand. Aspirin works by slowing the blood’s ability to clot. During a heart attack, aspirin slows blood clotting and minimizes the size of the blood clots that might have formed.

Once the EMS arrive, they will transport you to the hospital, where you receive care for the specific type of heart attack you had.

Learn more about treatments for different types of heart attacks.

How to Survive a Heart Attack

As a former critical care nurse, Linda VanTuyle, RN, was well aware of the symptoms of a heart attack. Yet, when she experienced them firsthand, she did not do what she knew she should have done: call 911 right away. By the time she arrived at the emergency room, an electrocardiogram (EKG), which measures the heart’s electrical activity, showed she was clearly having a heart attack.

“Part of me knew I should go to the ER,” says VanTuyle, 72, who lives in Richmond, Virginia. “I was afraid they’d tell me it was indigestion, and I’d be embarrassed.”

VanTuyle is not alone. More than one million Americans have heart attacks each year, according to the American Heart Association. Many, like VanTuyle, don’t seek immediate medical attention.

Mark Applefeld, MD, director of the Heart Center at Mercy Medical Center in Baltimore, says this is common. “People are in denial. They don’t want to think they are having a heart attack.”

Is It…Or Isn’t It?

Heart attack symptoms vary widely among individuals and between men and women. The most common symptom is pain in the chest. It may feel like pressure, tightness, squeezing, or an aching sensation. The pain may radiate into the neck, arms, back, jaw, or stomach. A heart attack can start slowly and be mild, or come on suddenly and be intense. Some patients don’t experience pain at all.

Men typically experience a heart attack as chest pain. While women may also have pain, they’re more likely to have one or more of these other symptoms:

  • Nausea, indigestion, heartburn, or abdominal pain
  • Shortness of breath
  • Breaking out in a cold sweat
  • Fatigue
  • Feeling lightheaded or dizzy

Dr. Applefeld says people often feel tired and fatigued during a heart attack, especially women and people with diabetes. “Individuals who have terrible pain are likely to call 911 right away.” However, he worries about individuals who have less severe or obvious symptoms. They often do not seek immediate medical attention and end up with more serious heart damage.

“Anything that awakens you or that seems different, or if your symptoms are brought on by exertion, you should call your physician or go to the emergency room,” Applefeld says.

Heart Attack 101

A heart attack, or myocardial infarction, occurs when there is a blockage in the coronary arteries. These major blood vessels deliver oxygen-rich blood to the heart. Lack of blood and oxygen can cause heart muscle to die (infarction means tissue death). The sooner you receive medical help, the more likely you will prevent or minimize damage to the heart. Once heart muscle dies, it cannot grow back or be repaired.

What to Expect at the Hospital

In the ER, the top priority is to prevent clotting, relieve chest pain, and restore blood flow to the heart. Often this involves clot-busting medication or drugs that ease stress on the heart.

In addition to an EKG, emergency room physicians have numerous ways to evaluate the scope of your heart attack. An echocardiogram, for example, uses sound waves to produce an image of your heart. Imaging techniques, such as a chest x-ray or CT scan (computerized tomography), provide pictures of your heart and blood vessels.

Once the immediate danger is under control, your physician may recommend additional procedures to restore as much heart and circulatory function as possible. You may need a stent, or wire mesh tube, in your blocked vessel to hold it open so blood can flow freely. A surgeon may replace a damaged part of your artery with a piece of healthy blood vessel from another part of your body, known as a coronary artery bypass.

Are You at Risk?

The top three risk factors for heart disease are high blood pressure, high cholesterol, and smoking. About half of Americans have at least one of these risk factors, according to the U.S. Centers for Disease Control and Prevention.

Other risk factors include age (over 55 for women, over 45 for men), diabetes, family history, being sedentary or obese, stress, and illegal drug use. If you’ve already had a heart attack, you are at increased risk for a second one.

