Heart disease is the leading cause of death in America today.

Heart attacks may cause immediate cardiac arrest (cease in heartbeat) or may progress to cardiac arrest. However, not every heart attack causes cardiac arrest.

Many heart attack victims die before they reach a hospital. The average person waits 3 hours before seeking help for symptoms of a heart attack. The sooner someone gets to the emergency room, the better his or her chance of not only surviving, but also of minimizing heart damage following the attack.

In adults, causes of heart attack include clot formation or spasm in one of the arteries that supply blood to the heart muscle. These and other similar conditions block the supply of blood and oxygen to an area of the heart, leading to damage or death of the cells in that area. Most often, this occurs in an artery that has been narrowed from changes related to hardening of the arteries (atherosclerosis).

Other causes for cardiac arrest may include drowning, suffocation, electrical shock, severe allergic reaction (anaphylaxis), drug overdose, and trauma.

Babies and children rarely suffer heart attacks. Atherosclerotic heart disease is extremely rare in infants and children. The primary cause for cardiac arrest in children is a preceeding respiratory arrest (cessation of breathing). This may occur for a number of reasons including drowning, suffocation, electrical shock, illness, poisoning, and inhaling or swallowing a foreign object (foreign body aspiration).

In adults:

• chest pain behind the breastbone
  • pain may radiate to the:
    • neck, teeth, or jaw
    • arms, shoulder, or back
    • abdomen
• pain is similar to angina, but not relieved by rest or nitroglycerin
• pain that may be described as:
  • squeezing, aching, tightness, or pressure
  • a tight band on the chest
  • "an elephant sitting on my chest"
  • "bad indigestion" or heartburn
  • pain may be intense or subtle; however, the victim may not have any pain at all
• shortness of breath that occurs suddenly
  • may or may not be accompanied by pain
• sweating, may be profuse
• nausea or vomiting
• light-headedness, dizziness, or fainting
• feeling of "impending doom"

Note: Heart attacks may be associated with a wide range of symptoms, from subtle to intense. Women and elderly persons are more likely to experience subtle or atypical symptoms. The victim often denies that he or she may be having a heart attack.

In babies and children:

• victim is limp and unresponsive
• skin may be bluish in color

1. Have the victim sit down and rest, and attempt to keep calm.
2. Loosen any tight clothing.
3. If the victim has a known heart condition, ask if he/she takes a chest pain medication.
4. Assist the victim in taking the medication (usually nitroglycerin, which is placed under the tongue).
5. If the pain does not subside promptly with rest or within 3 minutes of taking nitroglycerin, call for emergency medical assistance.
6. If an adult victim is unconscious and unresponsive, call 911 (or your local emergency number), then begin CPR.
7. If an infant or child is unconscious and unresponsive, perform 1 minute of CPR, then call 911.

• DO NOT leave the victim alone except to call for help, if necessary.
• DO NOT allow the victim to deny the symptoms and convince you not to call for emergency medical assistance.
• DO NOT wait to see if the symptoms go away.
• DO NOT give the victim anything by mouth unless he/she has a prescribed heart medication (such as nitroglycerin).

• If sudden chest pain or other symptoms suggestive of heart attack occur.
• If an adult is unresponsive or appears to not be breathing.
• After performing 1 minute of CPR on a baby or child or immediately if you do not know CPR.

Adults should take steps to control heart disease risk factors whenever possible. If you smoke, quit. Smoking more than doubles the chance of developing heart disease. Keep blood pressure and diabetes in good control and comply with your doctor's prescription orders.

Follow your total cholesterol levels and modify your diet if necessary. Lose weight if obese, and follow a regular exercise program to improve cardiovascular fitness. (Consult your health care provider before starting any new fitness program.)

Limit your alcohol intake. One drink a day is associated with reducing the rate of heart attacks, but consuming two or more drinks a day can damage the heart and cause other medical problems.

Teach safety to young children and create a safe environment for them to prevent accidents that may lead to cardiac arrest.