You can only perform CPR on someone who is unresponsive, not breathing, and has no pulse. A person actively having a heart attack who is still awake and breathing does not need CPR, and chest compressions could harm them, so the right response is to call emergency services and stay with them.
Because a heart attack can suddenly progress to cardiac arrest, monitor the person closely. If they collapse and stop breathing, begin CPR right away and continue until trained help arrives.
Cardiopulmonary resuscitation, better known as CPR, is one of the most powerful skills an ordinary person can carry. It is most effective when it begins as soon as possible after cardiac arrest, and in many situations it doubles or even triples the chance of survival when performed promptly. Yet one of the most common questions people ask is whether CPR is the right response to a heart attack. The short answer is that it depends entirely on the person’s condition, and understanding the difference can change the outcome of an emergency.
You only perform CPR on someone who is not breathing and has no pulse. As long as the person having a heart attack is breathing and alert, there is no need for chest compressions. Knowing how a heart attack, cardiac arrest, and other medical emergencies differ helps you make the right decision in the moment. Whatever the emergency, the first step is always to call for medical help and then carry out the procedures the situation actually calls for.
What Is the Difference Between a Heart Attack and Cardiac Arrest?
Cardiac arrest and a heart attack are often used interchangeably in everyday conversation, but they are different medical events. When someone is having a heart attack, a blocked artery prevents oxygen rich blood from reaching part of the heart muscle. The person is usually still able to breathe and talk. They may feel chest pain or pressure, pain spreading to the arm, jaw, or back, shortness of breath, nausea, or a cold sweat. In most cases they will not need CPR, but they do need immediate medical treatment at a hospital because the longer the blockage lasts, the more heart muscle is damaged.
Cardiac arrest is different. During cardiac arrest the heart experiences an electrical malfunction that causes an irregular or chaotic rhythm, and the heart stops pumping blood effectively. The person suddenly collapses, becomes unresponsive, and stops breathing normally. If the victim loses consciousness and is not breathing, it is critical to start CPR right away. This is the only situation in which chest compressions are appropriate.
Why the Two Are Connected
The two events are linked even though they are not the same. Someone experiencing a heart attack has an increased risk of going into sudden cardiac arrest, because the stress on the heart muscle can disrupt its electrical signals. That is why a person who is having a heart attack should never be left alone. A bystander who can recognize the moment a heart attack tips into cardiac arrest, and who knows how to respond, can keep blood and oxygen moving until paramedics arrive. Recognizing that turning point is one of the core skills taught in hands on CPR and AED training.
Can You Perform CPR on Someone Having a Heart Attack?
The guiding rule is simple. CPR is reserved for a person who is unresponsive, not breathing normally, and without a pulse. If the person clutching their chest is awake, talking, or breathing on their own, do not perform chest compressions. Instead, help them sit or lie in a comfortable position, loosen tight clothing, call emergency services, and reassure them while you wait. Pushing on the chest of someone whose heart is still beating can cause real harm.
What you should do is stay alert. Heart attacks can deteriorate quickly, and the safest assumption is that the situation could change at any moment. If the person becomes unresponsive, stops breathing, and has no detectable pulse, that is cardiac arrest, and CPR becomes both appropriate and urgent. Acting in those first moments, before professional responders arrive, is exactly when bystander CPR has the greatest effect on survival.
Why Is Heart Disease a Leading Cause of Death in Canada?
Understanding how common cardiac emergencies are helps explain why CPR knowledge matters for everyone, not only healthcare workers. According to data from the Canadian Chronic Disease Surveillance System, heart disease is the second leading cause of death in Canada, even though overall rates have been declining. Heart disease affects roughly 2.6 million Canadian adults aged 20 and over, and it is about twice as likely to affect men as women.
Those numbers translate into a simple reality. The person who collapses in cardiac arrest could be a coworker, a parent, a customer, or a stranger on the street, and the people most likely to be nearby are not paramedics but ordinary bystanders. The Government of Canada publishes detailed surveillance on these trends through the Public Health Agency of Canada, which you can review in its national report on heart disease in Canada. The takeaway is that widespread CPR readiness across the general public is one of the most effective ways to improve survival.