RELATED: Top 8 Ways We Overtax Our Hearts

VanTuyle says she was nervous following her heart attack and appreciated her prescribed cardiac rehabilitation. Her rehab program included monitored exercising and classes on diet, stress management, and medications. “It was comforting knowing someone was watching my heart to make sure everything was alright,” she says. “The most valuable part was the peer group. We all had this common experience and had to figure out together: What does this mean for the rest of our lives?”

Bottom Line

If you suspect you’re having a heart attack:

  • Call 911. Emergency medical providers will begin treatment immediately. These minutes are crucial in preventing long-term heart damage.
  • Stay still and don’t exert yourself.
  • If you have access to aspirin (and are not allergic), take one immediately to help prevent clotting. Applefeld suggests crushing or chewing the aspirin so it gets into your blood stream faster.
  • Don’t get chilled if possible, says VanTuyle. It constricts blood vessels.
  • Try to remain calm until medical help arrives.

“If you’re in doubt, go to the hospital. It’s hard to tell sometimes if it’s a heart attack,” says VanTuyle. “If it’s nothing serious, you can go home and celebrate.”

The real danger about the misinformation regarding so-called “cough CPR” is that it could prevent heart attack victims from getting the life-saving help they need.

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Social media posts on the Internet claim that by coughing vigorously when you have a heart attack, you can keep yourself from passing out, theoretically saving yourself until your heart starts beating normally again.

The facts

Heart attacks are not the same thing as cardiac arrest. Cardiac surgeon A. Marc Gillinov, MD, says that social media-based information about cough CPR misleads readers. “This confuses heart attack and sudden cardiac death. They are two different things.”

Heart attacks occur when the heart’s oxygen supply gets cut off, which is usually caused by blockages in the cardiac arteries that feed the heart oxygen-rich blood.

When you have a heart attack, tissue in the heart can die. However, your heart usually keeps on beating. Cough CPR is ineffective for heart attacks.

During cardiac arrest, your heart suddenly stops beating. Serious irregularity in the heartbeat (arrhythmia) can cause this.

Cardiologist Steven Nissen, MD, says, “Cough CPR is an effective way to maintain circulation for a minute or two following cardiac arrest.” However, it is “not useful in a patient with a heart attack and shouldn’t delay calling 911.”

When cardiac arrest occurs, unconsciousness and death follow swiftly. Defibrillation is the only way to reliably reset the heart once it has suffered a fatal arrhythmia.

If you see someone collapse following cardiac arrest, call 911 immediately. You can administer approved CPR techniques to keep oxygen circulating to the victim’s brain until medical help arrives.

Cough CPR’s limited use

Coughing violently physically forces blood from the chest up to the brain because of the pressure exerted from the cough. In a clinical setting, patients might be told to cough vigorously during testing, if healthcare professionals detect specific problems.

Cough CPR is not useful outside of a hospital setting. Anyone experiencing the symptoms of a heart attack should immediately call 911. Anyone who loses consciousness following cardiac arrest cannot cough, or even breathe, and needs emergency help.

Anyone witnessing a person having a heart attack should immediately call 911, or perform approved CPR rescue while a second bystander calls 911. Dr. Gillinov stresses, “The most important advice to give is: If you get chest pain or feel faint or feel an irregular heartbeat, call 911.”

Having a heart attack is scary no matter what the circumstance, but if you are alone and having chest pain you need to be prepared.

Daniel Zalkind, MD, Cardiologist at the St. Elizabeth Heart & Vascular Institute warns, “A heart attack can begin as chest pain and quickly progress to sudden cardiac arrest. Statistics tell us if you don’t call 911 during the initial chest pain and it progresses to cardiac arrest, if you are completely alone, you have only an 11 percent chance of survival.”

Whether you live alone or you just find yourself alone in certain situations the key to survival is recognizing a heart attack and taking the right steps to get help.

Recognizing the Symptoms of a Heart Attack
Dr. Zalkind said the main symptom of a heart attack is chest pain and tightness. If you have never had a heart attack before, you may not recognize the nature of the pain immediately. If you have had a heart attack before, you may recognize your pain more quickly.

