How to Do First Aid for Chest Pain: 9 Step-by-Step Emergency Guide

If you need to know how to do first aid for chest pain, act quickly: stop activity, help the person rest, call emergency medical services, and monitor their breathing and responsiveness. New, sudden, severe, or unexplained chest pain can signal a heart attack or another life-threatening condition, so you should treat it as an emergency rather than trying to diagnose it at home- Mayo Clinic

Emergency warning: If chest pain is happening now and feels severe, tight, heavy, squeezing, or unexplained—or if it occurs with breathing difficulty, sweating, nausea, dizziness, fainting, or pain spreading to the arm, jaw, neck, back, or stomach—call your local emergency number immediately. In Kenya, you can try 999 or 112 for general emergency assistance, but use the emergency number that operates in your area.

Why Chest Pain Needs Urgent First Aid

Chest pain can result from several conditions, including a heart attack, angina, inflammation around the heart, lung disease, acid reflux, anxiety, or an injured chest muscle. Unfortunately, you often cannot identify the cause safely without medical assessment.

A heart attack happens when blood flow to part of the heart muscle becomes blocked. The affected heart muscle may become damaged or die if treatment does not restore blood flow quickly. Early emergency care can reduce damage and improve the person’s chance of survival.

The pain does not always feel dramatic. It may feel like pressure, fullness, squeezing, tightness, aching, burning, or indigestion. Some people experience mild discomfort rather than severe pain. Others may have symptoms without obvious chest pain, especially older adults, people with diabetes, and some women.

You should not wait to see whether the pain disappears. Chest pain that goes away and returns can still indicate a serious problem. The American Heart Association and American Red Cross recommend activating emergency medical services for adults with acute chest pain.

Recognize Emergency Chest Pain

Before providing first aid, look for signs that suggest a medical emergency. Call for immediate help if the person has any of the following:

• Chest pressure, tightness, heaviness, squeezing, burning, or unexplained discomfort.
• Pain lasting more than a few minutes or pain that disappears and returns.
• Pain spreading to one or both arms, the shoulder, back, neck, jaw, teeth, or upper abdomen.
• Shortness of breath, gasping, choking, or difficulty speaking normally.
• Cold sweating, pale or grey skin, nausea, or vomiting.
• Dizziness, light-headedness, unusual weakness, or a feeling of impending doom.
• Fainting, collapse, confusion, or reduced responsiveness.
• A rapid, irregular, or unusually weak heartbeat.
• Sudden severe pain in the upper back, neck, or abdomen.
• Chest pain combined with swelling in one leg or sudden breathing difficulty.

The NHS identifies persistent or unexplained chest pain, pain spreading to the arms, neck, jaw, stomach, or back, and chest pain accompanied by sweating, nausea, light-headedness, or shortness of breath as reasons to seek emergency help.

Do not assume that a sharp pain, burning sensation, or pain that changes with movement is harmless. Some serious conditions can produce unusual symptoms. If you cannot confidently explain new chest pain, treat it as potentially serious.

Step 1: Check Scene Safety

Before you approach, check whether the area is safe. Look for traffic, fire, electrical hazards, violence, chemical exposure, smoke, or anything else that could injure you.

Move the person only if the location presents immediate danger. Otherwise, leave them where they are and begin your assessment.

If you have disposable gloves, put them on. Gloves can reduce contact with blood or other body fluids, but you should not delay lifesaving care while searching for protective equipment.

Approach calmly from where the person can see you. Introduce yourself and explain that you want to help. If the person is conscious and able to make decisions, ask for permission before touching them. If the person is unconscious or unable to respond, emergency consent generally applies for lifesaving first aid.

Step 2: Stop Activity and Help the Person Rest

Tell the person to stop walking, exercising, working, or driving. Help them sit in a comfortable position with their back supported.

A comfortable sitting position often means sitting on the floor or in a chair with the back supported and knees bent. If breathing feels difficult, allow the person to sit upright or lean slightly forward. Do not force them to lie flat if sitting helps them breathe.

The 2024 first-aid guidelines advise allowing an alert person with breathing difficulty to assume the position most comfortable for breathing, which commonly means sitting up.

Loosen tight clothing around the neck, chest, and waist. Keep the person calm, but do not tell them that the pain is “only stress” or “just indigestion.” Reassure them with clear statements such as, “I am staying with you. Help is on the way.”

Do not let the person walk to a vehicle, climb stairs, or continue normal activities. Exertion can worsen the strain on the heart and may cause the person to collapse.

Step 3: Call Emergency Medical Services

Call emergency services as soon as you suspect a serious cause. Do not wait for the pain to become unbearable, and do not wait for medication to work before calling.

