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The two terms are used interchangeably in ordinary speech and they are not the same event. The response differs, so the distinction is worth being clear about before you need it.
Heart attack versus cardiac arrest
A heart attack is a circulation problem. A blocked artery starves part of the heart muscle of blood. The person is usually conscious and talking, and the heart is still beating. It is an emergency because untreated it damages muscle and can lead to arrest.
A cardiac arrest is an electrical problem. The heart stops pumping effectively. The person is unresponsive and not breathing normally. This is the situation that needs CPR and a defibrillator immediately.
A heart attack can cause a cardiac arrest, which is why a conscious patient must be monitored continuously.
Recognizing a heart attack
- Chest pain or pressure, often described as tightness, squeezing or a heavy weight
- Pain spreading to the arm, jaw, neck, back or stomach
- Shortness of breath
- Cold sweat, nausea, light headedness
- A sense that something is badly wrong
Symptoms are frequently less typical in women, who more often report shortness of breath, nausea, back or jaw pain and unusual fatigue rather than crushing chest pain. That difference contributes to delayed treatment, so treat these symptoms seriously even without classic chest pain.
What should I do if I notice these signs?
- Call emergency services immediately. Do not drive the person yourself if an ambulance is available, because treatment begins on arrival.
- Sit them down, leaning slightly back, knees bent. This eases the load on the heart.
- Loosen tight clothing and keep them calm and still.
- Ask about prescribed medication such as nitroglycerin and help them take their own.
- Aspirin may be advised by the dispatcher. Follow their instruction rather than deciding yourself, because it is not appropriate for everyone.
- Stay with them. If they become unresponsive and stop breathing normally, begin CPR and send for an AED.
The transition from conscious patient to cardiac arrest is the moment that decides the outcome, and it is why First Aid training matters even for people who expect only to make a phone call.
How quickly should you call for help?
Immediately, and before anything else you are tempted to do first. The treatments that save heart muscle work on a clock, and the delay that matters most is almost always the one before the call, not the one in the ambulance.
The most common reason for delay is denial. People minimize the symptoms, wait to see if they pass, or feel embarrassed about a false alarm. Emergency services would far rather attend a case of indigestion than a cardiac arrest that started as an ignored heart attack, and it is worth saying that out loud to a reluctant patient.
Should you give aspirin?
Only if the dispatcher or a medical professional tells you to. Aspirin can help by reducing clotting during a heart attack, but it is not appropriate for everyone, including people with certain bleeding risks or allergies, and a heart attack is not the only condition that presents this way.
If it is advised, the usual instruction is a single adult dose chewed rather than swallowed whole, because chewing gets it into the bloodstream faster. Never give aspirin to someone who is drowsy, struggling to breathe or unable to swallow safely, and never give it to a child.
What position should the person be in?
Sitting up and leaning slightly back with the knees bent, often called the W position, is the standard. It reduces the work the heart has to do compared with standing or lying flat and it makes breathing easier.
Do not let them walk about, and do not drive them yourself unless an ambulance genuinely cannot reach you. Treatment begins the moment paramedics arrive, and a person who arrests in a private car has no monitoring, no defibrillator and a driver who cannot do CPR while driving.
What do you do if they become unresponsive?
This is the transition the whole response is built around. If the person stops responding and is not breathing normally, the situation has become a cardiac arrest and the treatment changes completely.
Start chest compressions immediately at one hundred to one hundred and twenty per minute, pressing at least two inches deep in the center of the chest. Send someone specific to fetch an AED and to call back to emergency services with the update, because a heart attack call and a cardiac arrest call get different responses.
Do not stop to check for a pulse repeatedly. Pulse checks are unreliable even for professionals and every check costs circulation. Continue until emergency services take over, an AED tells you to stand clear, or the person begins breathing normally and moving purposefully. Occasional gasping during CPR is common and is not a reason to stop. For the full sequence, see a CPR Class.
Frequently asked questions about first aid for a heart attack
What is the first thing to do for a suspected heart attack?
Call emergency services immediately. Do not wait to see whether the symptoms pass and do not drive the person yourself. Then sit them down leaning slightly back with their knees bent, loosen tight clothing, and stay with them continuously in case they deteriorate.
What is the difference between a heart attack and cardiac arrest?
A heart attack is a blocked artery starving heart muscle of blood, and the person is usually conscious. Cardiac arrest is an electrical failure where the heart stops pumping and the person is unresponsive and not breathing normally. Only cardiac arrest needs CPR.
Are heart attack symptoms different in women?
Often, yes. Women more frequently report shortness of breath, nausea, unusual fatigue, and back or jaw pain rather than crushing chest pain. Because these do not match the expected picture, treatment is more often delayed, so take them seriously even without classic chest pain.
Should you give someone water or food?
No. Keep them from eating or drinking anything except prescribed medication they take themselves, because they may need surgery or a procedure shortly after arrival. Anything in the stomach raises the risk if they lose consciousness or need an anesthetic.
Reviewed by Jackie Stern, Lifeguard Instructor, Firefighter and EMT. Jackie Stern has taught lifeguarding for more than 20 years and works as a firefighter, EMT and swim instructor. She reviews course content, prerequisites and rescue standards against current certification requirements.