Heart Attack First Aid: What to Do in the First Few Minutes

Last reviewed: 27 October 2026 · 9 sources (listed at the end). Educational content only. Part of the Jaan Bachayega India series.

Quick answer: If you think someone is having a heart attack, call an ambulance on 108 or 112 straight away. Do not drive them in your own car if an ambulance can come. Help them sit and rest, loosen tight clothing and stay with them. If they are awake and not allergic, they can chew one 300 mg aspirin slowly while you wait. If they collapse and are not breathing normally, call 112 and start CPR.

The mistake many families make: “Who will wait for the ambulance? Put him in the car.” It feels faster. But the 2025 heart attack guideline from the American College of Cardiology and the American Heart Association says people with a suspected heart attack should go to hospital by ambulance, because the crew can check, monitor and treat dangerous heart rhythms or cardiac arrest on the way. In a private car, nobody can do that.

Heart attack or cardiac arrest: what is the difference?

A heart attack usually happens when a blood clot stops enough blood reaching part of the heart. The person is usually awake, in pain and breathing. A cardiac arrest is when the heart suddenly stops pumping. The person collapses, does not respond and is not breathing normally. A heart attack can lead to a cardiac arrest, which is why the first minutes matter so much. This guide covers both: what to do while the person is awake, and what to do if they collapse.

Heart attack symptoms: how to recognise it

Chest pain or discomfort: pressure, squeezing, tightness or a heavy feeling in the chest.
Pain that spreads: to one or both arms, the jaw, neck, back or stomach.
Shortness of breath, with or without chest pain.
Sweating, often a cold sweat.
Feeling sick or vomiting, or a feeling like indigestion.
Feeling light headed, or unusually tired.

Women often have different or milder signs. The American Heart Association lists shortness of breath, nausea, vomiting, an upset stomach, pain in the shoulder, back or arm, and unusual tiredness or weakness. These are easy to brush off. Many Indian families say “it is just acidity” and wait. If the feeling is new, unusual or getting worse, treat it as a possible heart attack and call for help. A doctor can rule it out. Nobody at home can.

What to do, step by step

Step 1: Call 108 or 112 straight away

Dial 108, the free ambulance number in most states, or 112, the national emergency number that works everywhere in India. Say clearly: “I think this person is having a heart attack.” Do not wait to see if the pain settles. The American Heart Association says calling for an ambulance is almost always the fastest way to get life saving treatment.

Step 2: Sit and rest. No walking, no stairs

Help them into a comfortable position. The NHS suggests sitting on the floor with the knees bent and the back supported, for example against a wall or a sofa. A chair is fine if that is easier. Do not let them walk around, climb stairs or carry on working, because any effort makes the heart work harder. Loosen tight clothing at the neck, chest and waist. Stay with them and keep them calm.

Step 3: Aspirin, only if it is safe

Aspirin helps stop the clot from getting bigger. It is useful, but it is optional, and it must be the right tablet:

The dose: one 300 mg aspirin tablet, chewed slowly, not swallowed whole. This is the advice of the NHS and St John Ambulance. American guidelines give a range of 162 to 325 mg.
Do not give it if they are allergic to aspirin, they are under 16, a doctor has told them not to take aspirin, or they are not fully awake and able to chew and swallow.
Low dose tablets are not the same. Many heart patients in India keep 75 mg tablets at home. That is a daily dose, not the emergency dose. If that is all you have, ask the ambulance call taker or a doctor on the phone what to do.
When in doubt, leave it. Calling the ambulance matters far more than the aspirin.

If the person has been prescribed their own angina medicine, such as a spray or tablet under the tongue, help them take it the way their doctor told them.

Step 4: Keep watching the breathing

Stay with them until the ambulance arrives. Keep talking to them and watch their breathing. If they stop responding, move straight to the next section.

If they collapse and are not breathing normally: start CPR

This is the most important section. If the person becomes unresponsive and is not breathing, or is only gasping, this may be a cardiac arrest. Gasping is not breathing. Call 112, put the phone on speaker and start CPR straight away.

Lay them flat on their back on a firm surface. If they are on a bed and it is safe, move them to the floor.
Hand position: put the heel of one hand in the middle of the chest, put the other hand on top and interlock your fingers.
Push hard and fast: keep your arms straight, press down about 5 to 6 cm, let the chest come back up, and repeat at 100 to 120 times a minute.
Not trained in rescue breaths? Keep giving chest compressions without stopping. The ambulance call taker can guide you.
Defibrillator (AED): if there is one nearby, in a mall, office, airport or station, send someone to bring it and follow its voice instructions. If you are alone, do not leave the person to look for one.
Do not stop until the ambulance team takes over, the person starts breathing normally, or you are too exhausted to continue. If someone else is there, take turns so the compressions stay strong.

These are the short steps. Read the complete CPR guide for every step, using an AED, and CPR for children and babies.

How to call for help

Put the phone on speaker so your hands stay free. Tell them, in this order:

Where you are: the area, the nearest landmark, the PIN code or district.
What is happening: “I think this person is having a heart attack” or “the person has collapsed and is not breathing.”
The person’s approximate age, and whether they have heart disease, diabetes or high blood pressure.
Your phone number. Do not hang up first. Let them end the call.

