Heart attack.
Chest pain or pressure, often described as a weight or a band rather than a sharp pain, which may spread to an arm, the jaw, the neck or the back. With it: sweating, nausea, breathlessness, a feeling that something is very wrong. In women, in older people and in people with diabetes it presents more often without the classic chest pain — breathlessness, fatigue, indigestion-like discomfort — and is missed for exactly that reason.
- Call the emergency number immediately. 112 across the European Union and the EEA; the local emergency number elsewhere. Do not drive them yourself unless there is no ambulance.
- Sit them down — on the floor, back supported, knees bent — and keep them still. Do not let them walk about "to see if it passes".
- Aspirin only if the dispatcher or local guidance tells you to, and not if they are allergic to it or have been told not to take it.
- If they become unresponsive and are not breathing normally, start chest compressions.
Stroke: FAST.
- Face — has it fallen on one side; can they smile.
- Arms — can they raise both and keep them up.
- Speech — is it slurred, are they using the wrong words, can they understand you.
- Time — call immediately.
Also stroke: sudden loss of vision in one or both eyes, sudden severe headache with no cause, sudden loss of balance or coordination, sudden numbness down one side.
The number that decides the treatment is the time they were last seen well — not the time somebody found them. Write it down and tell the crew. The treatments that dissolve or remove a clot are given inside a window measured from that moment, so "he was fine when I left at seven" is clinically more useful than anything else you can say.
Nothing to eat or drink, including medication, including water. A stroke often takes away the ability to swallow safely before it is obvious.
Symptoms that go away are not a false alarm. They may be a transient ischaemic attack, which is a warning of a stroke in the following days and needs urgent assessment the same way.
Source. World Health Organization, Stroke fact sheet, https://www.who.int/news-room/fact-sheets/detail/stroke ; WHO, Cardiovascular diseases fact sheet, https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) ; European Resuscitation Council, Guidelines 2021, First Aid section, https://cprguidelines.eu/guidelines-2021
What this is not. Reading, not certification, and not a diagnosis. If in doubt, call.