Heart Attack And Unstable Angina: When To Call A Doctor

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When to Call a Doctor

Call 911 or other emergency services immediately if you have any of the following symptoms of a heart attack:

• You have chest pain that has not improved or that gets worse within 5 minutes after taking 1 dose of nitroglycerin and/or resting. After you call 911 , continue to stay on the phone with the emergency operator. He or she will give you further instructions. See how to take nitroglycerin.
• You have chest pain or discomfort that is crushing or squeezing, feels like pressure on the chest, and gets worse or lasts more than 5 minutes, especially if it occurs with any of the following symptoms:
  • Sweating
  • Shortness of breath
  • Nausea or vomiting
  • Pain that spreads from the chest to the neck, the jaw, or one or both shoulders or arms
  • Dizziness or lightheadedness
  • A fast or irregular pulse
  • Signs of shock

Women are more likely to have symptoms such as shortness of breath, heartburn, nausea, jaw pain, back pain, or fatigue.

After you call 911   or other emergency services, you should chew 1 regular-strength aspirin (325 mg) unless you cannot take aspirin because of allergy or some other reason. By calling 911   and taking an ambulance to the hospital, you may be able to start treatment before you arrive at the hospital. If any complications occur along the way, ambulance personnel are trained to evaluate and treat them.

If an ambulance is not readily available, have someone else drive you to the emergency room. Do not drive yourself to the hospital.

If you witness a person become unconscious, call 911   or other emergency services and start CPR (cardiopulmonary resuscitation). The emergency operator can coach you on how to perform CPR. To learn more about CPR, see the Rescue Breathing and Cardiopulmonary Resuscitation (CPR) section of the topic Dealing With Emergencies.

Never wait if you have symptoms of a heart attack. Many people are unsure if they are having a heart attack and take a "wait and see" approach. Heart attack symptoms can vary. People often discount their symptoms if they do not fit into the expected "extreme chest pain" scenario. Some people are embarrassed or don't want to bother others by calling for help if they think it may not be a heart attack. Even if you're not sure it's a heart attack, you should still have it checked out. Rapid treatment can save your life.

Who to See

You will be evaluated and treated by an emergency medicine specialist in the emergency room. For ongoing care, you will likely see a cardiologist. If surgery is needed, you will be referred to a cardiovascular surgeon.

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Last updated:	May 14, 2007
Author:	Robin Parks, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
Editors:	Kathleen M. Ariss, MS, Pat Truman