What Does CPR Actually Do?
CPR is the emergency procedure that can save a person’s life when their heart stops and they are no longer breathing. During cardiac arrest, the heart stops pumping the blood that other organs need to function, which means the body’s organs are no longer receiving oxygen. When organs such as the brain and lungs are deprived of oxygen, it takes only a few minutes before permanent damage and death occur.
Chest compressions and rescue breaths work by mimicking the action of the heart. Each compression squeezes the heart between the breastbone and spine, pushing oxygenated blood out to the brain and other vital organs, and each release allows the heart to refill. CPR does not usually restart the heart on its own. Instead, it buys time, keeping oxygen circulating so that the brain stays viable until an automated external defibrillator or advanced medical care can correct the underlying rhythm. That bridge between collapse and professional help is what makes early CPR so valuable.
How Do You Perform CPR During a Cardiac Emergency?
Performing CPR keeps blood flowing throughout the body so that vital organs continue to receive oxygen until emergency help arrives. Ideally the procedure is carried out by someone with proper training, because trained responders start faster and push at the correct depth and rate. The basic steps for performing CPR on an adult who has no pulse and is not breathing are as follows:
- Call for emergency services such as 911, or send someone else to call while you begin.
- Check for normal breathing and make sure the scene is safe before approaching.
- Place the person on their back on a firm, flat surface.
- Position both hands in the centre of the chest, keep your arms straight, and push hard and fast at a rate of about 100 to 120 compressions per minute, which is roughly two compressions every second.
- Allow the chest to recoil fully between compressions so the heart can refill.
- If you are trained, add 2 rescue breaths after every 30 compressions. If you are not, continuous hands only compressions are still highly effective for adults.
- If an AED is available, attach it and follow its voice prompts. Deliver a shock only if the device advises one, then resume compressions immediately.
- If a second trained person is present, swap roles every couple of minutes so neither rescuer becomes too tired to compress effectively.
Using an AED Alongside CPR
An automated external defibrillator is designed for use by the public, not only professionals. Once switched on, it analyzes the heart rhythm and tells you, through clear voice prompts, whether a shock is needed. The device will only advise a shock when the rhythm calls for one, so you never have to interpret anything yourself. Apply the pads as illustrated on the device, make sure no one is touching the person during analysis or a shock, and return to compressions the moment the AED tells you to. Combining early compressions with prompt defibrillation gives a person the best possible chance.
CPR for Children and Infants
CPR on small children and infants differs because of their size and because their emergencies more often begin with a breathing problem. For children you may use one or two hands and compress to about one third the depth of the chest, while for infants you typically use two fingers or two thumbs. Rescue breaths carry more weight for these younger patients, which is why specialized programs such as child care first aid and CPR focus heavily on pediatric technique. The target compression rate of 100 to 120 per minute stays the same across all ages.
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When Should You Not Perform CPR?
Training does more than teach you how to perform CPR. It also teaches you when to hold back. Never perform CPR on someone having a heart attack who has a steady heartbeat and remains alert, because chest compressions on a beating heart can cause harm. In that situation the right action is to call paramedics and stay with the person until they arrive, watching closely for any sudden deterioration.
There is also a point at which an active rescue should pause. If you are performing CPR on a person who had no breathing or pulse and they begin to show signs of life, such as opening their eyes, moving, or breathing regularly, stop compressions. Keep a close eye on the person, because the heart can stop again, and be ready to restart CPR immediately if it does. You should also continue CPR until trained emergency responders take over or until you are physically unable to keep going.
Need CPR Certification for Healthcare or Work?
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What Are the Survival Rates After CPR?
Survival after cardiac arrest has improved over time, though it remains modest, which is precisely why fast bystander action matters so much. Data from a 2020 analysis of 141 studies indicates that the survival rate of people receiving CPR has increased, yet it remains below 50 percent, and the average one year survival rate for people who received CPR held at about 13.3 percent between 2010 and 2019.
