Health Library

Categories > Heart Health > Heart disease: Symptoms

Rapid response: ER attention for chest pain
At the emergency room

Be alert to the signs
Be alert to the signs

Don’t let fear of a “false alarm” prevent you from seeking emergency help when you experience these heart attack symptoms:

  • uncomfortable pressure, fullness or squeezing pain in the center of your chest, lasting more than a few minutes
  • pain spreading to your shoulders, neck or arms
  • light-headedness, fainting, sweating, nausea or shortness of breath

When chest discomfort strikes, many people ignore the symptom, chalking it up to heartburn or some other benign malady rather than seeking emergency care. Their wait-and-see strategy often means a delay of several hours before getting medical attention. However, when chest pain is caused by a heart attack, such a delay could cost a person his or her life.

If you suspect you’re having a heart attack, don’t let fear, denial or embarrassment prevent you from seeking timely medical attention. Call 911, and while you’re waiting for help, chew an aspirin to prevent blood from clotting. Do not try to drive yourself to the hospital.

At the emergency room

When you get to the ER, the staff will try to determine the cause of your chest pain. Your blood pressure, pulse and temperature will be checked right away. The staff may perform some of these tests to rule out a heart attack:

Electrocardiography (ECG). In this painless test, electrodes are attached to your skin, providing a recording of the heart’s electrical activity, which appears as a graph. In case of chest pain, an ECG can indicate whether a heart attack is in progress or whether one has already occurred. Because injured heart muscles do not conduct electricity normally, an ECG can also reveal if parts of the heart have been damaged.

Blood tests. When portions of the heart muscle are damaged they release specific enzymes into the bloodstream, such as creatine kinase. If a blood test shows elevated levels of these enzymes, the heart muscle may have been damaged.

Chest X-rays. A chest X-ray shows the heart’s size and shape and whether fluid has accumulated in the lungs. It also allows doctors to evaluate major blood vessels.

Echocardiography. In this test, a small, microphone-like device called a transducer is passed over your chest to send ultrasound waves into your body and then receive the waves as they bounce back, or echo, from the heart’s surface. The “echoes” create a video image of the heart at work. Portions of the heart that are pumping weakly may indicate damage caused by heart attack.

Nuclear scan. Trace amounts of a radioactive material, such as thallium, are injected into the bloodstream. A special camera that detects the radioactivity is then used to trace blood flow and observe the circulatory system at work.

Cardiac catheterization. A tapered tube called a sheath is inserted into an artery, usually in the upper thigh. A catheter is then threaded through the sheath and guided toward the heart. An X-ray dye is injected through the catheter, allowing the heart to be viewed on a video screen. Doctors can find out how well the heart’s pumping chambers are working, check for blockages and look for other signs of heart disease.

Other imaging techniques. The staff may also use an MRI, CT scan or ultrafast CT scan to view the heart.

If the ER team finds that you are having a heart attack, clot-busting drugs, angioplasty or surgery may be the next step. But remember—to receive possibly lifesaving treatment for heart attack, you must seek prompt medical help.