Chest pressure, tightness, or heaviness lasting more than 15 minutes without relief — call 120; do not drive yourself

Cost: No cost at all.
In plain terms: If you feel chest pressure, tightness, or heaviness that lasts over 15 minutes without easing up, call 120 right away. For patients treated within 55 minutes of arrival at the hospital, the mortality rate within 30 days is 2.8%. For those treated later than 55 minutes, the rate rises to 9.7%. Every minute of delay means more heart muscle tissue dies. Do not drive yourself — losing consciousness while behind the wheel could lead to a second accident.
Benefit: Israel conducted a nationwide study on acute coronary syndrome. The research focused on patients experiencing ST-segment elevation myocardial infarction, a specific type of heart attack. It measured the time interval from hospital admission to the point when a balloon catheter was used to reopen the blocked blood vessel. For patients treated within 55 minutes, 5 out of 178 (2.8%) died within 30 days. For those treated after 55 minutes, 15 out of 155 (9.7%) died within the same timeframe.
Evidence grade: B
Sources:Karkabi B, Meir G, Zafrir B, et al. (2021). Door-to-balloon time and mortality in patients with ST-elevation myocardial infarction. European Heart Journal - Quality of Care and Clinical Outcomes. https://doi.org/10.1093/ehjqcco/qcaa037
Notes: This study compares outcomes based on the time elapsed after hospital admission, not from the onset of symptoms to arrival at the hospital. However, the underlying principle remains the same: any delay results in additional heart muscle damage. The pain may also be felt in the upper abdomen, back, or jaw, and numbness in the left arm can also be a symptom. Diabetic patients and older adults may not experience any pain at all, only shortness of breath. Again, do not drive yourself — losing consciousness while driving can easily cause another accident.