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Nursing Manual: Signs of Heart Attacks, Cardiac Arrests, and Strokes

Heart Attack

Each year, approximately 1.2 million people in the United States have heart attacks. Nearly half of people who have heart attacks die within an hour of the first symptoms; therefore, it is important to take immediate action if someone experiences the symptoms of a heart attack. A heart attack occurs when the flow of oxygen-rich blood fails to distribute or reach properly to a section of heart muscle. If blood flow to this area is not restored quickly, the section of heart muscle begins to die. Heart attacks commonly occur as a result of coronary heart disease (CHD), which is also known as coronary artery disease. CHD is characterized by the build-up of plaque inside the coronary arteries which supply oxygen-rich blood to the heart. Eventually, an area of plaque may rupture inside of an artery, which results in the formation of a blood clot on the plaque’s surface. Many of these clots became significantly large in size and, in turn, block blood flow through a coronary artery. If treatment is not sought, the portion of heart muscle fueled by the artery begins to die.


  • Pain or discomfort located in the chest which is experienced for a few minutes at time, ceases, and then returns. This type of discomfort may include an extreme pressure, a sense of feeling of squeezing, or pain located in the center or left side of the chest which may range from mildly to extremely uncomfortable.
  • Pain or discomfort in one or both the arms, back, neck, jaw, or upper area of the stomach.
  • Shortness or gasping for breath, which can occur before or during chest discomfort.
  • Nausea, vomiting, sudden bouts of dizziness, or breaking out into a cold sweat.

Steps to Take
If someone experiences these symptoms, it is important to take action immediately. Call 9-1-1 in order for an ambulance to be dispatched and medical personnel to begin providing life-saving assistance.  If a doctor has prescribed a nitroglycerin pill, make sure to take it if experiencing heart attack symptoms.


Stroke is the third leading cause of death among in United States. Those with high blood pressure, significant weight problems, and addictions such as smoking run a higher risk of experiencing a stroke. Each year, nearly 795,000 people suffer from a stroke in the United States. More than 140,000 people die each year from stroke in the United States. A stroke occurs when a blood clot blocks an artery, which is an important blood vessel responsible for transporting blood from the heart to the body. One may also experience a stroke when the tube through which blood moves throughout the body breaks. If a tube is severed or broken, the blood flow to an area of the brain is interrupted. If blood is not transported properly to all areas of the brain, brain cells begin to die and brain damage occurs.

Although stroke is considered a disease of the brain, stroke affects the entire body. A stroke may result in paralysis, difficulties in cognitive processing, problems with speaking, and emotional problems. In addition, those suffering from stroke may experience numbness in one or both sides of the body.


  • Suddenly feeling numb or weak in the face, arm, or leg, typically on only one side of the body.
  • Sudden and extreme confusion, processing difficulty or understanding speech
  • Difficulty seeing in one or both eyes
  • Difficulty walking, loss of balance and coordination
  • Extreme and sudden dizziness
  • Sudden and severe headache with no known cause

It is important to recognize the symptoms of a stroke. May times those suffering from stroke do not link the symptoms to the signs of a stroke, as the stroke first affects the brain. Stroke victims have the best chance of survival when someone around them recognizes the symptoms and acts quickly.

Steps to Take
If someone is suffering from the symptoms of a stroke, call 9-1-1 immediately. As weith a heart attack, every second and minute count. The longer blood flow is cut off to the brain, the greater the damage to the brain and body. The most common kind of stroke, ischemic stroke, is treated with a drug that dissolves or breaks up the clots blocking the blood flow. Those suffering from stroke typically have a three hour window opportunity to receive treatment before severe damage occurs; however, it best for them to be at the hospital and evaluated within 60 minutes of the onset of symptoms.

Cardiac Arrest

According to the American Heart Association, less than eight percent of people who suffer cardiac arrest outside the hospital survive. Approximately 383,000 out-of-hospital sudden cardiac arrests occur annually. Four out of five cardiac arrests occur at home. Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly ceases beating. Once the heart stops beating, blood cannot flow to the brain and other vital organs. SCA is different from a heart attack. During a heart attack, the heart does not stop beating. Those with heart disease have a higher risk of suffering from SCA; however, SCA is known to happen in individuals who appear healthy, with no known heart disease or related health conditions which would increase their chances of SCA. Most people who have SCA die from it, often within in minutes.


  • Sudden loss of responsiveness
  • No response to tapping on shoulders
  • No response to verbal communication such as asking if the person is okay nothing
  • Lack of normal breathing or lack of breathing altogether, even when the head is tilted up

If signs for cardiac arrest are present, dial 9-1-1 for emergency medical services immediately. If an automated external defibrillator (AED) is available, retrieve it and began the use process of its correct. Begin CPR immediately and continue until emergency medical personnel arrive.

Additional Resources
Cardiac Glossary provides a detailed glossary of terms and definitions related to the heart.
What are the Warning Signs of a Heart Attack? contains detailed symptoms of a heart attack.
Heart360 is a health data tracker which enables users to access additional information and resources on how to be heart healthy.
National Stroke Association provides a variety of educational resources, statistics, and facts on stroke.
Interactive Atlas of Heart Disease and Stroke provides a visual which allows users to view county-level maps of heart disease and stroke.
Prevention Works: CEC Strategies for a Heart Healthy and a Stroke Free America  contains a comprehensive guide to the implementation of effective strategies for optimal health.