Signs of a heart attack:

  • Squeezing or pressure in chest lasting more than 10 minutes.
  • Pain or discomfort in your arm or back, especially your left arm.
  • Shortness of breath.
  • Nausea.

Signs of a heart attack for women may be different. They may not recognize the chest pain and are more likely to experience shortness of breath, fatigue, nausea, vomiting, and back pain.

What to Do If You Are Alone and Having a Heart Attack

  • Call 911 immediately – Emergency Medical Services (EMS) can begin treatment immediately and alert the hospital to your arrival.
  • If you are driving, pull over in a safe location write down where you are and call 911. If possible find a location around other people or flag someone down, so you are not alone while you wait for the ambulance – do not drive yourself.
  • Give the 911 operator exact directions to your location. If you are in a multi-story building, let them know the floor you are on and directions to your exact location. If you are in a remote location alone, try to get to an area where the EMS or someone else can find you.
  • Notify your family – let them know you have called 911 and they are on their way.
  • Chew a 325mg aspirin – chewing slowly on an aspirin can help slow down the heart attack.
  • If you are diabetic, test your blood sugar – the information will be useful to EMS when they arrive.

Don’t be afraid that it isn’t a heart attack. If you don’t call 911 immediately, a heart attack can progress quickly, and you could lose consciousness.

Often your best friend in a situation like this is a total stranger that has learned how to perform CPR. There are countless stories of people trained in CPR saving a life, especially when a heart attack occurs in a remote location. Performing CPR until paramedics arrive can mean the difference between life and death. If you encounter someone having a heart attack, knowing just a few steps can make a lifesaving difference.


What to do in an emergency

Symptoms of a heart attack

One symptom is chest pain – often starting in the middle of your chest and perhaps moving to your neck, jaw, ears, arms and wrists. It can travel between your shoulder blades, back or stomach area.

If you do have chest pain, it can be very severe, or it can start off as a dull pain or ache. It’s been described as a “heaviness, burning, tightness, constriction or squeezing sensation” or as a “heavy weight or pressure”. It can feel similar to indigestion or heartburn.

Symptoms which may indicate that you are having a heart attack include:

  • pain (sometimes travelling from your chest) in your arms, jaw, neck, back and abdomen
  • feeling or being sick
  • feeling sweaty and clammy
  • looking grey and pale
  • feeling generally unwell, restless or panicky
  • breathlessness, wheezing or coughing
  • feeling your heart beating very quickly
  • feeling dizzy

You may not have chest pain at all, especially if you’re a woman, are elderly or have diabetes

Don’t delay phoning 999 if you’re not sure or don’t want to make a fuss. The sooner you get emergency treatment for a heart attack, the greater the chances of survival.

Even if your symptoms don’t match the above, but you think you – or someone else – are having a heart attack, phone 999 immediately.

More about heart attacks

What should I do in a heart attack emergency?

The first thing to do is phone 999 immediately for an ambulance.

You should then sit and rest while you wait for the ambulance to arrive.

Aspirin can sometimes help, but don’t get up and look around for an aspirin, as this may put unnecessary strain on your heart.

If you’re not allergic to aspirin and have some next to you – or if there is someone with you who can fetch them for you – chew one adult aspirin tablet (300mg). If the aspirin isn’t nearby, however, anyone with you should stay with you and not go looking for aspirin.

Before the ambulance arrives

If you can, before the ambulance arrives, you can help the paramedics by doing the following:

  • if you’re outside, stay with the patient until help arrives
  • phone 999 again if the patient’s condition worsens
  • phone 999 again if your location changes
  • if you’re phoning from home or work, ask someone to open the doors and tell ambulance staff where they’re needed
  • shut any family pets away
  • if you can, write down the patient’s GP details and collect any medication they’re taking
  • tell the paramedics if the patient has any allergies
  • tell the paramedics if the patient has taken an aspirin
  • stay calm – Scottish Ambulance Service are there to help you

Many people survive heart attacks and make a good recovery. Your heart is a tough muscle. Stress, shocks or surprises don’t cause heart attacks.

