Recognition and Management of a Heart Attack

Recognition of Heart Attack

For some people, sudden cardiac arrest may occur as the first sign of heart attack – however most experience some warning signs. It is important to note:

  • A heart attack can occur in a victim without chest pain or discomfort as one of their symptoms.
  • The most common symptom of heart attack in a victim without chest pain is shortness of breath.
  • A victim who experiences a heart attack may pass off their symptoms as ‘just indigestion’.
Warning signs

If the warning signs are severe, get worse quickly, or last longer than 10 minutes, act immediately. The victim may experience one or a combination of these symptoms:

  • Pain or discomfort in the chest, neck, jaw or arms
  • Pale skin
  • Shortness of breath
  • Nausea or vomiting
  • Sweating
  • Feeling dizzy or light-headed

Discomfort or pain in the centre of the chest may start suddenly or come on slowly over minutes. It may be described as tightness, heaviness, fullness or squeezing. The pain may be severe, moderate, or mild. The pain may be limited to, or spread to, the neck, throat, jaw, either or both shoulders, the back, either or both arms and into the wrists and hands

A typical chest pain is defined as pain that does not have a heaviness or squeezing sensation (typical angina symptoms), precipitating factors (e.g., exertion), or usual location.

NOTE: Not all heart attacks are accompanied by chest pain. Some casualties just look and feel unwell. This is known as a silent heart attack (silent infarct).

Management for Heart Attack (Acute Myocardial Infarction)
  • Encourage the person to stop what they are doing and to rest in a comfortable position.
  • If the person has been prescribed medication such as a tablet or oral spray to treat episodes of chest pain or discomfort associated with angina, assist them to take this as they have been directed.
  • Send for an ambulance if symptoms are severe, get worse quickly or last longer than 10 minutes.
  • Follow the instructions of the ambulance call taker/operator who will advise you what to do.
  • Stay with the person until the ambulance or on-site resuscitation team arrives.
  • If practical and resources allow, locate the closest AED and bring it to the person.

If the person is unresponsive and not breathing normally, commence resuscitation.