Heart attack warning signs and what to do in the first hour

A heart attack is a medical emergency. Acting fast can save a life and protect the heart. This guide covers the common warning signs, the signs that are easy to miss, what to do in the first hour, and which doctors care for heart problems in Bangladesh.

What is a heart attack?

A heart attack happens when the blood supply to the heart is blocked. The heart muscle then does not get enough blood. According to the US CDC, the longer it takes to start treatment that restores blood flow, the more the heart muscle is damaged. This is why every minute counts. MedlinePlus says that the risk of sudden death is greatest in the early hours of a heart attack.

Heart disease is common. In its fact sheet on cardiovascular diseases (diseases of the heart and blood vessels), the World Health Organization (WHO) estimates that 19.8 million people around the world died from these diseases in 2022. That was about 32% of all deaths worldwide. Heart attacks and strokes caused 85% of these deaths, and more than three quarters of them happened in low- and middle-income countries.

Common warning signs

The NHS, the US CDC and MedlinePlus list these as the main signs of a heart attack:

Chest pain or discomfort. It can feel like pressure, heaviness, tightness, squeezing or fullness, usually in the centre or left side of the chest. It often lasts more than a few minutes, or it goes away and comes back.
Pain spreading to other parts of the body, such as one or both arms (usually the left), the shoulders, neck, jaw, back or stomach.
Shortness of breath. This often comes with chest discomfort, but some people are short of breath without any chest pain.
Sweating, including a cold sweat.
Feeling sick (nausea) or vomiting.
Feeling light-headed, dizzy, weak or faint.
A feeling like indigestion, such as a burning feeling in the chest or feeling full or bloated.
An overwhelming feeling of anxiety, like a panic attack.
Coughing or wheezing.

The pain is often severe, but not always. The NHS says some people only have mild pain, like indigestion.

Signs that are easy to miss

Not everyone has severe, crushing chest pain. MedlinePlus says women, older adults and people with diabetes are more likely to have mild or unusual symptoms. They may have little or no chest pain. Symptoms can include:

unusual tiredness or weakness
nausea or vomiting
pain in the back or jaw without chest pain
shortness of breath without chest pain
changes in thinking or behaviour, especially in older adults

Heart attack symptoms can feel like indigestion, so it is easy to think chest discomfort is just gas or acidity. If the discomfort is new, does not go away, or comes with sweating, breathlessness, nausea or pain spreading to the arm or jaw, treat it as a possible heart attack until a doctor says it is not.

Warning signs that need urgent care now

Call for emergency help or go to a hospital emergency department straight away if someone has:

chest pain that feels tight, heavy or squeezing, or chest discomfort that does not go away
chest pain spreading to the arms, neck, jaw, back or stomach
chest pain with sweating, nausea, light-headedness or shortness of breath
severe difficulty breathing, such as gasping, choking or not being able to speak
pale, grey or blue lips or skin (on brown or black skin this may be easier to see on the palms of the hands)
chest pain with a heartbeat that feels racing, very slow, skipping or fluttering
passed out and is not responding normally

If you are not sure, it is still safer to get checked. MedlinePlus says the average person waits 3 hours before seeking help for heart attack symptoms. Do not wait to see if the symptoms go away.

What to do in the first hour

Stop and rest. Help the person sit down, rest and stay calm. Loosen any tight clothing. Do not leave them alone, except to call for help if you must.
Call for help immediately. In Bangladesh, the National Emergency Hotline is 999, and many ambulances are linked to it. If an ambulance cannot reach you quickly, go straight to the nearest hospital with an emergency department.
Do not drive yourself. If you have symptoms, ask someone else to take you, or wait for an ambulance. Do not let the person talk you out of getting emergency help.
Do not go home to rest or wait until morning. The sooner treatment starts, the less damage there is to the heart.
Medicines, food and drink: do not give the person anything by mouth unless a doctor or the emergency call handler tells you to. Follow their advice.
Bring information. If you can, bring the person’s prescriptions, past test results or medical reports, and a list of their medicines.
If the person collapses and is not responding or not breathing, call for emergency help and start CPR (cardiopulmonary resuscitation) if you know how. If an automated external defibrillator (AED) is available, follow the instructions on the device.

If you are unsure what to do, the DGHS health helpline Shasthyo Batayon 16263 gives advice from doctors 24 hours a day. For a suspected heart attack, do not let a phone call delay getting to hospital.

What happens at the hospital

At the hospital, doctors will do tests to find out whether it is a heart attack. Treatment aims to restore blood flow to the heart as quickly as possible. The doctors will choose the right treatment based on the test results and the person’s condition. Afterwards, follow your doctor’s advice and go to all follow-up appointments.

Who is at higher risk?

WHO says most cardiovascular diseases can be prevented by tackling these risk factors:

tobacco use
an unhealthy diet with too much salt, sugar and fat
obesity
not getting enough physical activity
harmful use of alcohol
air pollution

MedlinePlus says smoking more than doubles your chance of getting heart disease. It also advises keeping blood pressure, cholesterol and diabetes well controlled.

Which specialist to see

Situation	Who to see
Suspected heart attack now	Hospital emergency department, without delay
Diagnosis and treatment of heart disease	Cardiologist (heart specialist)
Angiography, angioplasty and stents	Interventional cardiologist
Bypass surgery	Cardiac surgeon (heart surgeon)
Blood pressure, cholesterol and general check-ups	Medicine specialist or general physician
Diabetes control	Endocrinologist (hormone and diabetes specialist) or diabetes clinic
Recovery and safe return to activity	Cardiac rehabilitation team, if available, with your cardiologist

If you get chest discomfort when you are active or stressed, and it settles with rest, see a doctor soon even if it passes. This may be angina, which is chest pain caused by partly blocked heart arteries. The NHS says angina usually passes in less than 10 minutes. Heart attack pain is usually worse and lasts longer. If chest pain does not settle with rest, treat it as an emergency.

Key points to remember

Chest pain, pressure or discomfort lasting more than a few minutes is an emergency.
Women, older people and people with diabetes may have milder or unusual symptoms.
Call 999 or go to the nearest emergency department straight away. Do not drive yourself.
Rest while waiting. Do not give anything by mouth unless a doctor or call handler tells you to.
If someone collapses and is not breathing, start CPR.

This article is general information and not a substitute for advice from a doctor.

Find a doctor

Browse Cardiology doctors in Bangladesh on ratings.com.bd, with chambers and, where listed, visiting hours and phone numbers.

Sources

This article is general information, not medical advice. It was written by AI from the sources above. It did not pass the automatic check, and an administrator chose to publish it; no doctor or editor has reviewed it. For a diagnosis or treatment, see a registered doctor.