Tell the dispatcher:

• The person’s location and the best way to reach them.
• That the person has chest pain and may be having a heart attack.
• The person’s age, if known.
• Whether the person is conscious and breathing normally.
• When the pain started.
• The person’s major symptoms.
• Any known heart condition, diabetes, allergy, or prescribed medication.
• Whether you have started CPR or used an AED.

Put your phone on speaker so you can continue helping while following the dispatcher’s instructions. The AHA and Red Cross emphasize activating emergency services early and continuing first aid while waiting for trained rescuers.

If the person is alone, they should unlock the door if possible, sit near the entrance, and keep the phone nearby. They should not drive themselves unless no other emergency option exists. Driving can endanger the person and other road users, and the driver cannot provide care if the person loses consciousness.

Step 4: Ask Important Questions

While waiting for emergency responders, ask brief questions. Avoid overwhelming the person or delaying the emergency call.

Ask:

• When did the pain begin?
• Where exactly do you feel it?
• Does it spread anywhere?
• Does it feel like pressure, squeezing, burning, heaviness, or stabbing?
• Do you feel short of breath, sweaty, dizzy, or sick?
• Have you had heart problems or angina before?
• Do you have prescribed nitroglycerin or another emergency medicine?
• Do you have an aspirin allergy?
• Have you been told not to take aspirin?
• Are you taking blood thinners?
• Do you have a history of bleeding, ulcers, or another medical condition?

Record the answers and pass them to emergency responders. Do not interrogate the person if they struggle to speak or breathe. Your priorities remain emergency activation, rest, monitoring, and prompt escalation if their condition changes.

Step 5: Consider Aspirin Carefully

The 2024 AHA and American Red Cross first-aid guidelines state that an alert adult with non-traumatic acute chest pain may chew and swallow aspirin while waiting for emergency services, provided the person has no known aspirin allergy and has not been advised by a healthcare professional to avoid aspirin. The recommended range is 162–325 mg.

Some services specifically advise one 300 mg tablet. However, local emergency protocols and the person’s medical history matter. Ask the emergency dispatcher or healthcare professional for advice if you are uncertain.

Do not give aspirin if:

• The person has a known aspirin allergy.
• A healthcare professional has told them not to take aspirin.
• The person has active bleeding or a serious bleeding disorder.
• The person cannot safely chew or swallow.
• The person is unconscious, choking, or not responding normally.
• The person has chest pain caused by trauma and you do not know the full injury.
• You are unsure whether the medication is aspirin.

Never delay calling emergency services to find aspirin. Do not force a tablet into the mouth of someone who is drowsy or unable to swallow. That can cause choking or aspiration.

Do not substitute another painkiller, such as ibuprofen or diclofenac, for aspirin. These medicines do not provide the same emergency role and may create risks for some people.

Step 6: Help With Prescribed Nitroglycerin

If the person has prescribed nitroglycerin, glyceryl trinitrate, or GTN for angina, help them use it exactly as their healthcare professional instructed.

Do not give the person someone else’s nitroglycerin. Do not guess the dose, and do not advise the person to take extra doses beyond their prescription or the dispatcher’s instructions.

The person should remain seated while taking prescribed nitroglycerin because the medicine can lower blood pressure and cause dizziness or fainting. Continue monitoring them even if the pain improves.

Chest pain that does not settle with rest or prescribed medication still requires emergency assessment. Relief does not prove that the situation is harmless. Mayo Clinic specifically advises using nitroglycerin only when it has previously been prescribed for the person and warns against taking another person’s medication.

Step 7: Monitor Responsiveness and Breathing

Stay with the person until emergency responders arrive. Watch for changes in:

• Alertness.
• Breathing rate and effort.
• Skin colour.
• Ability to speak.
• Pain intensity.
• New sweating, vomiting, weakness, or confusion.
• Collapse or loss of responsiveness.

Ask simple questions such as, “Can you hear me?” and “Are you breathing comfortably?” Do not repeatedly move the person or make them stand.

If the person remains alert and breathing normally, allow them to stay in the position they find most comfortable. Keep them warm without overheating them. Do not give food, alcohol, coffee, or large amounts of water.

If the person vomits while conscious, help them lean forward or turn their head to the side so they do not inhale the vomit. Continue checking their breathing.

If the person becomes less responsive but continues breathing normally, place them in the recovery position if no injury prevents you from doing so. Continue watching their breathing closely because a person who becomes unresponsive may need CPR.

Step 8: Start CPR if the Person Collapses

Chest pain can progress to cardiac arrest, although a heart attack and cardiac arrest are different conditions. A heart attack involves blocked blood flow to the heart muscle. Cardiac arrest occurs when the heart stops pumping blood effectively, causing the person to become unresponsive and stop breathing normally.