What moves those odds is timing. Emergency cardiac care research consistently shows that when CPR begins within moments of a person going into cardiac arrest, the chance of survival can double or even triple compared with waiting for paramedics to arrive. Every minute that passes without compressions lowers the odds, so the single most important factor is often whether a trained bystander is present and willing to act immediately.
How Can You Learn CPR in Canada?
CPR is an invaluable skill that is straightforward to learn and to perform, and it can genuinely help you save a life. Hands on training classes make it far easier to learn the correct technique than reading alone, because you practise compressions, rescue breaths, and AED use on realistic manikins under the eye of an instructor. Across Canada, a comprehensive first aid course covers all the concepts required in many workplaces, while plenty of people take training simply to be ready for an emergency at home or out in public.
Programs are available in both classroom and blended formats, the latter combining online theory with in person skills practice. If you want a recognized credential that also covers a wide range of injuries and emergencies, a standard first aid and CPR course is a strong choice, and you can compare schedules and formats through the full list of course locations. Coast2Coast First Aid & Aquatics is a Canadian Red Cross Training Partner offering WSIB recognized CPR training and certification across Ontario and beyond.
Key Takeaway
CPR is only for a person who is unresponsive, not breathing, and without a pulse. A conscious heart attack patient needs emergency medical help, not chest compressions. Because a heart attack can progress to cardiac arrest, stay with the person, watch them closely, and be ready to begin CPR the instant they collapse and stop breathing. Started promptly, CPR can double or triple the chance of survival.
Be the Person Who Knows What to Do
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Frequently Asked Questions: CPR and Heart Attacks 2026
Q1: Can you do CPR on someone having a heart attack?
A: You only perform CPR on a person who is unresponsive, not breathing, and has no pulse. If someone having a heart attack is awake and breathing, CPR is not appropriate and could cause harm. Instead, call emergency services, keep the person calm and still, and stay with them. A heart attack can progress to cardiac arrest, so monitor the person closely. If they collapse, stop breathing, and lose a pulse, begin CPR immediately and continue until help arrives.
Q2: What is the difference between a heart attack and cardiac arrest?
A: A heart attack is a circulation problem caused by a blocked artery that cuts off oxygen rich blood to part of the heart muscle. The person usually stays conscious and breathing. Cardiac arrest is an electrical problem in which the heart suddenly stops beating effectively, so the person collapses, stops breathing, and has no pulse. A heart attack can trigger cardiac arrest, but they are not the same emergency, and only cardiac arrest requires CPR.
Q3: How do you know if someone needs CPR?
A: Check for three things: responsiveness, normal breathing, and a pulse. Tap the person firmly and shout to see if they react. Look for normal chest rise rather than occasional gasping. If the person is unresponsive and not breathing normally, they need CPR. Call emergency services or have someone else call, then begin chest compressions right away. When you are unsure whether breathing is normal, it is safer to start CPR than to wait.
Q4: What are the basic steps of CPR?
A: First, make sure the scene is safe and check whether the person responds. If they are unresponsive and not breathing normally, call emergency services and send for an AED. Place the person on their back on a firm, flat surface. Put both hands in the centre of the chest and push hard and fast. Continue compressions, adding rescue breaths if you are trained, and apply an AED as soon as one is available. Keep going until help takes over.
Q5: How fast should chest compressions be?
A: Chest compressions should be delivered at a rate of about 100 to 120 compressions per minute. That is roughly two pushes every second. Pushing too slowly does not move enough blood, while pushing too fast does not let the chest recoil fully between compressions. Allowing the chest to come all the way back up is just as important as the downward push, because it lets the heart refill with blood before the next compression.
Q6: How deep should chest compressions be?
A: For an adult, compressions should be at least 5 centimetres deep, which is about 2 inches, but no deeper than 6 centimetres. Push straight down using the heel of your hand with your shoulders directly over your hands and your arms straight. Effective depth is what actually circulates blood to the brain and other organs. Compressions that are too shallow are far less effective, so commit to firm, full compressions even though it can feel forceful.
Q7: Should you give rescue breaths or do hands-only CPR?