Symptoms of sudden cardiac arrest

Sudden cardiac arrest (SCA) is when the heart stops and person falls unconscious.

The person may:

  • appear not to be breathing
  • not be moving
  • not respond to any stimulation, like being touched or spoken to

This is a leading cause of premature death, but with immediate treatment, many lives can be saved. The heart stops because the electrical rhythm that controls the heart is replaced by a disorganised electrical rhythm. The quicker this can be treated, the greater the chance of successful resuscitation.

Read more on cardiac arrest from the British Heart Foundation

What’s the difference between a “heart attack” and a “cardiac arrest”?

A heart attack is a sudden interruption to the blood supply to part of the heart muscle. It’s likely to cause chest pain and permanent damage to the heart. The heart is still sending blood around the body, and the person remains conscious and is still breathing.

A cardiac arrest happens when the heart suddenly stops pumping blood around the body. Someone who’s having a cardiac arrest will suddenly lose consciousness and will stop breathing – or stop breathing normally. Unless immediately treated by cardiopulmonary resuscitation (CPR), this always leads to death within minutes.

A person having a heart attack is at high risk of experiencing a cardiac arrest.

Both a heart attack and a cardiac arrest are life-threatening medical emergencies and require immediate medical help.

What should I do in a sudden cardiac arrest?

Cardiac arrest is reversible, but it’s vital it’s recognised and acted upon in the first few seconds or minutes.

Seconds count – phone 999 FIRST.

You can save a life by trying chest compressions or using a defibrillator.

Chest compressions/hands-only cardiopulmonary resuscitation (CPR)

If someone is having a cardiac arrest, after phoning 999, you can can chest compressions to save their life.

Before you start chest compressions – or hands-only CPR – check the situation is safe to approach, like making sure the person’s not in a busy road

If you’re going to give someone CPR, phone 999 first or ask someone else to dial 999, but do this before you start chest compressions.

To carry out a chest compression:

  1. Place the heel of your hand on the breastbone at the centre of the person’s chest. Place your other hand on top of your first hand and interlock your fingers.
  2. Using your body weight (not just your arms), press straight down by 5-6cm on their chest.
  3. Repeat this until the ambulance arrives.

Try to do the chest compressions at a rate of 100-120 compressions a minute.

CPR is not as hard as you may think. Just phone 999 and then push hard and fast. The person on the other end of the 999 phone will talk you through what to do.

How to survive a heart attack when you’re alone

The first few hours after a heart attack are critical. Learn about heart attack warning signs and what to do if symptoms strike when you’re alone.

If you suspect you’re having a heart attack, the situation can be frightening, especially if you’re alone when experiencing symptoms.

“Those having a heart attack without cardiac arrest — which is when the heart suddenly stops, rendering someone unconscious — are usually conscious and will typically experience a number of symptoms, some of which may serve as warning signs leading up to a more serious attack or even cardiac arrest,” said Shawn A. Gregory, M.D., a cardiologist with the Vanderbilt Heart and Vascular Institute. Here are the steps you need to take to get emergency medical attention and prevent a possible attack from progressing into something worse. These tips will help you understand that surviving a heart attack is possible.

What symptoms might indicate a heart attack?

Chest discomfort is the most common symptom of a heart attack. These may also involve the neck, jaw, arms, upper abdomen or back. “This is typically a pressure or constricting sensation,” Gregory explained, “but many patients simply describe it as a discomfort.”

You may be unable to pinpoint the location of the sensation, and it may spread. Shortness of breath is also common, and all symptoms tend to worsen over time and with activity.

Other symptoms, though less common, may include nausea, lightheadedness, sweating, pale or clammy skin, and other forms of chest discomfort like a sharp pain or burning sensation.

When should a person take action?

When surviving a heart attack alone, follow your instincts. “If symptoms frighten you, get them evaluated quickly,” Gregory said. “Many of my patients who have survived heart attacks tell me that they just ‘knew’ that something very bad was happening at the time and that they needed help, or even that they were having a heart attack.”

