 I am Dr. Pradeep Harnali, Senior Constituent Cardiologist, Manipal Hospital, Whitefield. Heart attack is a commonly used term by people in various contexts, but it actually means acute myocardial infarction, which means sudden stoppage of blood flow to a segment of heart muscle. Heart attack is a life-threatening medical emergency wherein we have to act fast. The symptoms can be sudden onset, severe excruciating chest pain with tightness around the chest, with profuse sweating, symptoms of nausea, vomiting, and some people may refer these symptoms to indigestion. In some people, sudden cardiac arrest may also be a presenting symptom of heart attack wherein the person's heart stops beating suddenly and they go unconscious. It is a situation where we have to act within seconds. The very first step to be done when we have these symptoms is to call for help. Alert a family member or a colleague who can help you in this situation and then call for ambulance. It is very important because you cannot predict how these symptoms may evolve with the time. It is advisable to chew a tablet of aspirin if it is available. If it is not available, you should not run around to find a tablet of aspirin. You can also take a tablet of nitroglycerin below your tongue. But again, these measures should not bring any delay in you reaching the hospital or reaching an ambulance where you are in a safe zone, where there is accessibility to emergency measures like automated external defibrillator. This is the most important treatment which is needed when the heart stops beating suddenly and the person goes unconscious. Yes, it is advisable to take a tablet of aspirin or nitroglycerin but it should not delay or it is not a substitute for you to rush to the hospital. And it is all the more important to be seated or take rest when you take a tablet of nitroglycerin because taking nitroglycerin tablets back to back in a short time can make you feel dizzy or at times faint as well. When you reach an emergency with a heart attack, your doctor takes an ECG and does blood test and also may do an echocardiogram to arrive at the diagnosis. Once the diagnosis is arrived, depending on the type of hospital you are into, they may alert the cath lab team if the hospital is capable of performing a primary angioplasty, that is a process of immediately restoring the blood flow to the affected segment of heart muscle. If the hospital is not capable of performing an immediate primary coronary angioplasty, they may decide to use an injection in order to restore the blood flow to the affected segment or they may decide to shift you to another hospital where a primary coronary angioplasty can be performed, provided the travel time is short as 30 minutes and again all this depends on the patient's condition. Once a coronary angiogram is performed, your doctor may decide to proceed with primary coronary angioplasty to restore the blood flow to the affected segment or there might be a situation where they may consider doing an emergency bypass surgery. The other treatment options which may be required in treating a heart attack could be temporary pacemaker insertion and in extreme situations it could be a heart transplant as well.