What to do in an emergency

Heart emergencies include:

  • a heart attack
  • a sudden cardiac arrest or SCA (sometimes called out-of-hospital cardiac arrest - or OCHA)
  • an angina attack or unstable angina

If you think you - or someone you know - is having a heart emergency,  phone 999 immediately and ask for an ambulance.

Symptoms of a heart attack

One symptom is chest pain - often starting in the middle of your chest and perhaps moving to your neck, jaw, ears, arms and wrists. It can travel between your shoulder blades, back or stomach area.

If you do have chest pain, it can be very severe, or it can start off as a dull pain or ache. It’s been described as a "heaviness, burning, tightness, constriction or squeezing sensation" or as a "heavy weight or pressure". It can feel similar to indigestion or heartburn.

Symptoms which may indicate that you are having a heart attack include:

  • pain (sometimes travelling from your chest) in your arms, jaw, neck, back and abdomen
  • feeling or being sick
  • feeling sweaty and clammy
  • looking grey and pale
  • feeling generally unwell, restless or panicky
  • breathlessness, wheezing or coughing
  • feeling your heart beating very quickly
  • feeling dizzy

You may not have chest pain at all, especially if you’re a woman, are elderly or have diabetes

Don’t delay phoning 999 if you’re not sure or don’t want to make a fuss. The sooner you get emergency treatment for a heart attack, the greater the chances of survival.

Even if your symptoms don’t match the above, but you think you - or someone else - are having a heart attack, phone 999 immediately.

More about heart attacks

What should I do in a heart attack emergency?

The first thing to do is phone 999 immediately for an ambulance.

You should then sit and rest while you wait for the ambulance to arrive.

Aspirin can sometimes help, but don’t get up and look around for an aspirin, as this may put unnecessary strain on your heart.

If you’re not allergic to aspirin and have some next to you - or if there is someone with you who can fetch them for you - chew one adult aspirin tablet (300mg). If the aspirin isn’t nearby, however, anyone with you should stay with you and not go looking for aspirin.

Before the ambulance arrives

If you can, before the ambulance arrives, you can help the paramedics by doing the following:

  • if you’re outside, stay with the patient until help arrives
  • phone 999 again if the patient’s condition worsens
  • phone 999 again if your location changes
  • if you’re phoning from home or work, ask someone to open the doors and tell ambulance staff where they're needed
  • shut any family pets away
  • if you can, write down the patient’s GP details and collect any medication they’re taking
  • tell the paramedics if the patient has any allergies
  • tell the paramedics if the patient has taken an aspirin
  • stay calm - Scottish Ambulance Service are there to help you

Many people survive heart attacks and make a good recovery. Your heart is a tough muscle. Stress, shocks or surprises don’t cause heart attacks.

Symptoms of sudden cardiac arrest

Sudden cardiac arrest (SCA) is when the heart stops and person falls unconscious.

The person may:

  • appear not to be breathing
  • not be moving
  • not respond to any stimulation, like being touched or spoken to

This is a leading cause of premature death, but with immediate treatment, many lives can be saved. The heart stops because the electrical rhythm that controls the heart is replaced by a disorganised electrical rhythm. The quicker this can be treated, the greater the chance of successful resuscitation.

Read more on cardiac arrest from the British Heart Foundation

What’s the difference between a "heart attack" and a "cardiac arrest"?

A heart attack is a sudden interruption to the blood supply to part of the heart muscle. It’s likely to cause chest pain and permanent damage to the heart. The heart is still sending blood around the body, and the person remains conscious and is still breathing.

A cardiac arrest happens when the heart suddenly stops pumping blood around the body. Someone who’s having a cardiac arrest will suddenly lose consciousness and will stop breathing - or stop breathing normally. Unless immediately treated by cardiopulmonary resuscitation (CPR), this always leads to death within minutes.

A person having a heart attack is at high risk of experiencing a cardiac arrest.

Both a heart attack and a cardiac arrest are life-threatening medical emergencies and require immediate medical help.

