A short story: what would you do?
Follow Ramon as he feels the warning signs of a heart attack, and see what his family does next. Turn on your sound for the narration.
What happens in a heart attack
The heart muscle gets its blood from the coronary arteries. Over years, fatty plaque can build up inside them. If a plaque cracks, a blood clot forms on it and can block the artery. The heart muscle beyond the block starts to die within minutes to hours. [Ref: ESC 2023 ACS] [Ref: ACC/AHA 2025 ACS]
Doctors call this group of emergencies acute coronary syndrome. It includes heart attacks and unstable angina, which is chest pain that is new, getting worse or happening at rest. [Ref: ESC 2023 ACS] [Ref: AHA Angina]
The leading cause of death in the Philippines
Ischemic heart disease, the disease of blocked heart arteries that causes heart attacks, caused about 112,000 deaths in the Philippines from January to November 2025. That is about 1 in 5 of all deaths. [Data: PSA 2025]
What raises your risk: smoking, high blood pressure, high cholesterol, diabetes, being overweight, not being active, older age and a family history of early heart disease. [Ref: ESC 2023 ACS] [Ref: AHA/ACC 2023 CCD]
Symptoms in women
Chest pain or discomfort is the most common symptom in women, just as in men. But women are more likely to also have shortness of breath, nausea or vomiting, an upset stomach, back, shoulder or arm pain, anxiety, or unusual tiredness and weakness. Take these signs seriously. [Ref: AHA Heart Attack Warning Signs]
What happens at the hospital
An ECG within 10 minutes
A heart tracing shows whether an artery is fully blocked, which needs the fastest treatment. [Ref: PH AMI Pathway 2026] [Ref: ESC 2023 ACS]
A blood test for heart damage
Troponin rises in the blood when heart muscle is injured. [Ref: PH AMI Pathway 2026] [Ref: ACC/AHA 2025 ACS]
Opening the blocked artery
When an artery is fully blocked, doctors open it as fast as possible, within 2 hours at most, with a balloon and stent through a thin tube (angioplasty or PCI). If this cannot be done in time, a clot-dissolving medicine is given right away. It works best when given early, and it is usually only given up to 12 hours after symptoms start. Some people need bypass surgery. [Ref: PH AMI Pathway 2026] [Ref: ESC 2023 ACS] [Ref: ACC/AHA 2025 ACS]
PhilHealth coverage
PhilHealth has an expanded benefit package for heart attack care. It covers emergency care, angioplasty (PCI), hospital care and cardiac rehabilitation. Ask your hospital how it applies to you. [Ref: PH AMI Pathway 2026]
After a heart attack
About the medicines on this page
Medicines are described here only to help you understand your doctor's plan. Do not buy or take any medicine because you read about it here. Take only what your doctor prescribes for you, and never start, stop or change a dose on your own.
The goals are to heal, prevent another heart attack and get back to daily life. [Ref: ESC 2023 ACS] [Ref: ACC/AHA 2025 ACS]
Two blood-thinning medicines
Most people take two medicines that prevent clots (antiplatelets), for as long as their doctor advises. Never stop these on your own, especially in the first months after a stent. [Ref: ESC 2023 ACS] [Ref: ACC/AHA 2025 ACS]
Strong cholesterol-lowering medicine
A strong cholesterol-lowering medicine is started in hospital. Your doctor adjusts your medicines to bring cholesterol low enough. [Ref: ESC 2023 ACS] [Ref: ACC/AHA 2025 ACS]
Other heart-protecting medicines
Depending on how well your heart pumps, your doctor may add other medicines that protect the heart. [Ref: AHA/ACC 2023 CCD] [Ref: ESC 2023 ACS]
Cardiac rehabilitation
A supervised program of exercise, education and support. It lowers the chance of another heart problem and helps you return to work and daily life. [Ref: PH AMI Pathway 2026] [Ref: AHA/ACC 2023 CCD]
Also important: stop smoking completely, keep blood pressure and diabetes under control, eat a heart-healthy diet and stay active as advised. [Ref: AHA/ACC 2023 CCD] [Ref: ESC 2023 ACS]
After a heart attack, keep seeing your doctor.
Regular check-ups let your doctor see how your heart is healing, adjust your medicines and lower the chance of another heart attack. Dr. Aaron Christopher P. Novales sees patients with heart disease.
Chest pain, breathlessness or a cold sweat right now? Do not wait for a clinic visit. Go to the emergency room now →
Talk to your doctor about
Bring these questions to your visit.
- How long should I take two blood thinners?
- What is my cholesterol target?
- How well is my heart pumping now?
- Where can I join a cardiac rehabilitation program?
- When can I return to work, drive and exercise?
Related conditions
Guideline sources for this page
- ESC 2023 ACS: Byrne RA, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J 2023.
- ACC/AHA 2025 ACS: Rao SV, O'Donoghue ML, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the management of patients with acute coronary syndromes. Circulation 2025; J Am Coll Cardiol 2025.
- AHA/ACC 2023 CCD: Virani SS, et al. 2023 AHA/ACC multisociety guideline for the management of chronic coronary disease. J Am Coll Cardiol 2023.
- PH AMI Pathway 2026: Punzalan FER, et al. Development of the National Acute Myocardial Infarction Pathway for the PhilHealth IHD-AMI benefit package. Philippine Journal of Cardiology (Philippine Heart Association) 2026.
- AHA Heart Attack Warning Signs: American Heart Association. Warning signs of a heart attack.
- PSA 2025: Philippine Statistics Authority, provisional causes of death, January to November 2025, as reported by GMA News (28 May 2026).