Heart attack warning signs

The signs

What the warning signs look like

NSW Health draws the line between a heart attack and a cardiac arrest in one sentence:

“A cardiac arrest is different to a heart attack where a person is awake and has symptoms such as pain in the chest, difficulty breathing, nausea or feeling light-headed.”

NSW Health, cardiac arrest fact sheet

From NSW Ambulance’s guide for retirees

NSW Ambulance’s signs and symptoms guide for people of retirement age has a section headed chest pain. It lists:

• any unusual tightness or pain in the chest, such as a crushing or a stabbing pain
• pain that may also spread into the neck, jaw, back or arms
• a heartbeat that is fast or slow, or feeling anxious
• difficulty breathing, or frothy spit
• skin that looks pale or grey, or sweating
• feeling unwell or nauseous
• a sudden, urgent need to go to the toilet to open the bowels

For signs like these, the guide’s instruction is to get medical help straight away by calling Triple Zero (000) and asking for an ambulance.

Other services say the same in fewer words. The Queensland Ambulance Service lists chest pain or chest tightness among the medical problems to call an ambulance for. And healthdirect’s fainting page says to call an ambulance if someone has fainted and, before fainting, had chest pains, shortness of breath, palpitations or an irregular heartbeat.

First aid

What to do: healthdirect’s steps

This is healthdirect’s first aid for a heart attack, every step in its order, retold in plain words.

1. Call Triple Zero (000) right away and ask for an ambulance if you think that you, or another person, may be having a heart attack. Early treatment could save a life.

2. If you are the one with heart attack symptoms, healthdirect says you should:

   • chew aspirin: 300 milligrams of it, unless you are allergic to aspirin. Healthdirect says chewing aspirin during a heart attack can help reduce damage to the heart.
   • take glyceryl trinitrate as directed, if your doctor has prescribed it for a heart condition you already have.

3. If a person is unconscious or is not breathing, call for help and begin CPR at once. Use a defibrillator if there is one available.

4. Do not drive if you are having a heart attack. If there is no ambulance available, ask a neighbour or someone nearby to take you to hospital.

The second step is written for the person with the symptoms, and each part keeps its own condition: the aspirin step does not apply to someone allergic to aspirin, and the glyceryl trinitrate step applies only where a doctor has already prescribed it.

For the third step, healthdirect’s page on how to perform CPR sets out each part. It calls CPR a skill everyone can learn, and says you do not need training to use a defibrillator, which guides you with voice prompts.

Two different things

A heart attack and a cardiac arrest

Both are a call to Triple Zero. NSW Health’s fact sheet puts it directly: “If a person is experiencing a heart attack or more serious cardiac arrest, call Triple Zero (000) immediately for an ambulance.”

It also explains why speed matters so much in a cardiac arrest: “For every minute that passes after a person has a cardiac arrest, the chance of survival decreases. Quick action could save a life.” In its own state, it adds: “Over 8,500 people experience an out of hospital cardiac arrest in NSW every year. Only 12% will survive.”