What emergency steps should be taken to survive a heart attack alone?

Call 911

If you think you’re experiencing a heart attack, the most important thing to do is to get emergency medical help. “Anything that interferes with getting assistance should be avoided,” Gregory said. “This assistance should be professional and not, for example, asking a friend or loved one to drive you to the hospital. The ambulance service can provide immediate therapy and begin the process of making the diagnosis.” If you live alone and are at an increased risk of having a heart attack or experiencing other medical emergencies, Gregory recommends wearing a medical alert device.

Stay calm and rest

Exertion can worsen a heart attack, so rest and try to relax, even though it’s a scary situation. “Remind yourself that you are playing it on the safe side and getting help as soon as possible,” Gregory said. “You are making the smart move.”

Chew aspirin

As long as finding aspirin doesn’t delay calling for help or require much activity, take 300 mg. “This roughly correlates with four baby aspirins (81 mg each) or one regular aspirin (325 mg) in the United States,” Gregory said. Chew the tablets to get them into the bloodstream fast.

Prepare for first responders

As long as it doesn’t require exertion, make sure to keep your doors unlocked and pets in a closed room. Additionally, locate your list of medications and allergies. “I recommend my patients keep these lists in their wallets or purses,” Gregory said.

Other steps to take during a heart attack

Taking nitroglycerin may lessen the symptoms of a heart attack and may improve outcomes. “If you have been prescribed nitroglycerin for use as needed, I would advise taking it as directed during a potential heart attack,” Gregory said. “However, I would strongly advise against taking someone else’s nitroglycerin or other medications unless instructed to do so by a health-care provider.”

Lastly, Gregory advises against “cough CPR.” Inaccurate social media posts have made the claim that forced coughing intervals can induce cardiopulmonary resuscitation. “A heart-attack patient may actually worsen their condition by trying cough CPR. This would likely increase stress on the heart,” he said. “For this and several other reasons, health-care providers don’t perform standard CPR on conscious patients either. Therefore, cough CPR should be avoided unless you are instructed to do so by a health-care professional.”

The Vanderbilt Heart and Vascular Institute‘s team treats all types of cardiovascular diseases and conditions, from the common to the complex. Our team is consistently recognized by U.S. News & World Report among the best heart hospitals in the nation and the best in Tennessee. Our wide range of services are offered in convenient locations throughout the region.

Learn more


Heart Health

How to Survive a Heart Attack When Alone Hoax

This story was first published on October 4, 2004

Message claims heart doctors recommend that recipients learn ‘Cough CPR’, a procedure that involves vigorous coughing as a potential means of surviving a heart attack when alone.
Brief Analysis:
The information in the message is in no way condoned or recommended by medical authorities. Spreading such misinformation is counterproductive and potentially dangerous. Using the procedure outlined in the message in place of immediately seeking medical help could actually cost a life rather than save it.

Subject: IMPORTANT read this! Cough CPRA cardiologist says If everyone who gets this mail sends it to 10 people, you can bet that we’ll save at least one life.

Read this… It could save your life!! Let’s say it’s 6.15 pm and you’re driving home (alone of course), after an unusually hard day on the job. You’re really tired, upset and frustrated. Suddenly you start experiencing severe pain in your chest that starts to radiate out into your arm and up into your jaw. You are only about five miles from the hospital nearest your home. Unfortunately you don’t know if you’ll be able to make it that far. You have been trained in CPR, but the guy that taught the course did not tell you how to perform it on yourself.


Since many people are alone when they suffer a heart attack, without help, the person whose heart is beating improperly and who begins to feel faint, has only about 10 seconds left before losing consciousness. However, these victims can help themselves by coughing repeatedly and very vigorously. A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest. A breath and a cough must be repeated about every two seconds without let-up until help arrives, or until the heart is felt to be beating normally again. Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep the blood circulating. The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a hospital. Tell as many other people as possible about this. It could save their lives!!


Detailed Analysis:
A message that offers spurious advice about how to survive a heart attack has been continually circulating around the Internet since at least 1999.

