If you were to suffer a heart attack while in the company of people, calling out for help is probably the first instinctive thing you’d do. But what if a heart attack happened when you’re alone, would you likely survive it? The answer may surprise you.

What to do when a heart attack occurs?

Should you experience a heart attack – regardless of whether you’re alone or in the presence of others – the very first thing to do is to call for emergency medical help (call 995 if in Singapore). You need specialised treatment to be delivered to you as quickly as possible in order to save your heart muscle.

“Should you be alone when a heart attack occurs, stop whatever you’re doing, proceed to a safe place to rest and call for medical help. For example, if you’re driving, first pull to the side of the road and call for aid,” advises Dr Chin Chee Tang, Senior Consultant, Department of Cardiology, National Heart Centre Singapore (NHCS), a member of the SingHealth group.

What to do while waiting for medical help to arrive

Take an aspirin (if you are not allergic to it) – the most commonly taken blood thinning medication in the world – when taken during a heart attack improves survival.

Most cases of heart attack are caused by a blood clot forming in one of the blood vessels responsible for supplying blood to the heart. The resulting blockage deprives the heart of oxygen-rich blood, causing damage to the heart muscle, which progressively dies. Taking an aspirin during a heart attack may help as it prevents the clot from getting bigger, giving the body a chance to break down the blood clot.

If you have aspirin at home, and you know that you are not allergic to it, then you could consider taking it while waiting for the emergency medical services to arrive.

What not to do during a heart attack

Do not take nitroglycerin – Taking a prescribed medication such as nitroglycerin that temporarily widens blood vessels to improve blood supply to the heart, does not help.

Dr Chin says, “Nitroglycerin has not been shown to prevent heart attacks or improve survival substantially during an attack. It is more useful for patients with angina, an altogether different condition where patients experience chest pain or discomfort when exerting themselves.”

Angina results from an imbalance in the supply and demand for blood to the heart, but it is due to a narrowed blood vessel and not to a clot that needs to be broken down. Taking nitroglycerin during such a situation may temporarily expand the narrowed blood vessel and relieve discomfort.

Do not cough repeatedly – For self-administered “treatments” such as coughing repeatedly, Dr Chin cautions that these are probably just urban legends.

He explains, “In rare cases where the heart beat is very slow from an abnormal reflex mechanism, coughing may help restore normal heart rhythm – but this is not what happens in a heart attack.”

Do not apply pressure on the chest – Similarly, applying pressure on the chest area during a heart attack is unlikely to help unless the person’s heart has stopped beating (also known as a cardiac arrest). When this happens, CPR (cardiopulmonary resuscitation) should be administered – ideally by someone who is trained to do so.

“Even if a person is qualified to give CPR, he or she should call for help and notify the emergency medical services before administering aid,” says Dr Chin.

Recognising symptoms of a heart attack

To know for sure if you’re suffering from a heart attack, you first need to be able to identify its symptoms. Classical symptoms of a heart attack include:

  • Severe chest pain (like squeezing, or a heaviness, or pressing) at the central or left part of the chest, lasting usually for at least 20 min.
  • Pain that radiates to the left upper arm, neck or jaw.
  • Profuse sweating and a feeling of impending doom.

“About 90 per cent of heart attack sufferers experience the classical symptoms," says Dr Chin.

However, the elderly, females and those suffering from diabetes may develop non-classical heart attack symptoms. These include:

  • Shortness of breath
  • Mild chest pain
  • Nausea, vomiting
  • Pain in the epigastric region (upper central portion of the abdomen

Ref: S13