If the person collapses:

1. Check whether the scene remains safe.
2. Tap their shoulders and shout, “Are you okay?”
3. Check for normal breathing for no more than 10 seconds.
4. If they do not respond and are not breathing normally, call emergency services or tell someone else to call.
5. Ask someone to bring an automated external defibrillator, or AED, if one is available.
6. Place the person on their back on a firm, flat surface.
7. Begin chest compressions immediately.

Do not mistake occasional gasping for normal breathing. Gasping can occur during cardiac arrest. If the person is unresponsive and only gasping, begin CPR.

How to Perform Hands-Only CPR

If you are not trained in full CPR, perform hands-only CPR:

1. Kneel beside the person.
2. Place the heel of one hand in the centre of the chest, on the lower half of the breastbone.
3. Place your other hand on top.
4. Interlock your fingers or keep them raised away from the ribs.
5. Position your shoulders directly above your hands.
6. Push hard and fast at a rate of about 100–120 compressions per minute.
7. Allow the chest to recoil fully after each compression.
8. Continue until the person shows signs of life, trained responders take over, you become too exhausted, or the scene becomes unsafe.

If you know full CPR and feel confident, use cycles of 30 chest compressions followed by two rescue breaths. Mayo Clinic recommends hands-only CPR for untrained rescuers and 30 compressions followed by two breaths for trained rescuers who can provide them.

Do not stop compressions repeatedly to check for a pulse if you are not trained to do so. Follow the dispatcher’s instructions.

Step 9: Use an AED as Soon as Possible

An AED can assess the heart rhythm and deliver a shock when appropriate. You do not need to diagnose the rhythm yourself.

To use an AED:

1. Turn on the device.
2. Follow its voice or visual instructions.
3. Expose and dry the person’s chest.
4. Attach the pads exactly as shown in the diagrams.
5. Make sure nobody touches the person while the AED analyses the rhythm.
6. If the AED instructs you to deliver a shock, loudly say, “Stand clear.”
7. Ensure nobody touches the person.
8. Press the shock button if the device tells you to do so.
9. Immediately resume chest compressions when instructed.

The AED will not deliver a shock unless its analysis identifies a rhythm that may respond to one. Continue following the device’s instructions until emergency responders arrive.

Do not remove the AED pads to inspect the person repeatedly. Do not pause CPR longer than necessary to follow the device’s instructions.

What You Should Not Do

Knowing what to avoid can prevent delays and complications. Do not:

• Ignore unexplained chest pain.
• Ask the person to walk around to “test” the pain.
• Let the person drive themselves if emergency transport is available.
• Leave the person alone.
• Give food, alcohol, or unnecessary medication.
• Give someone else’s nitroglycerin.
• Give aspirin to a person who cannot swallow safely.
• Give aspirin without considering allergy or medical advice.
• Assume young age rules out a heart emergency.
• Assume women cannot have a heart attack without severe chest pain.
• Rub or massage the chest.
• Apply heat to unexplained chest pain.
• Encourage deep breathing as a substitute for medical assessment.
• Wait for symptoms to become severe.
• Stop monitoring the person after the pain improves.
• Search for a diagnosis online instead of calling emergency services.

The most dangerous mistake involves treating the symptom as minor because it resembles indigestion, muscle pain, anxiety, or gas. Although those causes can produce chest discomfort, you cannot safely exclude a heart or lung emergency at home.

First Aid for Different Situations

If the person has known angina

A person with diagnosed stable angina may recognize a familiar pattern that occurs during exertion and improves with rest or prescribed medicine. Help them stop activity, sit down, and use their prescribed medication according to their care plan.

Call emergency services if the pain is new, more severe, occurs at rest, lasts longer than usual, returns repeatedly, or does not improve with rest or prescribed medication. Mayo Clinic notes that angina that does not resolve with rest or medicine requires emergency medical help.

Do not assume every episode is ordinary angina. A heart attack can resemble a previous angina episode but may last longer or respond differently.

If the person is pregnant

Treat serious chest pain during pregnancy as an emergency. Help the person sit in a comfortable position and call emergency services. Tell the dispatcher that the person is pregnant.

Do not give medication unless emergency professionals or the person’s healthcare professional advises it. Monitor breathing and responsiveness closely.

If the person has diabetes

People with diabetes may experience less typical heart attack symptoms. They may report fatigue, nausea, breathlessness, weakness, or unusual discomfort rather than intense chest pain.

If the person has unexplained symptoms, call emergency services. Do not assume that low blood sugar explains the symptoms unless the person is alert, able to swallow, and has a known plan for treating hypoglycemia.

If the person is elderly

Older adults may have mild, vague, or atypical symptoms. Confusion, weakness, breathlessness, faintness, or sudden fatigue may accompany or replace obvious chest pain.

