What to do
Now that you know the symptoms of heart attack in women, the next step is to act fast and get help. When given quickly, medicines and other treatments can stop a heart attack and limit damage to your heart muscle. If you have any of the symptoms of heart attack, or if you think you might be having one, call 911 right away.
Be prepared for an emergency
No one wants to think about having a heart attack, but knowing what to do if one strikes can save your life. Writing down your own heart attack action plan will help you care for yourself, or loved ones who might have a heart attack.
How-to: Heart attack action plan
Work with your doctor to make your heart attack action plan (PDF) so you know what to do if you have heart attack symptoms.
Have aspirin in your home, or carry it with you. Ask your doctor if it’s safe for you to take aspirin in case of a heart attack. A 911 operator may tell you to chew and swallow an uncoated aspirin if you think you are having a heart attack and you are not allergic to aspirin or should not take it. Aspirin can help dissolve blood clots that can cause a heart attack. Some people should not take aspirin during a heart attack, so talk to your doctor now.
Ask your doctor about having nitroglycerin (nitro) available in case of emergency. Nitroglycerin widens the arteries, sending extra blood to the heart and buying you extra time to get the hospital during a heart attack. If your doctor has prescribed nitro and you have chest pain or discomfort, take one dose and wait five minutes. If the pain has not gone away, or if it gets worse, call 911 right away. You can take up to two more doses (one every five minutes) while waiting for the ambulance.
Share your action plan with loved ones and caregivers. A clear plan of action during a medical emergency can help everyone stay calm and focused.
Talk with your family and friends about your heart attack action plan, how to recognize the symptoms of heart attack, and why it is important to call 911 within five minutes of having symptoms. Tell them that you will be treated faster if they call 911 rather than driving you to the hospital themselves.
Have a paper copy of your heart attack action plan and other medical records where you can easily get to them. You should have copies at home and at work. If you regularly carry a bag or purse, that is a good place for an extra copy too. Having these written papers on hand can help doctors diagnose you faster and know which medicines are safe to give you. In an emergency, it might be difficult to access electronic health records or information on your cellphone if it is password protected.
You should have paper copies of:
- A list of all medicines you are taking, and any that you are allergic to (this should also be part of your heart attack action plan wallet card). This list should include over-the-counter medicines, prescription drugs, and any herbal or dietary supplements.
- A copy of your resting electrocardiogram (ECG). Call your cardiologist, primary care doctor, or the hospital where you had testing done and ask for a copy. This can help doctors better diagnose a heart attack and guide your treatment.
- The name and phone number of the person who needs to know if you go to the hospital.
When you should call 911
If you have heart attack symptoms for more than five minutes, call 911. Many women say they would only take action if their symptoms lasted for 30 minutes or more. Don't delay! If you wait too long, it may be too late to prevent permanent heart damage. When it comes to heart attack, "time is heart muscle." The quicker you get help, the more heart muscle you can save.
Heart attack treatments work best when given within one hour of when your symptoms started.1,2
- For every hour you delay going to the hospital after symptoms start, your risk of dying goes up by 20%.
- After six hours, your heart may have suffered permanent damage.
- Every 30 minutes you wait to get help could take one year off your life!
Don’t drive to the hospital. Call 911.
Calling 911 is the best and fastest way to get to the hospital when you’re having a heart attack. When you notice heart attack symptoms, call 911 right away (within five minutes at most). If you call 911, emergency medical personnel can begin life-saving treatment right away, even before you get to the hospital. Don't drive yourself or have someone else drive you.
If you, or someone else, drives to the hospital, you will waste time in the emergency waiting room. Arriving to the emergency room by ambulance usually means a doctor will see you right away.
What to do when you call 911
- Call from a landline or know your location address. While your cell phone always seems to know where you are, that may not be true for a 911 operator. A landline or corded telephone is always the best option to call 911 because emergency workers will know where you are. But if you have to call 911 from a cellphone, try to find the address of your location. If you don’t know the exact address, tell the 911 operator the closest intersection or highway exit and a description of the place where you are.
- Stay calm and try not to panic. Take long, deep breaths if you can. Speak slowly and clearly. The 911 operator will ask where you are, what is wrong, and what type of help you need. Say: "I think I am having a heart attack."
- Don’t hang up. Stay on the phone until help arrives or the 911 operator says you can hang up.
- Follow instructions from the 911 operator. After asking about other medicines you take, the 911 operator may tell you to chew and swallow an aspirin or take a nitroglycerin (nitro) pill if you have it. Aspirin and nitro to help with heart attack or chest pain are not right for everyone, so ask your doctor ahead of time if they are safe for you.
- Unlock the door. Have someone else unlock the door if you feel faint or dizzy. Lie down on the floor where emergency responders can see you as soon as they come in. Try to stay calm and take slow, deep breaths if you can.
What to do in the emergency room
Describe your symptoms in a clear, direct manner. Tell the doctor your symptoms and how long you’ve had them. Try to be quick and to the point, rather than telling a long story about how the symptoms started and what you think the cause might be.
Be specific. Describe how your symptoms feel, where in your body you feel them, and how serious they are.
Make it clear that these symptoms are not normal for you and that you think something is seriously wrong. Using the words "I have never felt this before" can help the doctor realize that something may be seriously wrong.
Don't give up. Keep describing your symptoms until you feel you are understood.
Listen carefully to any questions you are asked and answer them directly. But do not be afraid to take a few moments to organize your thoughts.
Be honest with yourself and your health care providers about pain. You may be asked to describe the pain you are feeling on a scale of zero to 10, with zero being no pain and 10 being the worst pain imaginable. Be honest and do not downplay your symptoms — now is not the time to "be tough." Sometimes women are more likely to describe the chest pain of a heart attack as “pressure” instead of “pain.” But if it feels like an elephant is sitting on your chest because of the pressure, know that many doctors and nurses think of this as “pain.”
Speak up. Don't be afraid to ask questions. If you have continued pain while you are in the hospital, make sure the doctor or nurse knows how you are feeling. Continued pain will be treated differently than pain that goes away.
What if I am not taken seriously?
Having heart attack symptoms is a stressful experience. The added pressures of having people, especially doctors, refuse to take you seriously can be almost too much to bear. But take heart: many women have faced the same challenge and were eventually able to receive the care they needed. Trust your instincts and be willing to fight for your health.
Be persistent. Never stop seeking care as long as you have a problem, even if the doctor says there is nothing wrong.
Be direct. Say "I think I'm having a heart attack." If you are told it is just nerves or indigestion, say "Have you checked to see if I've had a heart attack?"
Ask for more tests. Insist on having an ECG and blood tests before agreeing to go home. These tests are simple, fast, and very accurate at finding any heart problems. Even if your test results are normal, if you still have pain or discomfort, tell your doctor that you are still in pain.
Get a second opinion. If you feel the ER doctor is not taking you seriously, ask to see a clinical cardiologist (also called a noninvasive cardiologist), who specializes in heart attacks. Do not worry about offending anyone: your health is the most important thing.
- Rawles, J.M. (1997). Quantification of the benefit of earlier thrombolytic therapy: five-year results of the Grampian Region Early Anistreplase Trial (GREAT). Journal of the American College of Cardiology; 30(5): 1181-6.
- Avorn, J., Knight, E., Ganz, D.A., Schneeweiss, S. (2004). Therapeutic Delay and Reduced Functional Status Six Months After Thrombolysis for Acute Myocardial Infarction. American Journal of Cardiology; 94(4): 415-20.