Can You Spot a Heart Emergency?

Health Professional

Adults today spend more time than generations before on their health — from diet choices to workout tools. This growing self-interest doesn’t include knowledge about heart health, though.

In November 2017, a multigenerational survey by the Cleveland Clinic Foundation identified remarkable gaps in basic awareness about two types of cardiac emergencies—heart attacks and strokes. Millennials, the youngest group polled, were more interested in browsing Instagram than increasing heart education.

February is American Heart Month, the perfect (but not only!) time for everyone to learn to recognize and respond to cardiac emergencies.

What do you really know about your heart?

Heart disease risks increase with age, but damage doesn’t occur overnight. Many causes of heart damage, often silent, exist in younger adults:

  • Inherited defects, like valve stenosis, can remain undetected and stress the heart muscle.
  • Blood vessel damage from high cholesterol can begin without symptoms even in your 20s or 30s.
  • In existing heart disease, adding multiple sources of stress together increases the likelihood of a heart emergency.

The heart and blood vessels adjust immediately to changes in the body to keep oxygen and nutrients pumped consistently. When something drastic stops this process, it’s immediately life threatening—a cardiac emergency.

Would you know a heart emergency if you had one?

Stroke and heart attack — cardiovascular accident and myocardial infarction in medical terms — are two types of heart emergencies. Risk factors are similar: smoking, high blood pressure or cholesterol, diabetes, family history of heart disease, low physical activity.


Credit: Thinkstock

Stroke and heart attack don’t share symptoms, though, and many U.S. adults don’t know the difference. In fact, a surprising survey finding was that many Americans consider stroke and heart attack similar conditions.

A stroke occurs when oxygen-carrying blood can’t get to brain cells, either because of a clot or excess bleeding in a blood vessel there. Sudden weakness or numbness on one side of the body or face, and slurred speech, are characteristic symptoms. The heart is working, but the brain’s blood supply needs fixed.

Heart attacks occur when the heart muscle itself stops getting oxygen-rich blood. Fatty blood vessel plaques, weak artery walls, and smoking are some common causes. Key typical symptoms are pain, pressure, or squeezing in the chest that can travel down the arm or even to the back. Sudden breathing changes also can occur with heart attack, not stroke.

What makes a heart attack harder to identify are the atypical symptoms: nausea, vomiting, racing or unusual heart beats, back pain, and even a feeling of heartburn. These symptoms confuse patients, because they seem like indigestion, mild dehydration, or even “the stomach flu.” Many adults hesitate to visit an emergency room with chest pain, in case it’s just pain from overeating or a muscle sprain.

Don’t ignore symptoms

Doctors encourage patients to trust their instincts and get any type of chest pain checked out. Emer Joyce, MD, PhD, of the Cleveland Clinic Department of Cardiovascular Medicine, recognizes the danger in patients’ hesitation. Lack of lifesaving treatment results from the gaps in heart knowledge seen in the Clinic’s survey. According to Dr. Joyce, a key part of an in-the-moment response to a heart emergency, especially for younger adults, is to develop a strong relationship with your health provider. “Really talk about in advance what your symptoms may be, what your risk factor profile is like…and [how to take] steps to prevent” heart emergency risks.

Talking about heart symptoms ahead of time takes just a few minutes, but patients rarely ask. Approximately 40 percent don’t know what to ask about heart health, and more than 90 percent expect doctors to provide information proactively. You can start the conversation: ask easy questions from The Heart Truth®, for example, about your risk.

Do you know what to do in a heart emergency?

If you do recognize a heart emergency in yourself or another person, can you respond? Life-saving steps differ depending on whether the person loses consciousness (passes out) or not.

When someone with cardiac symptoms loses consciousness, they need cardiopulmonary resuscitation—CPR—until emergency personnel arrive. CPR is an easy and basic lifesaving skill. It can prevent permanent damage from a heart attack or stroke by keeping blood flowing around the body before hospital treatment.

In the United States, 60 percent of millennials think that they can perform CPR correctly, but only 6 percent are familiar with the correct approach. The updated adult technique uses only chest compressions; Dr. Joyce suggests a refresher course for everyone to confidently use this action in a heart emergency. CPR classes may be offered at low cost or for free at a local fire station or hospital.

As a patient or bystander, the response to heart symptoms without losing consciousness can seem less clear. Here, Dr. Joyce emphasizes a new Cleveland Clinic initiative called SCAN to help patients through these scary moments:

  • S—SYMPTOMS. Recognize them; don’t ignore them.
  • C—CALL 911. Most Americans are aware of this step, but some still try to drive themselves to the hospital or doctor. Calling 911 is always safer. “Don’t put anything to chance,” Dr. Joyce emphasizes.
  • A—ASPIRIN. You can prevent heart attack progression while waiting for emergency services. Especially with a history of heart disease, keep aspirin on hand and chew 2 baby tablets (81 mg each) or 1 full-dose tablet (325 mg).
  • N—NITROGLYCERIN: If you use a “nitro pill” for chest pain, remember to take it while you wait for help; it increases blood flow to the heart.

What else can I do?

Do you recognize yourself or a loved one in the Clinic survey results? You aren’t alone: nearly 70 percent of Americans worry about heart health. Start preventing and recognizing heart emergencies simply: browse social media:

Dr. Joyce encourages everyone to visit to learn more about SCAN and other aspects of lifesaving cardiac self-care.

See more helpful articles:

Blood Pressure Q&A: Questions to Ask Your Doctor

Can You Recognize a Heart Attack (quiz)?

National Library of Medicine: All About Stroke