Respond to the overall pattern rather than waiting for the person to describe classic crushing pain.

If the person is a child

Chest pain in children often has causes other than a heart attack, but severe or unexplained pain still requires prompt medical advice. Call emergency services if the child has difficulty breathing, collapses, becomes blue or grey, appears severely ill, or has chest pain after significant injury.

Use age-appropriate CPR procedures if the child becomes unresponsive and does not breathe normally. If you are unsure, follow the emergency dispatcher’s instructions.

If chest pain follows an injury

Chest pain after a fall, collision, stabbing, gunshot, or other trauma requires emergency assessment, especially if the person has difficulty breathing, coughing blood, severe tenderness, deformity, or an open chest wound.

Do not give aspirin automatically after trauma because bleeding may be present. Call emergency services and follow the dispatcher’s instructions. Do not remove an embedded object.

Chest Pain and Breathing Problems

Chest pain combined with sudden breathing difficulty can indicate a serious problem involving the heart, lungs, or blood vessels. Emergency symptoms include gasping, inability to speak full sentences, blue or grey lips, fainting, confusion, or rapid deterioration.

Help the person sit upright or assume a comfortable breathing position. Do not force them to lie down. Call emergency services and monitor them continuously.

Do not administer oxygen unless you have appropriate training, equipment, and local protocol. The 2024 AHA and Red Cross guidelines caution against inappropriate oxygen use and state that first-aid providers should consider pulse-oximeter limitations and avoid routine oxygen administration when oxygen saturation is above 92%.

How to Prepare Before an Emergency

You can improve your response by preparing in advance:

• Learn CPR and AED use through an accredited first-aid course.
• Save local emergency numbers in your phone.
• Keep a charged phone accessible.
• Learn the location of AEDs at work, school, places of worship, gyms, and community buildings.
• Keep a current list of prescribed medicines and allergies.
• Know whether household members have angina, heart disease, diabetes, asthma, or severe allergies.
• Discuss who will call emergency services and who will meet responders.
• Keep emergency access routes clear.
• Learn how to describe your exact location, including landmarks and building access details.

First-aid training helps you recognize emergencies, activate help, provide immediate care, and understand your limits. The 2024 guidelines emphasize that first aid begins with recognizing the need for help and continues until trained responders arrive or the person reaches definitive medical care.

Common Questions

Should you lie down when you have chest pain?

Not necessarily. Sit or rest in the position that feels most comfortable, usually with your back supported. If breathing is difficult, sitting upright may help. Do not force the person to lie flat.

Should you massage the chest?

No. Massage does not treat the underlying cause of unexplained chest pain and may delay emergency care.

Should you drink water for chest pain?

Do not rely on water, tea, or home remedies. A conscious person who can swallow may take prescribed medication or aspirin only when appropriate, but emergency assessment remains the priority.

Can anxiety cause chest pain?

Yes, anxiety can cause chest discomfort, rapid breathing, palpitations, and a sense of fear. However, you should not diagnose anxiety before excluding a serious medical cause, particularly when symptoms are new, severe, or accompanied by breathlessness, sweating, faintness, or pain spreading to other areas.

What if the pain stops?

Call for medical advice or emergency help if the pain was new, unexplained, severe, or accompanied by other warning signs. Symptoms that stop and return can still indicate a heart problem.

What if the person refuses help?

If the person is alert and capable of making decisions, explain the risks calmly and encourage them to call emergency services. If they become confused, unconscious, or unable to make decisions, call emergency services and follow the dispatcher’s instructions.

Can you drive someone with chest pain to hospital?

An ambulance is safer because emergency professionals can begin assessment and treatment during transport. If an ambulance cannot reach the person, have another responsible adult drive while someone monitors the person. The person with chest pain should not drive themselves unless no other option exists.

Final Emergency Checklist

When you need to provide first aid for chest pain, remember this sequence:

1. Check that the scene is safe.
2. Stop the person’s activity.
3. Help them sit and rest comfortably.
4. Call emergency medical services immediately.
5. Describe the symptoms and time of onset.
6. Consider aspirin only for an alert adult who can swallow, has no aspirin allergy, and has not been told to avoid it.
7. Help with prescribed nitroglycerin only as directed.
8. Loosen tight clothing and keep the person comfortable.
9. Stay with them and monitor breathing and responsiveness.
10. Start CPR if they become unresponsive and are not breathing normally.
11. Use an AED if one is available.
12. Continue care until trained responders take over.

Chest pain can have a minor cause, but you cannot safely determine that during an emergency. Treat sudden or unexplained chest pain seriously, call for professional help early, and use only the first-aid steps that match the person’s condition and your level of training.

This research provides general first-aid information and does not replace emergency medical care, professional first-aid training, or advice from a qualified healthcare professional.

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