What should I do in a sudden cardiac arrest?

Cardiac arrest is reversible, but it’s vital it’s recognised and acted upon in the first few seconds or minutes.

Seconds count - phone 999 FIRST.

You can save a life by trying chest compressions or using a defibrillator.

Chest compressions/hands-only cardiopulmonary resuscitation (CPR)

If someone is having a cardiac arrest, after phoning 999, you can can chest compressions to save their life.

Before you start chest compressions - or hands-only CPR - check the situation is safe to approach, like making sure the person’s not in a busy road

If you’re going to give someone CPR, phone 999 first or ask someone else to dial 999, but do this before you start chest compressions.

To carry out a chest compression:

  1. Place the heel of your hand on the breastbone at the centre of the person’s chest. Place your other hand on top of your first hand and interlock your fingers.
  2. Using your body weight (not just your arms), press straight down by 5-6cm on their chest.
  3. Repeat this until the ambulance arrives.

Try to do the chest compressions at a rate of 100-120 compressions a minute.

CPR is not as hard as you may think. Just phone 999 and then push hard and fast. The person on the other end of the 999 phone will talk you through what to do.

'Hard and fast' hands-only CPR (https://www.youtube.com/watch?v=ILxjxfB4zNk)

Watch the British Heart Foundation's hands-only CPR video where Vinnie Jones shows how to use this technique to the tune of Stayin' Alive by the Bee Gees.

Vinnie Jones TV ad saved my life (https://www.youtube.com/watch?v=M2STeerbaWA)

Alan Linton from Fife in Scotland is alive today because his friends remembered the British Heart Foundation's hands-only CPR advert and carried out hard and fast chest compressions in the middle of a golf course.

The above advice only applies to adults. Visit the St John Ambulance website to find out how to perform CPR on a child or baby.

Find out more:

Defibrillators

You can use a defibrillator to save a life. 

The most common type of defibrillator is an automated external defibrillator (AED). If you have access to an AED, use it.

It’s a safe, portable electrical device that most large organisations keep as part of their first aid equipment. You can find them in some public spaces, like your local shopping centre, gym, train station or village hall.

The defibrillator provides a shock that stops the heart so it can naturally return to a normal rhythm.

Once you open the defibrillator case, the instructions will talk you through exactly what to do. In between the shocks delivered, CPR should be continued.

Following defibrillation, continue to follow the instructions and keep the person as comfortable as possible.

Once life is established, the person should be positioned into the recovery position. Stay with the person until the ambulance comes.

Arrhythmia Alliance has more information about AEDs

What should I do if I have angina and have chest pains?

Angina often feels like a heaviness or tightness in your chest, which may spread to your arms, neck, jaw, back or stomach. Some people describe a feeling of severe tightness, while others feel more of a dull ache. Some have shortness of breath too.

Unstable angina can be undiagnosed chest pain or a sudden worsening of existing angina with angina attacks occurring more frequently, with less and less activity. These attacks may even happen at rest or wake you from sleep. They can last up to 10 minutes.

If you haven’t been diagnosed with angina but have chest pains, phone 999

If you have already been diagnosed with angina, you may experience angina pain or discomfort that you can manage by taking your glyceryl trinitrate (GTN) spray or tablets, and resting.

There are four stages in what to do when you have angina or chest pains or breathlessness:

  1. Stop what you’re doing and sit down. Take one dose of GTN (spray or tablet) and wait five minutes.
  2. If the pain or breathlessness remain, take a second dose of GTN and wait five minutes.
  3. If the pain or breathlessness don’t ease, phone 999.
  4. If you’re not allergic to aspirin, chew one adult tablet (300mg). If you don’t have any aspirin - or you’re not sure if you’re allergic to aspirin - rest until the ambulance arrives.

Become a lifesaver

The Scottish Government’s strategy to save lives from cardiac arrest includes encouraging people to attempt resuscitation if they witness a cardiac arrest.

British Heart Foundation also have a Nation of Lifesavers campaign to prevent the number of deaths caused by cardiac arrests.