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Tomorrow promises to be a great day of elk hunting, making today’s long trek to the high camp worth every step. Right now, everything seems perfect, especially after that chili. It was so good you went for seconds.

Lying in your sleeping bag, suddenly you don’t feel so well. There’s a growing tightness in your chest and your forehead breaks out in a cold sweat. Nausea sweeps over you and your head goes dizzy. You can’t catch your breath, as you pant through the pain. You try to convince yourself that it’s nothing–maybe a little indigestion, maybe exhaustion from the climb to altitude, maybe food poisoning. Could it have been that spicy chili? What if it’s your heart?

Heart attack is a serious medical emergency in which every second counts. According to the National Heart, Lung and Blood Institute, “Coronary heart disease (CHD) is the leading cause of death for both men and women in the United States. CHD is caused by a narrowing of the coronary arteries that supply blood to the heart, and often results in a heart attack. Each year, about 1.1 million Americans suffer a heart attack. About 460,000 of those heart attacks are fatal. About half of those deaths occur within one hour of the start of symptoms and before the person reaches the hospital.”

The American Heart Association stresses that “heart attack and stroke victims can benefit from new medications and treatments. But to be effective these drugs must be given relatively quickly after heart attack or stroke symptoms first appear.”

The point is, if it’s really a heart attack, there’s no time to lose. Knowing what the symptoms are can help you determine whether to break camp and head for the nearest emergency room or just break out the antacids.


Chest discomfort–Most heart attacks present some level of discomfort in the chest area. It might feel like pressure or squeezing, a fullness or pain. It can last for several minutes, or it may subside and then return.

Upper-body discomfort–In addition to chest pain, you might experience discomfort or pain in either arm or in the back, neck, jaw or stomach.

Shortness of breath–This can occur simultaneously with chest discomfort or before the onset of chest discomfort.

Other symptoms–Nausea, lightheadedness or a cold sweat.

If symptoms include chest discomfort along with one or more of the other symptoms mentioned, get professional medical help as quickly as possible.


Not all heart attacks present themselves in the same way. Some are classic “movie-type” attacks in which the victim suddenly clutches his chest with great intensity and then collapses. But they don’t all happen that way. Many heart attacks begin slowly, with only mild pain or discomfort, leaving everyone wondering what’s happening. Confusion about the seriousness of the situation can easily lead to delays in seeking treatment, which can, in turn, lead to unnecessary death.

The best course of action is to call for help from a team of emergency medical services (EMS) personnel, who are trained and equipped to handle the situation. Having a satellite phone or a ham radio in camp can be a literal lifesaver. If there’s no way to contact anyone, you’re going to have to handle the crisis to the best of your abilities, and that means being prepared. If you’re the victim, you may need to direct the activities of the others in camp trying to help. Tell them what to do. If possible, contact someone who can initiate a medical rescue–the sheriff, the park rangers, the nearest hospital, etc.

If you are the first person on the scene and the victim is still conscious:

1. Ask if he uses heart medicine (nitroglycerin). If the answer is yes, find the medication and place one tablet under the tongue. You can administer as many as three tablets in a 10-minute time span if necessary.

2. Loosen clothing around the patient’s neck, chest and waist.

3. Position the patient in a half-sitting posture, with the legs up and bent at the knees. Support the knees with a pillow or rolled towel, and support and cushion the patient’s back and head.

4. Calm and reassure the patient.

5. Monitor breathing and pulse. Be prepared to do CPR or rescue breathing. CPR is performed on victims who have stopped breathing and have no pulse. Rescue breathing is done on patients who still have a pulse but need assistance breathing. [See sidebar, page 95.]


You’ve probably heard about administering aspirin to suspected heart attack victims. Here’s what the American Heart Association recommends. (We offer this knowing that in some cases calling 911 might not be an option.)

“The more important thing to do if any heart attack warning signs occur is to call 911 immediately. Don’t do anything before calling 911. In particular, don’t take an aspirin, and then wait for it to relieve your pain. Don’t postpone calling 911. Aspirin won’t treat your heart attack by itself.

“After you call 911, the 911 operator may recommend that you take an aspirin. He or she can make sure that you don’t have an allergy to aspirin or a condition that makes using it too risky. If the 911 operator doesn’t talk to you about taking an aspirin, the emergency medical technicians or the physician in the Emergency Department will give you an aspirin if it’s right for you. Research shows that getting an aspirin early in the treatment of a heart attack, along with other treatments EMTs and Emergency Department physicians provide, can significantly improve your chances of survival.”

How to Perform Rescue Breathing on Adults

1 Position the victim on his back. Gently tilt the victim’s head back and lift his chin. Be sure to maintain an open airway while you pinch his nose shut.

2 Seal your mouth around the mouth of the victim and deliver two long, slow breaths. Continue to blow into the victim’s mouth until his chest gently rises.

3 Check for a pulse. If a pulse is present but the victim is still not breathing, deliver one slow breath every five seconds for a minute–12 breaths in all.

4 After the 12 breaths, check for a pulse and breathing. Continue rescue breathing as long as a pulse is present but the person is not breathing.

Quick Tip

STRIKING RANGE If you can hear thunder, take cover–you’re close enough to be struck by lightning. Annually, lightning kills an average of 73 people in the United States; hundreds of others are injured. Survivors often report a variety of long-term, debilitating symptoms.