Remember HEART
The most important rule is simple: if you or someone around you may be having a heart attack, do not wait for every “classic” symptom to appear. Call 911 immediately!
You can remember what to do with the word HEART:
Help is needed
Call 911 without delay, even if you are not certain.
Ease into a comfortable position
Stop all activity. Help the person sit or lie down in whatever position is most comfortable and encourage them to rest.
Act on the dispatcher's instructions
Stay on the phone and follow the 911 dispatcher’s directions. If the person has been prescribed nitroglycerin, they should take it as directed; it can cause severe dizziness or fainting. Tell the dispatcher about recent medications, including sildenafil or tadalafil, which can interact dangerously with nitrates. Follow the dispatcher’s guidance about ASA (aspirin), and tell them about allergies, active bleeding or bleeding disorders. Medication must never delay the emergency call.
Remain with the person
Stay with them and monitor their condition until emergency services arrive. If you are at home, make it easy for paramedics to reach you.
Take action if the person is unresponsive and not breathing normally
If the person is unresponsive and is not breathing normally, they may be in cardiac arrest. Tell the dispatcher, start CPR immediately and use an AED as soon as one is available. Gasping is not normal breathing.
Four myths that delay care
Misconception 01“I’m having chest pain like never before, jaw pain, and I’m sweating even though I’ve been sitting still. Let's wait a few minutes and see if it goes away.”
The facts
Heart attack symptoms are not always dramatic: they may be mild, develop gradually, or even disappear and return. That does not mean it is safe to wait. If you think symptoms could represent a heart attack, you do not need to diagnose it yourself before asking for help. Call 911 first. The medical dispatcher will ask questions about what is happening, assess the urgency of the situation and give you instructions while help is on the way.
Misconception 02“I can drive myself to the hospital if there is no traffic and I can make it in less than 30 minutes.”
The facts
Do not drive yourself or someone having a heart attack to the hospital. In your car, you cannot safely treat someone whose heart suddenly stops. Worse, if you are having a heart attack, you could lose consciousness and cause a fatal crash. Calling an ambulance is the single best way to ensure rapid care for a heart attack.
An ambulance is not just a ride to the hospital. Calling 911 activates the prehospital emergency-care system. Paramedics who arrive on scene can assess the person's condition, monitor them, begin emergency treatment for cardiac problems and respond immediately if their condition deteriorates. They can also record a 12-lead ECG at the scene and transmit it ahead to the hospital, which shortens the time to life-saving treatment. Québec's prehospital system also directs patients toward a hospital able to meet their medical needs, as not every hospital has a cath lab needed to address an acute STEMI, for example. This is particularly important because a heart attack can sometimes trigger a dangerous abnormal heart rhythm and progress to cardiac arrest.
Call 911 and let emergency services come to you.
Misconception 03“I'll give them their medication and see if it works.”
The facts
Medication should never delay the emergency call. If the person has been prescribed nitroglycerin for angina, they should take it as prescribed while emergency help is on the way.
Never give someone another person's prescription medication. If symptoms are new, worsening, different from their usual angina, occurring at rest, or not responding to nitroglycerin as they normally do, the person needs emergency assessment.
Misconception 04“Aspirin can resolve a heart attack.”
The facts
Aspirin (acetylsalicylic acid, or ASA) can be taken during a heart attack, but it does not resolve the heart attack. Most heart attacks involve a blood clot forming in a coronary artery, and ASA helps prevent that clot from growing larger. However, ASA is not appropriate for every person or every emergency. Someone may have an allergy or intolerance, a significant bleeding risk, or symptoms caused by another condition for which aspirin could be harmful.
The Heart and Stroke Foundation of Canada advises calling 911 first, then chewing and swallowing ASA, not any other painkiller, if the person is not allergic or intolerant to it: either one 325 mg tablet or two 81 mg tablets. Most importantly, ASA does not replace emergency medical care.
While help is on the way
Stay with the person and prepare for help to arrive. There are several useful things you can do while waiting:
- Monitor how the person is doing.
- Follow the dispatcher's instructions and remain on the phone.
- Loosen any tight clothing to make them more comfortable.
If you are at home:
- unlock the door
- clear the entrance, stairs or hallways
- make sure the address is visible
- secure any pets that could escape when emergency services arrive
- gather the person's medications
If another person is with you, have them guide emergency services to you.
If the person becomes unresponsive
You need to recognize cardiac arrest and act immediately.
A person having a heart attack is usually conscious and breathing. But a severe heart attack can sometimes trigger cardiac arrest, meaning the heart suddenly stops pumping blood effectively.
If the person:
- suddenly collapses
- becomes unresponsive
- is not breathing or is not breathing normally
… the emergency has changed and is now a cardiac arrest.
If the person is unresponsive and is not breathing normally, tell the dispatcher immediately and start CPR, following their instructions. You do not need to check for a pulse. Have someone retrieve an automated external defibrillator (AED) if one is available. Use it as soon as possible and follow its spoken instructions.
Module 04 / Knowledge check
Quiz
Adapted from CAPIO’s Module 4 script, with light editing for clarity and linked references. This lesson is educational and does not replace care from a healthcare professional.
Original module script (PDF)