Those experiencing heart attack symptoms should call 9-1-1 within minutes — 5 at the most. Instead, studies show they wait 2 hours or more before seeking emergency care.

The National Heart, Lung, and Blood Institute (NHLBI), the American Heart Association, and other organizations recently issued a host of resources aimed at helping Americans know how to react to a heart attack and so save heart muscle and lives. The resources — which include a wallet card, a brochure, and a special Web page — are part of a major campaign called, "Act In Time To Heart Attack Signs."

The wallet card and brochure are available in English and Spanish. The wallet card and single copies of the brochure are free from the NHLBI Health Information Center (see address below). All materials are available free on the "Act In Time" Web page at www.nhlbi.nih.gov/actintime.

All of the resources give the warning signs of a heart attack, how to respond, and a "heart attack survival plan," which records key medical information for keeping in a handy place. The Web page also has information on heart attack — including a video showing a heart attack in progress — its tests and treatments, and links to other resources.

Other organizations involved in the campaign are the American Red Cross and the National Council on the Aging. The American Heart Association also is implementing Operation Heartbeat, an effort to increase public awareness and support for emergency treatment of sudden cardiac arrest, a life-threatening condition that can follow a heart attack. Information about Operation Heartbeat can be found online at http://216.185.112.5/presenter.jhtml?identifier=4803.

In addition, Act In Time is reaching out to doctors with a "call to action" that urges them to educate their patients about heart attack warning signs and the need to act fast.

"Our goal is to save lives by increasing the woefully low number of heart attack patients who are treated within the first hour of experiencing symptoms," said NHLBI Director Dr. Claude Lenfant. "It is during that crucial 60-minute window that clot-busting medication and other treatments are most effective. Alarmingly, only 1 in 5 patients gets to the hospital emergency department soon enough to benefit from these treatments."

Each year, about 1.1 million Americans suffer a heart attack. About 460,000 of those heart attacks are fatal — and for nearly half, death occurs within the first hour of the start of symptoms.

A heart attack occurs when blood flow to the heart is nearly or completely blocked. Artery-opening treatments should be given, ideally, within the first hour of the start of symptoms to restore blood flow and save heart muscle — and lives.

Unfortunately, patients, and especially women, delay seeking help for various reasons: For instance, they may not be sure they're having a heart attack because what they experience doesn't resemble the "Hollywood" version, in which a character is hit with a sudden, crushing chest pain. Many real-life heart attacks are much quieter, causing only mild chest pain or discomfort, for example.

Some patients delay out of worry about being embarrassed if their symptoms turn out to be a false alarm.

Additionally, most women hesitate because they still view heart attacks as being a man's problem, though heart disease is the leading killer of both men and women.

Act In Time urges Americans to protect themselves from heart attacks by following these steps:

• Learn these signs of a heart attack: Chest discomfort or pain; discomfort in the arm(s), back, neck, jaw, or stomach; shortness of breath; and breaking out in a cold sweat, nausea, or light-headedness.

• Act fast to any of the heart attack signs. Wait no more than a few minutes — 5 at the most — before calling 9-1-1. Calling 9-1-1 is like bringing the hospital to the patient. Emergency medical personnel can begin delivering treatment at once. Persons should not drive themselves to the hospital.

Act In Time materials are available from the NHLBI Health Information Center at P.O. Box 30105, Bethesda, MD 20824-0105, or at (301) 592-8573.

More information about heart attack, heart disease, and its risk factors is available at these Web pages — all can be reached through the NHLBI Web site at www.nhlbi.nih.gov:

• "Your Guide To Lowering High Blood Pressure"

• "Live Healthier, Live Longer," about high blood cholesterol

• "Aim For A Healthy Weight"

To interview an expert about this topic, contact the NHLBI Communications office at (301) 496-4236.

NHLBI press releases, publications, and other information can be found online at www.nhlbi.nih.gov.

Sidebar A

Plan Ahead

Knowing what to do in case of a heart attack can save lives. Americans can plan ahead by following these steps:

• Learn the heart attack warning signs

• Talk with family and friends about the warning signs and the need to call 9-1-1 quickly

• Talk with your health care provider about factors that increase your chance of having a heart attack — and how to reduce your risk

• Talk with your health care provider about what to do if you experience heart attack symptoms

• Make a heart attack survival plan that has vital medical information and keep it handy

• Decide who would care for any dependents in an emergency

Sidebar B

Reduce Your Heart Attack Risk

Acting fast is crucial for surviving a heart attack. But Americans also can take action to reduce their risk of ever having one — or of having a repeat heart attack.

They should:

• Stop smoking — If you can't quit the first time, keep trying.

• Lower high blood pressure — Be sure you follow a heart healthy eating plan that includes foods lower in salt and sodium.

• Reduce high blood cholesterol — Get your blood cholesterol level checked once every 5 years (and more often, if needed). This test measures the cholesterol level in the bloodstream.

• Aim for a healthy weight — Losing weight and keeping it off depends on a change of lifestyle that combines sensible eating with regular physical activity.

• Be physically active each day — Do at least 30 minutes of moderate-level physical activity, such as brisk walking, on most and preferably all days of the week.

• Manage diabetes — The steps that lower your risk of heart disease also help manage or reduce your chance of developing diabetes.