A: If you are trained and willing, the standard approach combines 30 chest compressions with 2 rescue breaths. If you are untrained, uncertain, or unwilling to give breaths, hands-only CPR with continuous compressions is still very effective for adults and is much better than doing nothing. For children, infants, and drowning cases, rescue breaths are more important because the emergency often begins with a breathing problem rather than a sudden heart issue.
More FAQs: AEDs, Recovery, and Training
Q8: What does an AED do during cardiac arrest?
A: An automated external defibrillator analyzes the heart rhythm and, if needed, delivers a controlled electric shock to help the heart re establish a normal beat. AEDs give voice prompts that guide you step by step, so you do not need to interpret the rhythm yourself. The device only advises a shock when the rhythm calls for one. Apply the pads as shown, follow the prompts, and resume compressions immediately after any shock or whenever the AED advises against one.
Q9: Can you hurt someone by doing CPR?
A: CPR can cause bruising or even cracked ribs because effective compressions are forceful. However, a person in cardiac arrest is clinically dead, so the alternative to CPR is no chance of survival at all. Performing CPR on someone who genuinely needs it is the right choice, and minor injuries can be treated afterward. The real risk is performing chest compressions on someone who still has a pulse and is breathing, which is why you confirm cardiac arrest first.
Q10: When should you stop performing CPR?
A: Continue CPR until trained emergency responders take over, the person shows clear signs of life such as breathing or moving, an AED instructs you to pause, or you are physically unable to continue. If the person starts breathing normally, stop compressions and keep monitoring them, since the heart can stop again. If a second trained rescuer is available, switch every couple of minutes to avoid fatigue, because tired rescuers deliver weaker, less effective compressions.
Q11: Is CPR different for children and infants?
A: Yes. The principles are the same, but technique changes with size. For children you may use one or two hands and compress about one third the depth of the chest. For infants you typically use two fingers or two thumbs. Rescue breaths carry more weight for young patients because their emergencies often start with breathing problems. The compression rate of 100 to 120 per minute stays the same. Specialized child care and first aid training covers these differences in detail.
Q12: Do you need to be certified to perform CPR?
A: No. Anyone can and should perform CPR in an emergency, and many regions have legislation that protects bystanders who help in good faith. You do not need a certificate to act. That said, formal training builds the confidence and muscle memory that make a real difference under pressure. Certified responders tend to start sooner, push at the right depth and rate, and use an AED without hesitation, all of which improve a person’s chance of survival.
Q13: What are the survival rates after CPR?
A: Outcomes have improved over the years but remain modest. A 2020 review of 141 studies found that the average one year survival rate for people who received CPR was about 13.3 percent between 2010 and 2019. Survival depends heavily on how quickly CPR begins, how soon an AED is used, and how fast advanced care arrives. Every minute without CPR lowers the odds, which is why immediate bystander action is so important.
Q14: What should you do if you are alone with someone in cardiac arrest?
A: Call emergency services first and put your phone on speaker so the dispatcher can guide you while you keep your hands free. If an AED is nearby and quick to reach, get it. Then begin chest compressions and do not stop except to use the AED. For adults, hands-only CPR is appropriate when you are alone and untrained in breaths. Stay on the line with the dispatcher, who can coach your compression rate and depth until help arrives.
Q15: How can you learn CPR in Canada?
A: CPR is taught as part of standalone CPR and AED courses and within broader first aid programs across Canada. Courses are offered in classroom and blended formats, where part of the theory is completed online before in person skills practice. Training covers compressions, rescue breaths, AED use, and how to manage choking. Workplace learners often need a recognized first aid and CPR certificate, while many people train simply to be ready to help family, friends, or strangers.
About This Article
Written and reviewed by Ashkon Pourheidary, B.Sc. (Hons), Co-Founder of Coast2Coast First Aid & Aquatics and a Canadian Red Cross certified instructor since 2011. Coast2Coast is a Canadian Red Cross Training Partner.
Source: Public Health Agency of Canada, Report from the Canadian Chronic Disease Surveillance System: Heart Disease in Canada.
