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It is important to recognise the problem before the heart stops.  Signs may include a change in the colour of the patient's skin, they may confuse the symptoms they are experiencing with indigestion, or they may become very anxious.

 It is important to sit them down and reassure them to reduce their anxiety level until help arrives. Activate the EMS and be ready in case they goes in to cardiac arrest, if the heart stops then you would need to perform CPR.