Do this now
- Call 108 — say “chest pain, possible heart attack,” give the location and a landmark. The ambulance is free and carries trained staff.
- Sit the person down and keep them still. Do not let them walk, climb stairs, or go anywhere alone. Physical effort during a heart attack makes damage worse.
- Loosen tight clothing, keep the room airy, and stay calm with them — panic raises the heart’s workload.
- Give nothing by mouth — no food, no water, no tablets, including aspirin — unless a doctor or the 108 team instructs you.
- Note the time the pain started and list the person’s regular medicines to hand over at the hospital.
- If they collapse and are not breathing normally, start chest compressions — push hard and fast in the centre of the chest — and keep going until help arrives.
Warning signs
- Chestpain, pressure, heaviness or squeezing lasting more than a few minutes, or coming and going.
- Spreadingdiscomfort moving to the left arm, both arms, jaw, neck, upper back or stomach.
- Sweatingsudden cold, clammy sweat.
- Breathingbreathlessness, with or without chest pain.
- Stomachnausea, vomiting, or indigestion-like discomfort that feels unusual.
- Collapsesudden severe weakness, dizziness, or fainting.
Take it seriously even when the pain is moderate. Many people reach hospital late because the pain was “not that bad” or was mistaken for gas or acidity. Chest discomfort in anyone with diabetes, high blood pressure, high cholesterol, a smoking history, or a family history of heart disease should be treated as cardiac until a hospital proves otherwise.
Silent heart attacks in diabetes
This is one of the most dangerous facts in diabetes care and one of the least known: long-standing high sugar damages nerves, including those that carry pain from the heart. As a result, people with diabetes can have a heart attack with little or no chest pain — the so-called silent infarction. What appears instead is sudden breathlessness, drenching sweat, unexplained vomiting, extreme fatigue, or simply a collapse. Families dismiss these as weakness, heat, or age. In a person with diabetes, unexplained breathlessness or sudden severe weakness deserves an emergency call, not a wait-and-watch. Call 108.
24×7 emergency & ICU at PPK Hospital, Marthandam
PPK Hospital, NH 47, Marthandam. The emergency entrance is on the highway and receives 108 ambulances directly.
The hospital operates a 24×7 emergency department and intensive care units with ventilator support and continuous cardiac monitoring, led by Dr. Dante Ruskin, critical-care specialist and diabetologist. Because he also manages diabetes, patients under his care arrive in the ICU with their sugar control, kidney function and medicines already known — which shapes safe decisions quickly during a cardiac emergency.
Lowering the risk before it happens
Heart attacks in diabetes are not bad luck; they are the end of a long, quiet process. High sugar, high blood pressure, high cholesterol and tobacco damage arteries together, and treating only the sugar leaves most of the risk untouched. Regular review means blood pressure and lipids get treated with the same seriousness as glucose, kidney function is tracked, tobacco is addressed honestly, and warning symptoms are investigated rather than explained away. Most cardiac emergencies in this clinic’s experience were preceded by months of ignored numbers.
Questions people ask in this emergency
What are the warning signs of a heart attack?
Chest pain, pressure, tightness or heaviness lasting more than a few minutes, often spreading to the left arm, both arms, jaw, neck, or back — usually with cold sweating, breathlessness, nausea, or sudden severe weakness. Some people, especially those with diabetes and older women, feel little or no chest pain at all.
Can a heart attack happen without chest pain?
Yes. People with long-standing diabetes can have a "silent" heart attack because nerve damage blunts pain signals. Unexplained breathlessness, cold sweating, sudden exhaustion, vomiting, or a feeling that something is badly wrong should be treated as an emergency in a person with diabetes — call 108.
What should I do while waiting for the ambulance?
Have the person sit down and rest — not walk, not climb stairs, not go to the bathroom alone. Loosen tight clothing, keep the room airy and calm, and stay with them. Do not give food, water or medicines by mouth unless a doctor instructs. If they become unresponsive and are not breathing normally, start chest compressions if you know how.
Should I give aspirin for chest pain?
Only if a doctor or the 108 team instructs you to. Aspirin helps some heart attacks but is dangerous in other conditions that cause chest pain. Call 108 first and follow their instructions rather than giving any tablet on your own.
Where is the nearest emergency hospital to Marthandam?
PPK Hospital, on the Trivandrum–Nagercoil highway opposite the CSI Church in Marthandam, runs a 24×7 emergency department and ICU with ventilator support, led by intensivist Dr. Dante Ruskin. The emergency entrance is on the highway and receives 108 ambulances directly.