Send one person to the main road or gate to guide the ambulance. Unlock the gate and keep the path clear. Keep the person’s medicines and old reports, such as an ECG, ready to hand over.

If no ambulance can come

The ambulance is always the first choice. If it truly cannot reach you, ask someone else to drive the person to the nearest hospital with an emergency department, not the famous one that is far away. The person having chest pain should never drive themselves; the NHS is clear on this. Keep them sitting comfortably in the car with someone beside them watching the breathing. If they collapse and stop breathing normally, stop the vehicle, call 112 and start CPR. This part of the guide is practical advice for Indian conditions, not a quotation from a guideline.

The viral myth: “cough hard to stop a heart attack”

A message keeps going round on WhatsApp: if you are alone and having a heart attack, cough hard and repeatedly and you can save yourself. This is called “cough CPR”. The American Heart Association says there is no evidence to support it as a recommended practice, and the Association does not endorse it. It is not a replacement for an ambulance. If you are alone with chest pain, do not waste time coughing. Call 108 or 112, unlock your door if you can, then sit down and rest.

What not to do

Do not wait to see if the pain goes away, or decide it is gas.
Do not put them in your own car if an ambulance can come.
Do not let them walk, climb stairs or drive.
Do not give food, water or anything by mouth to a person who is not fully awake.
Do not give aspirin if they are allergic, under 16, told not to by a doctor, or not able to swallow.
Do not rely on cough CPR or any home remedy instead of calling for help.

Who is at higher risk

A heart attack can happen to people who seemed healthy, which is why everyone in the family should know these steps. The NHS lists the factors that make it more likely: smoking, high blood pressure, high cholesterol, diabetes, being overweight, and a close relative who has had a heart attack. Many of these can be checked and treated early. You can read more in our guide on keeping your heart healthy.

🛒 Know your blood pressure: Omron HEM 7120 digital blood pressure monitor

An upper arm monitor with a published validation study, arm circumference 22 to 32 cm.

For checking blood pressure at home, as your doctor advises. It cannot tell you whether chest pain is a heart attack. If you have chest pain, call 108 or 112.

Being overweight is one of the risk factors you can track at home. A simple, regular weight check helps you and your doctor see the trend over months, not days.

🛒 Track your weight: HealthSense digital weighing scale

A basic bathroom scale for weekly weight checks.

A scale does not lower heart risk by itself. It only helps you see whether your efforts are working.

After a heart attack

Most people are given medicines to take long term after a heart attack, to protect the heart and lower the chance of another one. Never stop or change them without asking your doctor. Missing doses is common when there are many tablets, especially for elderly parents, so a simple system at home helps.

🛒 Never miss a dose: PharmEasy 7 day weekly pill box

A box with one compartment for each day of the week, so you can see at a glance whether today’s tablets were taken.

Fill it exactly as prescribed. Ask your doctor or pharmacist if any medicine must stay in its original strip.

Share it with your family

Take a screenshot of this box and send it to your family WhatsApp group, especially to your parents and grandparents.

Save and send: if you suspect a heart attack

Call 108 / 112. Ambulance, not your own car.
Sit and rest. No walking, no stairs. Loosen clothing.
Aspirin, if safe: one 300 mg tablet, chewed. Not if allergic or under 16.
Stay with them. Watch the breathing.

Collapsed, not breathing or only gasping: call 112 and start CPR. Use an AED if one is near.

Coughing does not stop a heart attack. Emergency numbers: 108 (ambulance, most states) · 112 (national). Health Beats by Biswa

Disclosure: the product links on this page are Amazon affiliate links. If you buy through them, this site may earn a small commission at no extra cost to you. Nothing linked here treats a heart attack. Calling an ambulance does.

This article is health education, not medical advice, and not a diagnosis for any person. It reflects the author’s own views as a nursing and public health professional and does not represent any employer or institution. For chest pain or any symptom in this article, call 108 or 112 or see a qualified doctor.

Sources

American College of Cardiology and American Heart Association: 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes. Circulation, 2025. ahajournals.org
NHS (UK): Heart attack, reviewed 31 March 2026. nhs.uk/conditions/heart-attack
American Heart Association: Warning Signs of a Heart Attack. heart.org
American Heart Association News: Why “cough CPR” is not the lifesaver it’s made out to be, 22 January 2025. heart.org
St John Ambulance: Heart attack, clinically reviewed 28 April 2025. sja.org.uk
St John Ambulance: How to do CPR, clinically reviewed 18 September 2026. sja.org.uk
American Red Cross: Heart attack, learn first aid. redcross.org
Government of India: 112 India, Emergency Response Support System. 112.gov.in
National Health Mission: ERS / Patient Transport Service (Dial 108 / 102). nhm.gov.in

Heart Attack First Aid: What to Do in the First Few Minutes

Heart attack or cardiac arrest: what is the difference?

Heart attack symptoms: how to recognise it