Think You're Having a Heart Attack? Do This Right Now.

Why this is always a 911 call

Heart disease is the leading cause of death in the United States, accounting for 683,491 deaths in 2024 alone 6Ref 6Centers for Disease Control and Prevention, National Center for Health Statistics (2026).FastStats: Leading Causes of Death.Heart disease is the leading cause of death in the United States, accounting for 683,491 deaths in 2024. Many of those deaths happen before a person reaches the hospital — which is precisely why calling 911 is the single most important action you can take.

An ambulance crew can begin treatment the moment they reach you: oxygen, medication, an IV line, and a 12-lead ECG can all be started before you arrive at the ER. Driving yourself removes that advantage and puts you and other drivers at risk if you lose consciousness 1Ref 1Rao SV, O'Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, Baber U, et al. (2025).2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes.Call 911 immediately; do not drive; early pre-hospital intervention including aspirin guidance and defibrillation improves acute coronary syndrome outcomes; atypical presentations in women, older adults, and people with diabetes. The 2025 ACC/AHA/ACEP guidelines make this explicit: pre-hospital care is part of the treatment chain for acute coronary syndromes, not a prelude to it 1Ref 1Rao SV, O'Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, Baber U, et al. (2025).2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes.Call 911 immediately; do not drive; early pre-hospital intervention including aspirin guidance and defibrillation improves acute coronary syndrome outcomes; atypical presentations in women, older adults, and people with diabetes.

What do I do right now, step by step?

1. Call 911 — or have someone nearby call. Give your address clearly and stay on the line. 2. Sit or lie down. Do not walk to the car, climb stairs, or exert yourself further. 3. Loosen tight clothing around your chest and neck. 4. If the 911 dispatcher advises aspirin and you are not allergic, chew one regular-strength (325 mg) aspirin. Wait for the dispatcher's guidance — do not decide on your own 1Ref 1Rao SV, O'Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, Baber U, et al. (2025).2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes.Call 911 immediately; do not drive; early pre-hospital intervention including aspirin guidance and defibrillation improves acute coronary syndrome outcomes; atypical presentations in women, older adults, and people with diabetes. 5. Unlock your front door so paramedics can enter without delay. 6. Stay on the phone with dispatch until help arrives. The dispatcher can guide bystanders in CPR if needed 2Ref 2Kleinman ME, et al. (2025).Part 7: Adult Basic Life Support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Bystander CPR and early AED use while waiting for ambulance; pre-hospital life support actions.

Minutes matter. EMS teams can begin treatment on arrival and may provide faster hospital access than self-transport 4Ref 4American Heart Association (2024).Warning Signs of a Heart Attack.Heart attack warning signs; minutes matter — EMS teams can begin treatment on arrival; women may experience additional symptoms including nausea, back pain, jaw pain, and unusual fatigue.

What does a heart attack actually feel like?

The dramatic chest-clutching from movies is one version — but many heart attacks present differently. Common warning signs include 3Ref 3National Heart, Lung, and Blood Institute (2024).Heart Attack — Symptoms.Heart attack symptoms including chest pain, shortness of breath, nausea, cold sweat, and atypical symptoms; silent heart attacks more common in people with diabetes and older adults4Ref 4American Heart Association (2024).Warning Signs of a Heart Attack.Heart attack warning signs; minutes matter — EMS teams can begin treatment on arrival; women may experience additional symptoms including nausea, back pain, jaw pain, and unusual fatigue:

• Pressure, squeezing, tightness, or pain in the center or left side of the chest (the most common symptom)
• Pain or discomfort spreading to the shoulder, arm (often the left), back, neck, or jaw
• Shortness of breath, with or without chest discomfort
• Sudden cold sweat
• Nausea or lightheadedness
• Unusual fatigue, sometimes lasting for days
• Rapid or irregular heartbeat

Women, people with diabetes, and older adults more often have atypical presentations — jaw pain, back pain, nausea, unusual fatigue, or simply feeling extremely unwell — without the classic chest pressure 1Ref 1Rao SV, O'Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, Baber U, et al. (2025).2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes.Call 911 immediately; do not drive; early pre-hospital intervention including aspirin guidance and defibrillation improves acute coronary syndrome outcomes; atypical presentations in women, older adults, and people with diabetes3Ref 3National Heart, Lung, and Blood Institute (2024).Heart Attack — Symptoms.Heart attack symptoms including chest pain, shortness of breath, nausea, cold sweat, and atypical symptoms; silent heart attacks more common in people with diabetes and older adults. Do not wait for a "textbook" presentation before calling 911.

