emergency room visits chest pain

Learn how UpToDate can help you.

Select the option that best describes you

Medical Professional
Resident, Fellow, or Student
Hospital or Institution
Group Practice
Find in topic

CALCULATORS

When Chest Pain Is an Emergency and When It's Not

Learn to recognize key signs, and know what action to take in either case

detail of person wearing beige sweater holding hands to chest as though they're in pain

Chest pain can signal something serious, and it’s often an emergency . But discomfort in your chest area can also be a sign of a minor annoyance. That means that when you notice it, you may be uncertain about whom to call or what to do.

Experts agree that in the moment, it’s key to take the right action without hesitation, erring on the side of caution. Here, the most common causes of chest pain, when to seek help as soon as possible, and when you can wait.

Simple or Serious?

Chest pain is one of the most common reasons people go to an emergency department or a doctor’s office, says Martha Gulati, MD, a cardiologist and president-elect of the American Society for Preventive Cardiology.

Discomfort in your chest is sometimes due to gas, heartburn , inflammation in your rib cartilage, or anxiety. But it’s important to be aware of the serious and even deadly problems that can also cause pain.

For instance, the risk of a heart attack —a blockage in any artery that delivers blood and oxygen to your heart—increases with age. An aortic dissection, which is a tear along the vessel that delivers blood to the rest of your body, also causes chest pain. The pain can sometimes be a warning sign of a lung blood clot called a pulmonary embolism , or even a rupture of the esophagus, the tube that connects your throat to your stomach. Each one of these problems is an emergency.

What doctors refer to as chest pain is generally centered in the chest area but can include other sensations and even extend to other areas of your body. The American Heart Association guidelines for diagnosing and treating chest pain list “pain, pressure, tightness, or discomfort in the chest, shoulders, arms, neck, back, upper abdomen, or jaw” as potentially serious symptoms. Another sign of a possible emergency is chest discomfort plus fatigue or shortness of breath.

Your symptoms can help you determine whether you need help immediately. And there are a few key factors to consider when you’re deciding what to do.

When to Consult Your Doctor

If you’ve already been diagnosed with a condition like angina , you may have discomfort that hasn’t changed significantly and that your doctor has already assessed. You also may have a chronic problem that’s getting worse but only very gradually. Maybe you’ve already talked to your doctor about the heartburn you get after eating , but lately you’ve noticed it’s more severe and more frequent.

In such cases, you should consult a doctor ASAP, but not necessarily in an emergency room. “If it’s a symptom you’ve had in the past, and it feels similar and it has already been evaluated, that’s when a nonurgent evaluation would be appropriate,” says Michael Nanna, MD, a cardiologist and an assistant professor at the Yale School of Medicine.

When to Call 911

Acute chest pain, or sudden discomfort you haven’t experienced before, always warrants emergency care . When in doubt, call 911.

Don’t research your symptoms online or call your doctor’s office when you have such chest pain, Nanna says. Your medical provider will probably send you to the emergency department anyway, because it’s not possible to diagnose a serious problem over the phone. “I always suggest the patient be evaluated as soon as possible, because there’s no way for a patient to be able to differentiate a heart attack from reflux,” Nanna says.

For potentially serious causes, quick treatment can be critical to survival. That’s one reason it’s best not to drive or get a ride to a hospital if you have acute chest pain. If you call 911, paramedics can begin administering necessary medication in the ambulance, and a team will be ready for you when you arrive at the hospital.

If a serious cause is ruled out, Nanna says your provider will work with you to manage whatever is causing your chest pain and discuss ways to prevent future problems. Either way, never be embarrassed about a false alarm.

“Yes, for the majority of people, it will not be cardiac or life-threatening, but we don’t want to miss anyone,” Gulati says. “We can joke about it later being reflux or gas, but I would rather you be around to joke about it.”

Editor’s Note: A version of this article also appeared in the September 2022 issue of Consumer Reports On Health .

Ashley Abramson

Ashley Abramson is a freelance writer focused on health and psychology. In addition to Consumer Reports, she's written for the New York Times, the Washington Post, and the Guardian. She lives in Milwaukee with her husband, two young sons, and their pair of pups. When she's not writing, she enjoys good food, movies, and the Lake Michigan views down the street.

Sharing is Nice

We respect your privacy . All email addresses you provide will be used just for sending this story.

Trending in Chest Pain

How to Stay Healthy Longer

Best Checkup for Your Heart

How to Track Your Health at Home

What to Do When You Need Medical Care Fast

Patient Portal
Good Faith Patient Estimate Tool

What happens when you go to the emergency room for chest pain symptoms?

Understanding the common signs of chest pain and knowing when to go to the ER can help save your life in the event of an emergency. Chest pain is a common symptom of heart attack and other life-threatening conditions, so it should never be taken lightly. When in doubt, call 911 or visit your nearest emergency department.

Possible Causes of Chest Pain

Chest pain can occur anywhere from your neck to your upper abdomen. As there are many possible causes, chest pain can present differently for everyone. It can feel:

Tight, squeezing, or crushing

Chest pain can be caused by a wide range of conditions. Although your first thought may be that your pain is heart-related, chest discomfort can also be due to lung, gastrointestinal, musculoskeletal, and other issues. Below are some of the most common causes of chest pain.

