“What are the immediate steps to do for a heart attack?”

The most important first step as a patient or concerned person nearby to someone who may be having a heart attack is to RECOGNIZE IT. About 2/3 of persons, males more than females, present in a pattern that could be considered "typical" or "classic"--this would be chest heaviness or uncomfortable pressure, often with radiation of the pain to the neck or arm (left more often than right), and often associated with an increased work of breathing, sweating, and nausea. The elderly, diabetics, and females more often have variants, some with little to no pain in the chest but with the radiating pain, some get acutely confused, some feel profoundly weak, and the difficulty breathing, sweating and nausea are usually present. Unfortunately, for 300-500K Americans per year, the first sign is cardiac arrest--so if concerned, better to call 911 and have an EMS professional start assessing you and transport you to an Emergency Department. You should NOT try to drive yourself to the Emergency Department if you think you are having a heart attack--this is the time to call 911. If your Primary Care Provider has counseled you to use aspirin for heart attack prevention, then you may consider taking four "baby" aspirin (4x81mg=324mg) or one regular strength aspirin (325mg)--but these should be chewed if taken--if uncertain, wait for EMS, as they may give it to you, or the Emergency Department will.

Donald W. Alves, MD, MS, FACEP

Avoid exertion, chew on aspirin and get help immediately.