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What you must do when alone and having a heart attack

For some, symptoms of heart attack may appear hours or days before, while for others, it can escalate in minutes.

Early signs of heart attack begin subtly and gradually. (Photo: Freepik)

Between 2024 and 2025, nearly half of all sudden cardiac deaths occurred when the person was alone, and emergency help was either delayed or unavailable. Experts say that for some individuals, symptoms may begin hours or even days before a full-blown heart attack, while for others, it can escalate within minutes. This unpredictability makes instant intervention crucial. To understand how one can act in such a situation, we spoke with Dr C.M. Nagesh, Honorary Secretary of the Indian College of Cardiology and Founder of Cardea Super Speciality Hospital.

Q1. How can someone know that they are about to experience a heart attack? What are the signs?

Dr Nagesh explains that the early signs of a heart attack often begin subtly and gradually. “Nearly two-thirds of people experience warning symptoms before a major heart attack, especially while walking,” he says. Most describe it as pressure, heaviness, or a squeezing sensation in the chest that lasts several minutes or comes and goes. This discomfort may radiate to the jaw, shoulder, arm, or back. He adds that shortness of breath, nausea, dizziness, or profuse sweating are common. “Some individuals, especially diabetics and women, may have less typical symptoms like extreme fatigue, indigestion, or pain in the upper back,” he warns. Recognising these early signs and seeking immediate medical help, he stresses, can be life-saving.

Q2. What should someone do if they feel like they are about to have a heart attack when they are alone?

“If you suspect a heart attack, call emergency medical services immediately — do not drive yourself,” warns Dr Nagesh. He advises staying calm, sitting or lying in a comfortable position, and avoiding unnecessary movement.

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“If you have nitroglycerin prescribed, take it as directed. If you’re not allergic, chewing a regular aspirin may help slow clot formation while waiting for help,” he adds. Keeping the door unlocked and focusing on slow, deep breathing can also aid rescuers and reduce panic.

Q3. How much time does a person usually have between the first sign and a full-blown heart attack?

According to Dr Nagesh, the time window varies greatly. “For some, symptoms may appear hours or days before; for others, it can escalate in minutes,” he explains. Typically, chest pressure or radiating pain may precede complete blockage by 15 to 60 minutes. “Since this timeline is unpredictable, any chest discomfort that feels unusual or lasts more than a few minutes should be treated as an emergency,” he warns.

Q4. Are the symptoms and handling techniques different for men and women?

“Yes, there are key differences,” says Dr Nagesh. “Men often experience the classic crushing chest pain and left arm discomfort, while women may feel vague symptoms — fatigue, nausea, or pain in the back, jaw, or neck.”

He cautions that these subtler signs often cause women to delay seeking help. “That delay can be fatal. But the response steps remain the same: call for help, stay still, and if not allergic, take aspirin while waiting,” he advises.

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Q5. How effective is taking aspirin in this scenario?

Dr Nagesh clarifies, “Aspirin helps by preventing platelets from clumping and forming new clots — it can buy time but not replace treatment.” He emphasises that those allergic to aspirin, or with bleeding disorders, should avoid it. “The key is still to reach emergency care as quickly as possible,” he stresses.

Also Read | Patient had a heart attack at 32 although he weighed normal, didn’t smoke or drink, played table tennis on weekends: What was his trigger?

Q6. Some people recommend elevating the legs in this scenario. How does it help?

“Elevating the legs is not recommended during a heart attack,” warns Dr Nagesh. It increases blood return to the heart, which can worsen strain if the heart is already under stress. “The best position is semi-sitting or upright — it eases breathing and reduces cardiac workload,” he advises.

However, he adds, “Elevating the legs can be useful after cardiac arrest — not during a heart attack — as it increases venous return to the heart.”

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

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