Jerusalem Post

ByDR. ITAY GAL

A heart attack is often silent, deceptive, and feels like indigestion. Dr. Itay Gal explains how to distinguish between anxiety and a cardiac event – and how one pill can save a life in seconds.

Myocardial infarction (heart attack) occurs when one of the arteries supplying the heart is blocked by a blood clot, and the part of the heart that does not receive blood begins to die. This is a race against time: The faster we open the blockage in the catheterization lab, the smaller the damage to the heart will be. The stage in which the patient is still conscious, speaking and in pain is the critical stage for preventing cardiac arrest and resuscitation. In 2026, smartwatches can alert to arrhythmias, but they still do not know how to detect a mechanical heart attack – that is something you need to do.
How does it feel? (The classic signs)
Pressing pain: A sensation of "an elephant sitting on the chest", pressure, tightness or a burning feeling in the center of the chest.
Radiation: The pain often radiates to the left arm, shoulders, neck, lower jaw or back.
Accompanying signs: Cold sweat (literally dripping), shortness of breath, nausea, paleness and fear of death.
In women, the elderly and people with diabetes, the signs may be more subtle ("silent attack"). They may complain only of sudden extreme fatigue, shortness of breath, upper abdominal pain (like heartburn) or dizziness. In such a suspicion – do not take risks.

Home treatment protocol
Dial 101 immediately: Put it on speaker. Do not transport the patient in a private car! In an ambulance there is resuscitation equipment and a defibrillator in case of deterioration on the way, and a team that can transmit an ECG directly to the hospital.
Absolute rest: Seat the patient in a comfortable chair or armchair. They must not walk, and certainly not go down stairs to the ambulance. Any effort requires more oxygen from the heart – and it does not have it.
Aspirin saves lives: If the patient is fully conscious, not allergic to aspirin and does not have active bleeding (ulcer/injury) – give them to chew a 300 mg aspirin tablet (or 3–4 "Micropirin" tablets of 100/75 mg). Chewing accelerates absorption into the blood. Aspirin prevents platelets from sticking together and slows the growth of the clot that blocks the artery.
Calming: Try to calm the patient. Psychological stress increases heart rate and blood pressure, which burden the heart.
Heart attack or anxiety attack?

This is the big question, because the symptoms are very similar (palpitations, shortness of breath, chest pressure). The rule: If you are not doctors, do not try to distinguish. Treat every case as a heart attack. It is better to call an ambulance for nothing for an anxiety attack than to miss a heart attack that ends in death.