Ashling,
If I were somwhere outside UK airspace where a PAN was not being recognised, I too would probably resort to a MAYDAY, especially, in the case of this scenario, if a doctor on board confirmed that it was indeed a heart attack.
Also, in the case of somewhere like France, I would also seriously consider filing a report against an ATC unit that refused to recognise a PAN.
I made the same observation earlier and the worrying thing is that you may well only get the paramedic initially even if you request an ambulance as thats the way the NHS works.
Indeed.
I believe the practice (particularly for the larger NHS wards, such as London) is that if the phone operator is satisfied that your situation is serious enough (as would be the case with a heart attack), they will send out a FRU with an ambulance to follow.
So yes, you will get your ambulance, but the FRU system is the NHS's way to buy themselves more time to find an available ambulance and/or allow the ambulance to fight through traffic (because FRUs are generally just converted cars, they are smaller and more agile than an ambulance).