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Early Heart Attack Care and Community Education

Early Heart Attack Care (EHAC®) education is a public awareness campaign created by Dr. Raymond Bahr. The primary goal of EHAC is to promote awareness that heart attacks have "beginnings" that can occur weeks before the actual attack. EHAC focuses on intervention during these beginnings to help prevent acute myocardial infarction (heart attack) and cardiac arrest. The second goal of EHAC is to teach the public that individuals with heart attack symptoms must be evaluated and treated in an emergency department (ED) or Chest Pain Center. Dr. Bahr asks that you take action when you or someone in your presence has the early warning signs of a heart attack.

Prevention is a key word in medicine, and prevention of a heart attack is possible when you act quickly during the time that symptoms are minimal. About half of all heart attacks are preventable in that there are telltale signs that a heart attack is on its way ... early intervention can actually prevent heart attacks from taking place.

Dr. Raymond Bahr

EHAC Founder

Raymond Bahr

Dr. Raymond Bahr, MD, FACC
Retired, Coronary Care Unit
St. Agnes Healthcare, Baltimore, MD


Dr. Raymond Bahr was the founding father of the Society of Chest Pain Centers (later the Society of Cardiovascular Patient Care — the forerunner to ACC Accreditation Services). His Early Heart Attack Care (EHAC) program is a benchmark for community outreach and education in heart disease.

Dr. Bahr debuted EHAC as a common sense movement which recognizes that early symptoms of a heart attack occur in 50 percent of all heart attack patients and that these "beginnings" allow time for preventive measures to take place.

As part of the mission to change behavior and attitudes and increase awareness, Dr. Bahr devised the EHAC Pledge.

Dr. Raymond Bahr’s Early Heart Attack Care (EHAC) program has become a benchmark of community outreach and education for heart disease. Central to the program is the EHAC Pledge. We encourage individuals and community organizations to learn more about early warning signs and to ask others to take the EHAC Pledge:

"I understand that heart attacks have beginnings and on occasion, signs of an impending heart attack may include chest discomfort, shortness of breath, shoulder and/or arm pain, and weakness. These may occur hours or weeks before the actual heart attack.

I solemnly swear that if it happens to me or anyone I know, I will call 9-1-1 or activate our Emergency Medical Services."

By understanding the EHAC pledge, individuals become "deputized" into action. Deputized EHAC experts know to stay involved until the person experiencing early heart attack symptoms receives emergency medical treatment at the closest hospital or emergency center.

Early Heart Attack Symptoms

Not every heart attack displays the same symptoms as those we may see on the many medical TV shows we are exposed to daily. In fact, many people ignore the early signs of a heart attack, simply dismissing the more subtle symptoms because they expect the drama associated with a Hollywood episode. Unfortunately, when these early signs are ignored, we miss a "window of opportunity" to prevent the attack before any heart damage can occur. The following signs and symptoms are ones to be aware of in yourself or in your family members:

Shortness of Breath without Exertion

Although most of us experience shortness of breath when we are exercising or expending energy outside of what we do normally, difficulty breathing when performing normal activities is an early sign that should be investigated.


The sensation of heartburn or a burning in the chest can be mapped to spicy food and quickly discarded. This sensation can also be an early sign of a heart attack, especially if the condition becomes chronic. If you find yourself taking over-the-counter antacids on a regular basis, the underlying cause of your trouble needs to be discussed with your doctor.

Discomfort or Pain

Although we think of heart pain as pain occurring in the area of the heart, for some individuals this is not the case. People who have suffered a heart attack have described their early symptoms everywhere from crushing to squeezing to pressure occurring in the chest and even other areas of the body. Shoulders, neck, and jaw are areas reportedly affected prior to a heart attack. Always seek immediate attention if you are experiencing this type of pain, even if the symptoms disappear or are only intermittent.

A Feeling of Impending Doom

Some patients describe a feeling of anxiety and fear prior to the occurrence of a heart attack. Although not usually thought of as an early symptom, and certainly attributable to other matters, this "feeling" can still be an early indicator, especially when combined with any of the other symptoms listed above.

EHAC is a fully developed outreach program with materials and information available for review and download on the Deputy Heart Attack website. The Deputy Heart Attack program disseminates Early Heart Attack Care education.

If you require EHAC materials or logos, please send your request to community@acc.org.

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American College of Cardiology: 2400 N St. NW, Washington DC 20006