1 Recognizing Cardiac Emergencies

Distinguish the emergencies

A heart attack and cardiac arrest are different emergencies. A heart attack occurs when blood flow to part of the heart is blocked; cardiac arrest occurs when the heart suddenly stops pumping effectively. A heart attack can lead to cardiac arrest, so a person’s condition may worsen quickly.

Recognize heart attack warning signs

Possible heart attack warning signs include:

• Pressure, squeezing, fullness, or pain in the chest

• Shortness of breath

• Discomfort in one or both arms, the back, neck, jaw, or stomach

• Cold sweating, nausea, or lightheadedness

Symptoms vary. Not everyone has chest pain: shortness of breath, nausea, sweating, or discomfort elsewhere in the upper body can also be warning signs. Treat suspected heart attack symptoms as an emergency rather than waiting to see whether they pass.

Recognize possible cardiac arrest

Cardiac arrest often appears as a sudden collapse followed by unresponsiveness and absent or abnormal breathing. Occasional gasps, snorts, or irregular breaths are not normal breathing. A lay rescuer should not delay care by trying to check for a pulse.

Assess and respond

Follow these steps when someone may be experiencing a cardiac emergency:

1. Check scene safety. Approach only if it is safe to help.

2. Check responsiveness. Tap the person and ask loudly, “Are you OK?” If there is no response, call out for help.

3. Check breathing. Look for normal, regular breathing. Gasping or no breathing is abnormal.

4. Activate emergency services. Call 911 in the United States, or the local emergency number. If others are present, direct one person to call and another to get an automated external defibrillator (AED), if available. Give the dispatcher the location and what happened, and follow their instructions. Use speakerphone when possible so you can continue helping.

5. Prioritize immediate care. If the person is unresponsive and not breathing normally, begin CPR immediately. Use an AED as soon as it arrives and follow its prompts.

If the person is awake with suspected heart attack symptoms, call emergency services, keep them at rest, stay with them, and watch for changes. Do not delay the call to arrange private transport.

Respond to a change in condition

If the person becomes unresponsive or stops breathing normally while you are assisting them, treat it as cardiac arrest: alert the dispatcher and begin CPR. Continue monitoring the person and follow dispatcher instructions until emergency responders take over or the person shows clear signs of recovery.