What to do if someone has chest pain but is not sure it’s a heart attack?

Chest pain should always be treated as a potential medical emergency because it may indicate a heart attack, but it can also be caused by less serious conditions (muscle strain, indigestion, anxiety, etc.). Since you cannot know for sure without medical assessment, it is safest to act promptly.

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Immediate Steps

1. Stop activity and rest

   • Ask the person to sit down, preferably in a comfortable upright position, and remain calm.

   • Reassure them and avoid unnecessary movement.

2. Call emergency services (e.g., 911/999/112) if:

   • The pain is severe, persistent, or spreading (to arm, jaw, neck, or back).

   • It is accompanied by shortness of breath, sweating, nausea, lightheadedness, or palpitations.

   • The person has a history of heart disease, diabetes, or risk factors (e.g., high blood pressure, smoking).

3. Loosen tight clothing

   • This helps ease breathing and comfort.

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If the Person Has a Diagnosis of Heart Disease

• Assist with prescribed medication

  • If they have nitroglycerin spray/tablets, help them take one dose under the tongue.

  • If symptoms persist after 5 minutes, a second dose may be taken (up to a maximum of 3 doses in 15 minutes, unless otherwise instructed by their doctor).

• Give aspirin (if available and not allergic/contraindicated)

  • One adult aspirin (300 mg / 325 mg) to chew slowly can help reduce clot formation while waiting for emergency help.

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If the Person Becomes Unconscious

• Check responsiveness and breathing.

• If they are not breathing normally:

  • Call emergency services immediately.

  • Start CPR (push hard and fast in the center of the chest, ~100–120 compressions per minute).

  • Use an AED (defibrillator) if available, following its prompts.

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If Symptoms Seem Less Serious

• If pain is mild and resolves quickly (e.g., after rest or antacids), still advise medical review as soon as possible, especially if the person has risk factors.

• Encourage the person to keep a record of the episode (duration, severity, triggers) to share with a doctor.

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Key Principle

When in doubt, treat chest pain as a possible heart attack. Acting quickly could save a life.