Call 9-1-1 immediately. The longer you wait to get medical treatment, the greater the likelihood you will have severe, permanent damage to your heart or even die. The earlier you are treated, the more likely it is that damage to your heart will be kept to a minimum. Many treatments are most effective if given within 1 to 2 hours of when the heart attack begins.1, 2 It is important to call emergency services because research shows that people who arrive at the hospital via ambulance are treated sooner than those who get there by their own means.3 Calling your primary care physician instead can add to delays in receiving treatment.
Women having a heart attack are more likely than men to delay in seeking treatment.4 This is partly because women are less likely to realize that they are vulnerable to heart disease.5 Talk with your family and friends about the heart attack warning signs and the importance of acting fast by calling 9-1-1 within a few minutes—5 at the most—if those signs persist. Explain to them that you will be treated faster if they call 9-1-1 rather than driving you to the hospital themselves.
Below are some additional preparations you can make; however, you should not lose precious time searching for pills or documentation before calling 9-1-1.
Chew an Aspirin
After calling for help, you should chew an aspirin (162 mg to 325 mg), if it's on hand, to help prevent further clots developing.6 A chewed aspirin gets into the bloodstream more quickly than one swallowed whole. Enteric-coated or buffered aspirin is not absorbed as easily as regular aspirin. But if that is the only type of aspirin you have, crush the tablet before swallowing.7
If you've already had a heart attack, ask your physician about having nitroglycerin available in the event of a subsequent attack. If you experience chest pain that does not go away 5 minutes after taking one nitroglycerin tablet, call 9-1-1.6 You may take up to 3 nitroglycerin tablets (1 every 5 minutes) while waiting for the ambulance.
Information to Have Available
Find out the location of the nearest hospital that offers 24-hour emergency cardiac care and keep the address handy.
The American Heart Association recommends that doctors give a copy of the resting electrocardiogram ( ECG) to patients who have heart disease or who are at high-risk for a heart attack. If you have a copy of your resting ECG, give it to the emergency department doctors to help guide your treatment.
Make a list of medications you are taking and/or are allergic to. This will help ensure that you receive the appropriate treatments.
1. Boersma E, Maas AC, Deckers JW, Simoons ML. Early thrombolytic treatment in acute myocardial infarction: reappraisal of the golden hour. Lancet. 1996;348:771-775.
2. Steg PG, Bonnefoy E, Chabaud S, et al. Impact of Time to Treatment on Mortality After Prehospital Fibrinolysis or Primary Angioplasty. Data From the CAPTIM Randomized Clinical Trial. Circulation. 2003;108:2851-2856.
3. Canto JG, Zalenski RJ, Ornato JP, et al. Use of emergency medical services in acute myocardial infarction and subsequent quality of care: observations from the National Registry of Myocardial Infarction 2. Circulation. 2002;106:3018-3023.
4. Maynard C, Weaver WD, Lambrew C, et al. Factors influencing the time to administration of thrombolytic therapy with recombinant tissue plasminogen activator (data from the National Registry of Myocardial Infarction). Participants in the National Registry of Myocardial Infarction. Am J Cardiol. 1995;76:548-552.
5. Mosca L, Jones WK, King KB, et al. Awareness, perception, and knowledge of heart disease risk and prevention among women in the United States. American Heart Association Women's Heart Disease and Stroke Campaign Task Force. Arch Fam Med. 2000;9:506-515.
6. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). 2004;Available at http://www.acc.org/qualityandscience/clinical/guidelines/stemi/STEMI%20Full%20Text.pdf.
7. Hennekens CH, Dyken ML, Fuster V. Aspirin as a therapeutic agent in cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1997;96:2751-2753.