Heart Attack and Angina:
Recognising Symptoms and Providing First Aid

Heart attacks and angina are both serious heart conditions that require immediate attention. While angina is usually a warning sign of heart disease, a heart attack is a medical emergency that can be life-threatening. Understanding the symptoms of each and knowing how to provide first aid can help save a life.

What is a Heart Attack?

A heart attack, or myocardial infarction, occurs when the blood supply to a part of the heart muscle is blocked, usually by a blood clot. This prevents oxygen from reaching the heart muscle, which can cause permanent damage or even death if not treated quickly.

What is Angina?

Angina is chest pain or discomfort caused by reduced blood flow to the heart. It is a symptom of coronary artery disease (CAD) and typically occurs when the heart is working harder than usual, such as during physical activity or stress. Angina is a warning sign that the heart is not getting enough oxygen, but it is usually relieved by rest or medication.

There are two main types of angina:

• Stable Angina: Predictable and occurs with exertion or stress. It usually lasts a few minutes and is relieved by rest or medication.
• Unstable Angina: Unpredictable and occurs at rest or with minimal exertion. It is more severe and may signal an impending heart attack, requiring immediate medical attention.

Signs and Symptoms of a Heart Attack

A heart attack can present with a variety of symptoms, and not everyone experiences the same signs. The most common symptoms include:

• Chest Pain or Discomfort: A feeling of pressure, tightness, or squeezing in the centre of the chest. This discomfort may last for several minutes or come and go.
• Pain Radiating to Other Parts of the Body: The pain may spread to the arms (usually the left arm), jaw, neck, back, or stomach.
• Shortness of Breath: Difficulty breathing, which may occur with or without chest pain.
• Sweating: A sudden cold sweat, often accompanied by clammy skin.
• Nausea or Vomiting: Some people experience indigestion, heartburn, or nausea.
• Dizziness or Light-headedness: A feeling of faintness or unsteadiness.
• Fatigue: Unexplained tiredness, particularly in women.

Women, older adults, and people with diabetes may experience less typical symptoms, such as shortness of breath, fatigue, or discomfort in areas other than the chest.

Signs and Symptoms of Angina

• Chest Pain or Discomfort: Angina typically feels like pressure, heaviness, or tightness in the chest. The pain is often triggered by physical exertion or emotional stress.
• Pain Radiating to the Arm, Neck, or Jaw: Like a heart attack, angina pain can spread to other areas of the body.
• Shortness of Breath: The person may experience difficulty breathing, especially during activity.
• Relief with Rest or Medication: Unlike a heart attack, angina symptoms usually subside with rest or the use of prescribed medication (such as nitroglycerin).

If angina symptoms persist for more than a few minutes or occur at rest, this may indicate unstable angina or a heart attack, and emergency help is required.

First Aid for a Heart Attack

A heart attack is a medical emergency, and quick action is crucial. Follow these steps if you suspect someone is having a heart attack:

1. Call 999 Immediately:

• Dial 999 and ask for an ambulance. Clearly explain that you suspect a heart attack so that emergency services can respond quickly.

2. Help the Person to Sit Down:

• Encourage the person to sit down and rest. Sitting in a comfortable position, such as leaning forward slightly, can help reduce strain on the heart.
• Do not let them lie down unless they are feeling faint or light-headed.

3. Administer Aspirin (if advised):

• If the person is conscious and not allergic to aspirin, help them take 300mg of aspirin (usually one tablet) to chew slowly. Aspirin helps to thin the blood and reduce clotting, which can limit the damage to the heart.
• Ensure that they chew the tablet rather than swallow it whole, as this allows for faster absorption.

4. Use a Nitroglycerin Spray or Tablet (if prescribed):

• If the person has been prescribed nitroglycerin for angina, help them use their medication. Nitroglycerin helps to widen blood vessels and improve blood flow to the heart.
• Place the nitroglycerin spray under their tongue or give them a tablet to dissolve under their tongue.

5. Monitor Their Condition:

• Stay with the person and keep them calm. Monitor their breathing and level of consciousness.
• If they lose consciousness and stop breathing, start CPR (Cardiopulmonary Resuscitation) and use an AED(Automated External Defibrillator) if available.

First Aid for Angina

Angina symptoms can be relieved with rest and medication, but it’s important to take action quickly, as angina may be a sign of a heart attack. Follow these steps if someone is experiencing an angina attack:

1. Help the Person Sit Down and Rest:

• Encourage the person to stop what they are doing and sit down to rest. This will help to reduce the strain on the heart.

2. Administer Nitroglycerin (if prescribed):

• If the person has been prescribed nitroglycerin, help them take the medication according to their doctor’s instructions. Typically, they will place a tablet under their tongue or use a spray, which will help to relieve chest pain by widening the blood vessels.

3. Call 999 if Symptoms Don’t Improve:

• If the pain persists for more than 5 minutes after using nitroglycerin, or if the symptoms worsen, call 999 immediately, as this may be a heart attack.
• If the person has unstable angina, where symptoms occur at rest or unpredictably, always seek emergency help.

4. Stay Calm and Monitor:

• Stay with the person and monitor their condition. If they lose consciousness, be prepared to administer CPR.

When to Seek Medical Help

• For Heart Attack: Always call 999 immediately if you suspect a heart attack. Time is critical, and early treatment can prevent further damage to the heart.
• For Angina: If angina symptoms do not improve with rest or medication, or if the person has unstable angina, seek emergency help right away.

Prevention Tips for Heart Attacks and Angina

• Healthy Lifestyle: Regular exercise, a balanced diet, and maintaining a healthy weight can reduce the risk of heart disease.
• Manage Stress: Chronic stress can increase the risk of heart problems, so it’s important to manage stress through relaxation techniques, exercise, or therapy.
• Control Risk Factors: High blood pressure, high cholesterol, and diabetes are major risk factors for heart attacks and angina. These should be managed with medication and lifestyle changes.
• Avoid Smoking: Smoking significantly increases the risk of heart disease. Quitting smoking can reduce the risk of both heart attacks and angina.

Key Points to Remember

• Call 999 immediately if you suspect a heart attack.
• Help the person to rest and take prescribed medications like aspirin or nitroglycerin.
• Monitor their condition and be prepared to perform CPR if necessary.
• Angina symptoms usually improve with rest and medication, but seek medical help if the pain persists or worsens.