Recognizing a cardiac emergency. What should you do?

February 27, 2023 Swedish Heart & Vascular Team


In this article:

  • Cardiovascular disease is the leading cause of death in the United States, accounting for nearly one million deaths a year, according to the American Heart Association.

  • American Heart Month in February is an annual event dedicated to raising awareness about the prevention, diagnosis and treatment of cardiovascular disease.

  • A cardiologist from the Swedish Heart and Vascular Institute explains how to recognize and react if someone you’re with is having a cardiac event.

Imagine that you’re out to dinner with a loved one or friend. They seem a little “off,” with shortness of breath, heartburn and a heavy feeling in their chest. Is it a cardiac event or just a sign that their meal was too spicy? Knowing the answer could be the difference between life and death.

Cardiovascular disease is the leading cause of death in the United States, accounting for nearly one million deaths a year, according to the American Heart Association. Do you know the warning signs if someone else is having a cardiac event, such as cardiac arrest or a heart attack? And if so, do you know what to do next?

February is American Heart Month – an annual tradition dedicated to raising awareness about heart health and the prevention and treatment of heart disease. John Chen, M.D., a cardiologist at the Swedish Heart & Vascular Institute, explains how to recognize if someone is in cardiac distress and what to do if it happens.

Heart attack vs. sudden cardiac arrest

Although the terms are often used interchangeably, a heart attack and cardiac arrest are not the same.

  • Cardiac arrest occurs when your heart stops beating unexpectedly.
  • A heart attack occurs when a blocked artery creates a circulation problem and prevents oxygen-rich blood from reaching your heart.

Cardiac arrest is a medical emergency with immediate, severe symptoms that occur without warning. A heart attack often results from an evolving process that happens over time as a blockage forms. It may cause cardiac arrest but that is not always the case.

Signs of cardiac arrest

A person may be in cardiac arrest if they:

  • Lose consciousness suddenly.
  • Quit breathing or begin gasping for air.
  • Do not respond when shouted at or shaken.
  • Do not have a pulse.

Signs of heart attack

“When we describe the textbook symptoms of a heart attack, we typically start with chest pain. But it’s really chest pressure or heaviness,” says Dr. Chen. “It’s not always a sharp pain. It’s more a feeling of pressure and heaviness in the center of the chest that doesn’t go away.”

Someone having a heart attack may experience:

  • A squeezing or aching feeling in the center of the chest.
  • Pain that spreads to the arm, back, shoulder, jaw, neck, teeth or upper abdomen.
  • Indigestion, heartburn and nausea.
  • Difficulty breathing and shortness of breath.
  • Dizziness, lightheadedness or loss of consciousness.
  • Profuse sweating.

Immediate action saves lives

Get help immediately if a friend or loved one shows signs of a heart attack. The faster someone gets care, the better their chance of a successful outcome, according to Dr. Chen.

“I would always err on the side of caution and go to the hospital if someone is showing signs of heart attack,” advises Dr. Chen. “If it is a heart attack, time is of the essence. Some heart attacks damage the heart muscle if they’re not treated properly. If you or someone you know has any new symptoms of chest pressure or heaviness that don’t resolve right away, go get checked out.”

If someone you’re with is having a cardiac event, taking immediate action could help save their life, says Dr. Chen.

“If someone has fainted or is unresponsive, you should first confirm that they aren’t waking up. The next step is to check for a pulse,” affirms Dr. Chen. “If they don't have a pulse, they are in cardiac arrest.”

“The two biggest factors in increasing survival for cardiac arrest are high quality, early CPR without interruption and an early defibrillator option if it’s available,” he explains.

Automated external defibrillation

An automated external defibrillation (AED) is a device that checks a person’s heart rhythm and administers an electric shock to regulate or restart their heartbeat if needed. Although it’s always nice to have formal training before using an AED, the small, portable devices are designed to be user-friendly even if you don’t know how they work, according to Dr. Chen.

Electrodes with adhesive on the back are placed on the chest. A built-in computer checks the heart’s rhythm and determines if defibrillation is needed. A recorded voice prompts you to push the shock button and walks you through the process.

“If someone is in an abnormal heart rhythm, treating it right away with a defibrillator is very effective at increasing their chance of survival,” he explains.

Starting CPR

“It’s crucial to start CPR immediately after calling 911 if the person you’re with suddenly becomes unresponsive,” says Dr. Chen. The time between when the cardiac event is first recognized and the paramedics arrive is crucial. Someone could be getting CPR. If that does not happen, it’s really a lost opportunity.”

Recently, people across the country watched CPR in action during Monday Night Football when Buffalo Bills safety Damar Hamlin went into cardiac arrest during a game. The experience prompted Hamlin to partner with the American Heart Association to promote CPR training.

“We encourage everyone to get CPR training even if they don’t get certified. The American Heart Association has several resources that can help you get familiar with the basics,” says Dr. Chen. “It’s not rocket science. CPR is pretty simple. But it can have tremendous results."

“When someone gets CPR in the field before paramedics arrive, they typically have better outcomes and a greater chance of surviving cardiac arrest,” adds Dr. Chen. “Even if you’re not formally trained, you should do CPR if you’re the only person there. Some CPR is better than no CPR.”


Learn more and find a provider

Are you at risk for cardiovascular disease? Contact the experts at the Swedish Heart & Vascular Institute at 206-320-4100 to learn more about the cardiac care we offer that can make a lasting difference in your life. You can also visit the Swedish website to learn more about health and safety classes offered at Swedish.

Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction, and follow up as needed. If you need to find a provider, you can use our provider directory.

Join our Patient and Family Advisory Council.

Related resources

Heart Month raises awareness, promotes prevention to save lives

Experts recommend changes to low-dose aspirin protocol. What do you need to know?

Meditation, mindfulness and music for heart health

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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About the Author

The Swedish Heart & Vascular Team is committed to bringing you many years of expertise and experience to help you understand how to prevent, treat and recover from cardiovascular diseases and conditions. From tips to eating better to exercise and everything in between, our clinical experts know how to help you help your heart.

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