A heart attack is a medical emergency that occurs when a coronary artery is suddenly blocked, often due to plaque buildup. In Singapore, heart attacks are a leading cause of hospital admissions, and recognising the warning signs early can save lives. A blocked artery may severely damage the heart muscle, raising the risk of heart failure if not treated promptly.
Ischaemic heart disease is consistently a top cause of mortality. In 2022, they were the second leading cause of death in Singapore, responsible for 22.8% of all deaths. According to the Singapore Heart Foundation, 21 people die from cardiovascular diseases (heart disease and stroke) every day. Alarmingly, heart attacks are affecting younger people more frequently. The National Heart Centre Singapore (NHCS) has noted that approximately one in five heart attack patients is now under the age of 50.
Knowing how to respond in such a situation can significantly increase the chances of survival and reduce long-term damage to the heart and blood vessels. This guide will walk you through the crucial steps to take when a heart attack occurs, helping to prevent future heart attacks and protect overall heart health.
Understanding a Heart Attack
What is a Heart Attack?
A heart attack, also known as a myocardial infarction, happens when blood flow to the heart is suddenly restricted due to a blockage in the coronary arteries. This often results from a buildup of plaque, which can rupture and cause a blood clot to form, cutting off oxygen to the heart muscle. Without oxygen-rich blood, part of the heart muscle dies, leading to severe complications or cardiac arrest if not treated urgently.
Recognising the Symptoms of a Heart Attack
Identifying the symptoms of a heart attack quickly is essential to improve survival rates. Common signs of a heart attack include:
- Chest pain or discomfort – a pressing, squeezing, or burning uncomfortable sensation in the chest area.
- Pain radiating to other parts of the body – such as the arms, neck, jaw, back, or stomach.
- Shortness of breath – difficulty breathing even when at rest.
- Nausea or vomiting – more commonly experienced by women and older adults.
- Dizziness or light-headedness – which may lead to fainting.
- Cold sweats – inexplicable excessive sweating without physical exertion.
Not all heart attack symptoms are severe, and some people may only experience mild symptoms.
However, delaying treatment worsens outcomes, including death, heart failure, or stroke. If you notice any of these signs or symptoms of a heart attack, act immediately. See your cardiologist.
See your cardiologist in Singapore.
Immediate Steps to Take During a Heart Attack
Call Emergency Services
Dial 995 (or your local emergency number) at the first sign or symptom of a heart attack. Do not attempt to drive to the hospital, as heart attack patients may lose consciousness en route. Prompt on-site medical attention from emergency medical services may help support blood flow to the heart and reduce the risk of further damage.
Help the Person Stay Calm and Still
Encourage the person to sit down and remain as still as possible, preferably in a semi-reclined position. This reduces strain on the heart and slows the progression of damage to the heart muscle.
Give Aspirin (If Safe to Do So)
Aspirin may help prevent further clot formation, but should only be taken if advised by a doctor or emergency personnel. If the person is conscious, not allergic to aspirin or NSAIDs, and has no history of stomach ulcers, offer a 300mg aspirin tablet to chew on while waiting for medical help.
The key instruction is to have them chew the tablet slowly, rather than swallowing it whole. Chewing allows the medication to be absorbed much more quickly into the bloodstream through the lining of the mouth, helping to inhibit the clot’s growth faster.
However, this step is only safe if certain conditions are met. Do NOT give aspirin if the person:
⦁ Is unconscious.
⦁ Has a known allergy to aspirin or other NSAIDs (like ibuprofen).
⦁ Has been specifically advised by their doctor not to take it.
⦁ Has a history of bleeding disorders or is experiencing active bleeding (e.g., from a stomach ulcer).
Always prioritise calling 995. If you are unsure whether giving aspirin is safe, follow the dispatcher’s instructions.
Administer Prescribed Medication
If the individual has been prescribed nitroglycerin, assist them in taking it as directed. This medication helps dilate blood vessels, improving blood flow to the heart and relieving chest pain.
What Not To Do During a Heart Attack in Singapore
Do Not Delay Calling 995
Do Not Drive to the Hospital
It may seem faster to drive yourself or the person having symptoms to the nearest hospital, but this is extremely risky. A person experiencing a heart attack could lose consciousness, go into cardiac arrest, or have their symptoms worsen suddenly, potentially causing a serious traffic accident. In contrast, an ambulance is a mobile medical unit. Paramedics can begin life-saving treatment, such as administering oxygen and monitoring vital signs, the moment they arrive. They are also trained to handle emergencies and can transport the patient to the most appropriate medical facility for urgent cardiac care.
