•  The most common cause is one or more blood clots that block an artery in the heart. Often, a blood clot forms in an artery already narrowed by plaque.

•  Having a heart attack in the past increases the risk for another one.

•  Spasms occur in the large coronary artery. This can be triggered by: Heavy physical exertion, such as shoveling snow; exposure to cold; severe emotional stress; and having a heavy meal. These triggers are more likely to affect persons who are not active.

•  Cocaine or amphetamine abuse can cause a sudden heart attack. This can happen in persons with no signs of heart disease.

•  Feeling of pain (may spread to or be felt in the arm, neck, tooth, jaw, or back), tightness, burning, squeezing, or heaviness in the chest. This lasts more than a few minutes or goes away and comes back.

•  Chest discomfort with:

•  Unusual chest, abdominal, or stomach pain.

•  Dizziness; nausea; trouble breathing; jaw or arm pain without chest pain.

•  Fast or uneven heartbeat or pulse.

•  Sweating for no reason, pale, gray, or clammy skin.

•  Medicine(s) to keep blood from clotting.

•  “Clot busters” to dissolve blood clots in heart arteries.

•  Tests to diagnose the status of the heart and arteries.

•  Angioplasty, stents, or bypass surgery, if needed.

•  Follow prevention measures in Heart Disease.

•  Take medications, as prescribed.

•  Don’t shovel snow or carry heavy objects, especially if you are not physically fit.

•  Don’t use amphetamines and/or cocaine.

•  CHECK for a response. Do CPR, as needed.

•  If the person uses and has nitroglycerin, place one tablet under the tongue. Give as many as 3 tablets in 10 minutes.

•  Give the person a regular (325 mg.) aspirin or 4 children’s chewable aspirins (81 mg. each) to chew on. Give the aspirin after calling 9-1-1. Ask the 9-1-1 dispatcher if aspirin should be taken.

•  If you can’t call 9-1-1, drive the person to the hospital right away. If you are having heart attack signs, don’t drive yourself unless you have no other choice.

•  Loosen clothing around the neck, chest, and waist. Don’t let the person lie down, especially if he or she has breathing problems. A half-sitting position is better. Put the legs up. Bend them at the knees. Put a pillow or rolled towel under the knees. Support the back.

•  Reassure the person that you have called for medical help and will stay with him or her until it arrives.

•  After a heart attack, follow the doctor’s treatment plan.