What happens while I wait for the ambulance?

Stay as still and calm as you can. Physical exertion and anxiety both increase the heart's demand for oxygen, which worsens damage to heart muscle that is already not receiving adequate blood flow.

If you lose consciousness, a bystander who is trained should begin CPR immediately. If an automated external defibrillator (AED) is nearby, a bystander should retrieve and use it. The 2025 AHA guidelines for adult basic life support confirm that early bystander CPR and prompt defibrillation meaningfully improve survival when the heart stops during a cardiac event 2Ref 2Kleinman ME, et al. (2025).Part 7: Adult Basic Life Support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Bystander CPR and early AED use while waiting for ambulance; pre-hospital life support actions.

Paramedics will manage everything else. Your role is to remain on the line with dispatch and stay still.

What tests will the ER run?

Emergency staff typically begin these within the first few minutes of arrival 5Ref 5National Heart, Lung, and Blood Institute (2024).Heart Attack — Diagnosis.EKG is the most common initial test in the ER; troponin leaks into bloodstream when heart muscle cells die; chest X-ray and CT imaging evaluate heart function:

• Electrocardiogram (ECG/EKG) — the most common initial test; detects the electrical signature of a heart attack, often within minutes of arrival. Some types of heart attack (NSTEMI) may not show a classic ECG change, which is why blood tests are essential alongside it.
• Cardiac troponin blood test — troponin is a protein released into the bloodstream when heart muscle cells die. It is the key diagnostic marker for confirming a heart attack; tests are typically repeated over a few hours to detect a rising level 5Ref 5National Heart, Lung, and Blood Institute (2024).Heart Attack — Diagnosis.EKG is the most common initial test in the ER; troponin leaks into bloodstream when heart muscle cells die; chest X-ray and CT imaging evaluate heart function.
• Chest X-ray or CT imaging — evaluates heart size and structure, and helps rule out other causes of chest pain such as a collapsed lung or aortic dissection 5Ref 5National Heart, Lung, and Blood Institute (2024).Heart Attack — Diagnosis.EKG is the most common initial test in the ER; troponin leaks into bloodstream when heart muscle cells die; chest X-ray and CT imaging evaluate heart function.

Together, these tests allow emergency clinicians to confirm or rule out a heart attack and determine the best immediate treatment — which may include clot-dissolving medications or an emergency procedure to open the blocked artery 1Ref 1Rao SV, O'Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, Baber U, et al. (2025).2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes.Call 911 immediately; do not drive; early pre-hospital intervention including aspirin guidance and defibrillation improves acute coronary syndrome outcomes; atypical presentations in women, older adults, and people with diabetes.

Does having diabetes or being female change anything?

Yes, and both groups should be especially alert to atypical symptoms.

Diabetes: Nerve damage caused by long-standing high blood sugar can blunt pain signals, so a heart attack may feel less severe or present primarily as shortness of breath and unusual fatigue rather than chest pain — sometimes called a "silent" heart attack. Silent heart attacks are more common in people with diabetes and in older adults 3Ref 3National Heart, Lung, and Blood Institute (2024).Heart Attack — Symptoms.Heart attack symptoms including chest pain, shortness of breath, nausea, cold sweat, and atypical symptoms; silent heart attacks more common in people with diabetes and older adults.

Women: While chest pain remains the most common symptom for women too, women are more likely than men to experience back pain, jaw pain, nausea, vomiting, and profound fatigue as prominent or even primary symptoms 4Ref 4American Heart Association (2024).Warning Signs of a Heart Attack.Heart attack warning signs; minutes matter — EMS teams can begin treatment on arrival; women may experience additional symptoms including nausea, back pain, jaw pain, and unusual fatigue. Heart disease is the leading cause of death in women in the United States. Symptoms are sometimes mistaken for acid reflux, anxiety, or the flu — a delay that can be fatal.

Neither group should wait for a textbook presentation. When in doubt, call 911.