Do Not Ignore or Downplay Symptoms
Do Not Leave the Person Alone
If the Person Becomes Unresponsive
Start CPR Immediately
If the person collapses and is not breathing normally, perform Cardiopulmonary Resuscitation (CPR) immediately:
- Lay them flat on a hard surface.
- Place your hands in the centre of their chest, one on top of the other.
- Push down firmly at a rate of 100 to 120 compressions per minute (follow the rhythm of Stayin’ Alive by the Bee Gees).
- Continue CPR until emergency medical personnel take over.
Use an Automated External Defibrillator (AED)
AEDs, available in many public spaces like shopping malls and transport hubs, can help restore a normal heart rhythm. If one is accessible, follow the automated voice instructions carefully to deliver a controlled shock if needed.
Preventing a Heart Attack
Lifestyle Changes for Better Heart Health
- Eat a heart-healthy diet – include fresh fruits, vegetables, whole grains, and lean proteins while reducing LDL cholesterol, salt, and unhealthy fats, eg trans-fat, processed foods. Model your meals after Singapore’s Health Promotion Board (HPB) “My Healthy Plate.” Fill half your plate with fruits and vegetables, a quarter with whole grains like brown rice, and a quarter with lean proteins like fish or tofu. Actively reduce salt, saturated fats, and trans-fats from processed foods to manage cholesterol and blood pressure.
- Exercise regularly – 150 to 300 minutes of moderate activity per week to maintain cardiovascular health. Aim for at least 150 minutes of moderate-intensity activity like brisk walking, cycling, or swimming per week. Breaking this into 30-minute sessions on most days is effective. If you have a history of heart issues, always consult your doctor to create a safe exercise plan.
- Quit smoking – tobacco use increases the risk of heart disease and stroke. The chemicals in tobacco damage arteries, accelerate plaque buildup, and increase clot risk. Quitting is the single most effective lifestyle change for protecting your heart. Numerous smoking cessation programs across Singapore can provide support.
- Limit alcohol intake – excessive alcohol consumption raises blood pressure and cardiac stress. Excessive alcohol raises blood pressure and can damage the heart muscle. Follow health guidelines: no more than two standard drinks a day for men and one for women. A standard drink equals one can of beer (330ml) or a small glass of wine (100ml).
- Manage stress – practice meditation, prayer, deep breathing, or yoga to reduce heart stress. Chronic stress contributes to high blood pressure and unhealthy habits. Integrate daily stress-reduction techniques like mindfulness, deep breathing, yoga, or engaging in relaxing hobbies to protect your cardiovascular health.
Regular Health Screenings
Routine check-ups help detect heart disease and stroke risk factors early. It is essential to monitor:
- Blood pressure – hypertension is a significant risk factor for heart attacks.
- Cholesterol levels – high LDL cholesterol increases plaque buildup in arteries.
- Blood sugar levels – individuals with diabetes are at a higher risk of developing cardiovascular disease.
Receive Heart Care at Gerard Leong Cardiology Clinic
Recognising the symptoms of a heart attack and acting quickly can mean the difference between life and death. First responder assistance- Calling for medical help, administering first aid, and performing CPR promptly- can improve the chances of survival.
At Gerard Leong Cardiology Clinic, we provide treatment and care for individuals at risk of heart disease and those recovering from a heart attack. Our team specialises in personalised treatment plans, comprehensive cardiovascular assessment, and preventive care to help reduce the risk of another heart attack and improve heart health.
By staying informed and making heart-healthy lifestyle choices, you can protect yourself and your loved ones from cardiovascular disease. Take action today to support better heart health.
Meet Our Cardiologist
Dr. Gerard Leong
Senior Consultant Cardiologist & Interventional Cardiology Specialist
MBBS (Singapore), MRCP (UK), FRCP (Edinburgh), FAMS (Cardiology), Diplomate ASCeXAM (National Council of Echocardiography, USA), FACC (USA)
Dr. Gerard Leong delivers compassionate, tailored care built upon a foundation of more than 15 years of world-class international training. He honed his expertise in advanced heart failure at a Harvard Medical School affiliate and in interventional cardiology in Melbourne, Australia. His US Board Certification in Echocardiography further guarantees diagnostic excellence, which empowers him to manage complex conditions such as ischemic heart disease with precision. By prioritising trust, clarity, and holistic support, Dr. Leong ensures you are an active partner in your journey to long-term heart health.
He is dedicated to a patient-centric approach, ensuring that each patient receives a clear understanding of their condition and a personalised, evidence-based treatment plan for optimal heart health.