The message outlines a technique for surviving a heart attack while alone that involves vigorous coughing. According to the email, a cardiologist has advised forwarding the message to others in order to save lives. However, the alleged cardiologist is not named, nor is there any reference to a reputable medical institution. In my opinion, any life-critical “medical advice” that is not supported by credible reference material should be used with extreme caution.

It should be noted that the cough procedure outlined in the email is not, in itself, a hoax and has been researched and tested by medical experts. In fact, so called “Cough CPR” might be beneficial under certain controlled circumstances. However, this does not mean that the advice in the email message is valid and useful. The most important factor to consider is that, according to medical experts, cough CPR should only be performed under strict professional supervision.

According to the American Heart Association, “the usefulness of ‘cough CPR’ is generally limited to monitored patients with a witnessed arrest in the hospital setting”. The American Heart Association article also notes:

The American Heart Association does not endorse “cough CPR,” a coughing procedure widely publicized on the Internet. As noted in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, “cough CPR” is not useful for unresponsive victims and should not be taught to lay rescuers.

Moreover, the Resuscitation Council in the UK “knows of no evidence that, even if a lone patient knew that cardiac arrest had occurred, he or she would be able to maintain sufficient circulation to allow activity, let alone driving to the hospital”.

A victim would probably be better off directing his or her energy towards other life-saving options such as seeking immediate help or calling the emergency number. The American Heart Association article also states:

The best strategy is to be aware of the early warning signs for heart attack and cardiac arrest and respond to them by calling . If you’re driving alone and you start having severe chest pain or discomfort that starts to spread into your arm and up into your jaw (the scenario presented in the Internet article), pull over and flag down another motorist for help or phone on a cellular telephone.

Heart patient support organization Mended Hearts has also debunked the procedure:

Despite a contagious rumor, coughing doesn’t prevent a heart attack. An e-mail that spread around the world like a contagious disease a few years ago claimed that anyone who feels heart attack symptoms while alone should cough “repeatedly and very vigorously, repeating a breath about every two seconds…until help arrives, or (a normal heartbeat returns).”

Wrong, says the American Heart Association.

“It’s right up there with voodoo as far as I’m concerned,” says Dr. Cary Fishbein, a cardiologist with the Dayton Heart Center.

Another version of the message arrives as an email attachment rendered in Microsoft PowerPoint format. Someone has gone to quite a lot of trouble to convert the original message into an attractive presentation complete with graphics and sound. In spite of the probable good intentions of the creator, the advice presented in the PowerPoint version is as equally spurious as it is in the email version. The PowerPoint version falsely attributes the information to an article in the “Journal Of General Hospital, Rochester”. However, the Rochester General Hospital denies that such an article exists and has included the following statement on its website:

Important Notice Regarding the article “How to Survive a Heart Attack When Alone.”

Hundreds of people around the country have been receiving an e-mail message entitled “How to Survive a Heart Attack When Alone.” This article recommends a procedure to survive a heart attack in which the victim is advised to repeatedly cough at regular intervals until help arrives.

The source of information for this article was attributed to ViaHealth Rochester General Hospital. This article is being propagated on the Internet as individuals send it to friends and acquaintances – and then those recipients of the memo send it to their friends and acquaintances, and so on.

We can find no record that an article even resembling this was produced by Rochester General Hospital within the last 20 years. Furthermore, the medical information listed in the article can not be verified by current medical literature and is in no way condoned by this hospital’s medical staff. Also, both The Mended Hearts, Inc., a support organization for heart patients, and the American Heart Association have said that this information should not be forwarded or used by anyone. Please help us combat the proliferation of this misinformation. We ask that you please send this e-mail to anyone who sent you the article, and please ask them to do the same.

Thus, the “advice” presented in this email forward is not condoned by medical experts and it certainly should not be forwarded to “as many friends as possible”. Forwarding this sort of misinformation is irresponsible. Using the procedure outlined in the message in place of immediately seeking medical help could actually cost a life rather than save it.


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