Heart Attack First Aid: Recognising Symptoms and Acting Within Minutes

A heart attack happens when a coronary artery supplying the heart muscle becomes blocked, usually by a clot forming on a fatty plaque. The starved muscle begins to die, and the person may suffer dangerous rhythm disturbances or cardiac arrest. Speed is everything: the sooner the artery is reopened in hospital, the more heart muscle is saved. First aid for a heart attack centres on recognising the signs, calling the ambulance immediately, keeping the person at rest and being ready to start CPR.

Symptoms of a Heart Attack

• Tight, heavy or crushing pain across the chest, often poorly localised and not eased by rest or the person’s usual medicine
• Pain spreading to the neck, jaw, shoulders or arms, usually the left
• Shortness of breath
• Nausea or vomiting
• Pale, clammy, sweaty skin
• Dizziness, weakness and fatigue
• A sense of impending doom or anxiety

Not everyone has all of these. Women, older adults and people with diabetes may have little or no chest pain and instead feel breathless, sick, exhausted or have back or jaw pain. The most important clues are pain or discomfort and sweating.

Heart Attack First Aid for a Conscious Person

1. Call the emergency number immediately, even if you are unsure. Do not wait to see if it passes.
2. Make the person rest. Help them sit in a comfortable position, often half sitting with the knees supported, and do not let them walk around, because exertion strains the heart.
3. Loosen tight clothing around the neck, chest and waist and reassure them.
4. Offer aspirin if appropriate. If the person is not allergic, has not been told to avoid it and is not bleeding, they can slowly chew one regular adult aspirin (typically 300 mg in many countries, 160 to 325 mg in AHA guidance) while waiting for the ambulance. Do not give aspirin for chest pain if you are unsure whether they are allergic.
5. Help with their own prescribed medicine. If they have an angina plan, follow it, as explained in our guide to angina first aid.
6. Stay with them and monitor breathing, pulse and alertness. See vital signs observations.
7. Fetch an AED if one is nearby and keep it ready.

If the Person Becomes Unconscious

If they stop responding and are not breathing normally, they have suffered a cardiac arrest. Call the emergency number if you have not already, start CPR immediately and use an AED as soon as it arrives. Follow our guide to CPR for adults. If you are alone with an unresponsive person, call first, put the phone on speaker and begin compressions.

Why Not Drive Them Yourself?

Older manuals suggest driving the person to hospital when an ambulance is not available. Paramedics can start treatment, perform an ECG and defibrillate on the way, which is a major advantage. Driving a person with a heart attack in a hurry also risks road accidents and leaves them without monitoring. Use a private car only when an ambulance is genuinely unavailable, drive carefully and have a second person monitor them.

Heart Attack Compared With Angina

Angina pain usually follows exertion or stress and settles within minutes of rest or the person’s prescribed medicine. Heart attack pain does not settle, may last longer than 10 to 15 minutes and is often more severe. If you are unsure, treat it as a heart attack.

Reducing the Risk of a Heart Attack

Stopping smoking, controlling blood pressure, cholesterol and diabetes, eating a balanced diet, staying active and managing stress reduce the risk. Workplaces can support this by placing AEDs in accessible places and training staff in CPR and recognition of a heart attack.

Frequently Asked Questions

Should I give aspirin to everyone with chest pain?
Not automatically. Do not give it to people who are allergic, have been told to avoid it, are bleeding or when you are unsure.

Can a heart attack happen without chest pain?
Yes, particularly in women, older adults and people with diabetes. Breathlessness, nausea and fatigue may be the only signs.

References and Further Reading

• NHS, Heart attack
• American Heart Association and American Red Cross, Guidelines for First Aid

Last updated: October 2026
Prepared by: EHS Guidelines Editorial Team

This article is general educational information and is not a substitute for accredited first aid training or professional medical care. In an emergency, call your local emergency number immediately. Emergency numbers, medicines and protocols differ between countries, so follow local guidance.

Related Guides

• CPR for Adults: Current Technique and Compression Ratios
• DRABC Primary Survey: The Basic Life Support Flow Chart Explained
• Vital Signs Observations: Pulse, Breathing, Conscious State and Skin
• Checking a Pulse: Carotid and Radial Technique Explained