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Heart attack: how to recognise it and what to do

Chest pain that lasts longer than 15–20 minutes and does not change with breathing or position is treated as a heart attack until proven otherwise. Half of patients wait for hours hoping it passes — and that is exactly the time when the heart muscle dies. An ECG takes five minutes and settles the question.

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What to do right now

Stop everything and sit down
Half-sitting with support, legs down. Any exertion increases the load on the heart.
Chew one aspirin 250–325 mg
Not the coated one, and chew rather than swallow — unless you are allergic or have active bleeding.
Nitroglycerine, if prescribed
One tablet or spray under the tongue, sitting. Do not take it if blood pressure is below 100, or if erectile-dysfunction drugs were taken in the last 24–48 hours.
Call — do not drive
The crew records an ECG on the spot, starts treatment and alerts the cath lab. Driving yourself wastes the one advantage you have.
Unlock the door
Open the entrance door and keep the phone in hand — if you lose consciousness, the crew must be able to enter.

Call an ambulance if

Pressing, burning or squeezing chest pain lasting more than 15 minutes
Pain radiating to the left arm, shoulder blade, neck, jaw or upper abdomen
Cold sweat, nausea, sudden weakness, fear of dying
Shortness of breath at rest, especially in a diabetic or an elderly person without pain
Pain unrelieved by nitroglycerine after two doses
Fainting, irregular heartbeat with dizziness

What not to do

Do not take a hot bath or shower and do not use a heating pad
Do not take painkillers instead of nitroglycerine — they mask the picture
Do not drive yourself or let the patient walk down the stairs
Do not take a second aspirin dose "for certainty"

What the crew does

12-lead ECG within minutes, with immediate interpretation
Troponin rapid test — 15 minutes, detects damage the ECG may miss
Pain relief including strong analgesics, antiplatelet drugs, oxygen, treatment of arrhythmia
Transport to a hospital with a 24/7 catheterisation lab, with the cardiologist notified en route

This page is for information and does not replace a medical examination. If the condition worsens, call the crew: +7 (985) 887-82-52.

This page in Russian: Russian version.

Questions

Chest pain but the ECG is normal — is it safe?

A normal ECG makes a large heart attack unlikely but does not exclude it entirely. That is why we run a troponin test and, if pain continues, recommend hospital assessment.

How much does an ECG at home cost in Moscow?

Call-out 6,000 ₽ inside the MKAD, ECG recording 8,000 ₽ and interpretation 2,000 ₽ — 16,000 ₽ in total. The troponin test is charged separately.

Is it maybe just neuralgia?

Pain that changes with breathing, movement or pressing on the ribs is usually muscular. Pain that stays the same in any position, with sweating and weakness, is cardiac until an ECG says otherwise.