Heart Attack Warning Signs: What to Do and How to Prevent One

Every year, many people in Pakistan die of heart attacks because they took too long to get help. A man feels a heaviness in his chest and takes an antacid. A woman feels unusually tired and sick and lies down. Hours pass, and by the time they reach hospital the damage is severe. Knowing the warning signs and acting at once is the single biggest thing that can save a life, because during a heart attack heart muscle is dying minute by minute.

What is a heart attack?

A heart attack (myocardial infarction) happens when a blood clot suddenly blocks one of the arteries that supply the heart muscle, usually where fatty plaque has built up. The part of the heart cut off from blood starts to die unless the blockage is cleared quickly.

Heart attack warning signs

• Chest discomfort: pressure, squeezing, heaviness or tightness in the centre or left of the chest, lasting more than a few minutes, or going away and coming back
• Pain or discomfort that spreads to the left arm, both arms, shoulder, back, neck or jaw
• Shortness of breath, with or without chest discomfort
• Cold sweat, pale or clammy skin
• Nausea, vomiting or a feeling of indigestion
• Light-headedness or sudden weakness
• A feeling of doom or extreme anxiety

Symptoms that are easy to miss

Women, older people and people with diabetes often have less typical symptoms: unusual tiredness, breathlessness, nausea, upper back or jaw pain, with little or no chest pain. A heart attack can also feel just like gas or acidity. A burning or heavy feeling that comes on with effort, or comes with sweating and breathlessness, should never be treated as simple gas. If you are not sure, treat it as a heart attack.

What to do right away

1. Call for an ambulance immediately, such as Rescue 1122 or Edhi 115, or have someone take you to the nearest hospital with a cardiac unit. Do not drive yourself.
2. Sit down, rest, loosen tight clothing and stay calm. Do not walk around or climb stairs.
3. If you are not allergic to aspirin and have not been told to avoid it, chew one regular adult aspirin tablet (usually 300 mg) while waiting for help. Chewing works faster than swallowing it whole.
4. If your doctor has prescribed a nitroglycerin (GTN) tablet for angina, use it as instructed, but do not delay calling for help.
5. Tell the hospital staff when the symptoms began.

Do not wait to see whether the pain settles, do not take an antacid and lie down, and do not go first to a local clinic that has no cardiac facilities.

What happens in hospital

You will have an ECG and a blood test for a protein called troponin. If a major artery is blocked, doctors try to open it as fast as possible, ideally within about 90 minutes of arrival, using angioplasty with a stent, or clot-dissolving medicine if angioplasty is not available quickly. The sooner this is done, the more heart muscle is saved.

Angina or heart attack?

Angina is chest discomfort from reduced blood flow, usually brought on by effort or stress and settling within a few minutes with rest or a GTN tablet. A heart attack is longer, does not settle with rest and can happen at rest. New angina, or angina that is getting worse or happening at rest, needs urgent assessment.

How to lower your risk

• Check and control blood pressure, cholesterol and blood sugar
• Do not smoke, including shisha, and avoid second-hand smoke
• Cut down on salt, vanaspati ghee, fried foods and sweets, and eat more vegetables, fruit, daal and fish
• Be active for about 30 minutes on most days
• Reduce belly fat, and manage stress and sleep
• Know your family history, because heart disease runs in families and South Asians often develop it earlier

After a heart attack

Doctors usually prescribe a set of long-term medicines, such as aspirin and a second blood thinner like clopidogrel or ticagrelor, a statin, a beta-blocker, and often a blood pressure medicine. Do not stop any of these on your own, especially after a stent, because stopping early can cause a clot to form again. Cardiac rehabilitation, a supervised exercise and education programme, helps recovery.

Key takeaways

• Chest pressure, spreading pain, breathlessness, cold sweat and nausea are warning signs.
• Women, older people and diabetics may have mild or unusual symptoms.
• Call an ambulance at once, chew an aspirin if you are not allergic, and do not drive yourself.
• Control blood pressure, cholesterol, sugar and smoking to prevent it.

Related medicines on Medimart

These medicines are commonly prescribed for heart disease and after a heart attack:

• Aspirin: a blood thinner that helps prevent clots
• Clopidogrel: another blood thinner, often used after a stent
• Atorvastatin: a statin that lowers cholesterol
• Rosuvastatin: a potent statin
• Bisoprolol: a beta-blocker that protects the heart
• Glyceryl trinitrate: relieves angina chest pain
• Isosorbide mononitrate: used for long-term angina prevention

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse heart and stroke prevention medicines and angina medicines on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace emergency care. If you think you are having a heart attack, call an ambulance immediately.