Heart-Related Causes

Heart attack
Myocarditis
Pericarditis
Cardiomyopathy
Aortic dissection

Gastrointestinal Causes

Acid reflux
Disorders of the esophagus
Inflammation of the gallbladder or pancreas

Lung-Related Causes

Pneumothorax
Blood clot, or pulmonary embolism
Bronchospasm

Musculoskeletal Causes

Bruised or broken ribs
Compression fractures
Strained muscles

Other causes of chest pain can also include psychological conditions such as anxiety and panic attacks. If you commonly experience symptoms of chest pain or your chest pain is severe, medical intervention may be warranted.

When is chest pain serious enough to go to the ER?

Chest pain is common, but it shouldn’t be ignored. Although most cases of chest pain are harmless, you should go to the emergency room immediately if your chest pain is intense, prolonged, or is accompanied by other symptoms.

Here are some symptoms that may indicate you need immediate medical attention:

Difficulty breathing/shortness of breath
Confusion/disorientation
Excessive sweating
Nausea or dizziness
Pain that travels into the back
Pain in the jaw, left arm or back
Feelings of pressure, squeezing, tightness
Low blood pressure or heart rate
Rapid heartbeat and/or breathing

If your chest pain lasts more than a few minutes or becomes more severe, don’t wait. Call 911 immediately. Chest pain accompanied by the symptoms above may indicate a heart attack or other serious conditions, and it’s best not to delay treatment. Ambulances have a highly trained team and special equipment to transport you quickly and safely to the nearest emergency department.

What Happens When You Go to the ER for Chest Pain

Going to the emergency room can be critical if your condition is serious. If you or someone you know needs life-saving treatment, it’s helpful to know what symptoms to look for and what to expect in the emergency room.

If you are unsure about your chest pain, it is always best to be evaluated. Emergency departments provide 24/7 care and highly trained staff that deliver safe transportation and urgent treatment.

Calling 911 for Chest Pain

A visit to the ER for chest pain can be life-saving. When your chest pain persists, is severe, or is accompanied by shortness of breath, nausea, radiating pain, and changes in heart rate and blood pressure, call 911 immediately.

When transported by an ambulance, paramedics can begin preliminary testing for diagnosis of heart attacks and other conditions. Electrocardiograms (ECG) are often given to check the heart’s rhythm and detect a heart attack. A preliminary diagnosis can be sent to the emergency room to speed up care. Paramedics can also provide oxygen and other life-saving support.

Questions You May Be Asked in the ER about your Chest Pain symptoms

Upon arriving at the emergency room, you’ll meet with a triage nurse who will ask a series of questions to determine the severity of your chest pain. Patients whose conditions are more severe will see the doctor urgently. Be prepared to answer questions about your medications, medical conditions, and family health history. To help determine the cause of your chest pain, your doctor will ask questions about your symptoms.

These types of questions may include:

When did your symptoms start?
Is the pain getting worse?
Does your pain radiate to other parts of the body?
How would you describe your pain?
Do you have other signs and symptoms such as dizziness, shortness of breath, lightheadedness, or vomiting?

Tests and Exams for Chest Pain Symptoms

After learning about your symptoms of chest pain, your doctor will next perform a physical exam. To diagnose or eliminate heart-related problems, your doctor may also order a number of diagnostic tests. These may include:

Electrocardiogram (ECG or EKG)
Chest X-ray
Echocardiogram
Stress tests

Treatment and Emergency Cardiology Procedures

When the cause of your chest pain has been diagnosed, your doctor will recommend treatment. Treatments may include medication, noninvasive procedures, or in advanced cases, surgery. A combination of treatments may even be required to address your symptoms.

Common medications prescribed may include:

Artery relaxers
Thrombolytic drugs
Blood thinners
Anti-anxiety medications

In the event of a heart attack or other life-threatening conditions, surgery may be required. Common surgical procedures include:

Angioplasty
Stent placement
Surgical repair of the arteries
Bypass surgery
Emergency dissection repair
Lung reinflation

Emergency departments provide stabilizing treatments in the event of a crisis. However, they do not offer long-term solutions or treatment. It is always important to follow up with your primary care physician after a trip to the emergency room to address the source of your chest pain and prevent future events.

Treatment for Chest Pain After the ER

If your chest pain is due to a heart attack or another life-threatening condition, you will be admitted to the hospital.

In the first 24 hours after being admitted to the hospital, you may undergo further testing and monitoring as doctors closely watch over you. If you’ve had a heart attack, you will likely stay in the hospital for 2-4 days.

Once your condition is stable, and doctors determine that you are ready to go home, you will be discharged with instructions for home care. These may include medication directions and orders for follow-up care with a specialist.

Chest pain is often the result of an underlying condition. Upon returning home, you should always follow up with your primary care physician for further evaluation and care.

Emergency Care Close to Home

Treatment for life-threatening conditions should not be delayed. When it comes to chest pain, every second counts. Open 24 hours, seven days a week, Memorial Hospital of Gardena provides world-class patient care conveniently located close to home.

Memorial Hospital of Gardena is an accredited Geriatric Emergency Department and is highly trained for fast and efficient care of cardiac conditions, making us your hospital of choice for emergencies.

Thanks for visiting! GoodRx is not available outside of the United States. If you are trying to access this site from the United States and believe you have received this message in error, please reach out to [email protected] and let us know.

When Do Chest Pains Warrant a Trip to the ER?

Chest pain is a common symptom in the United States. Each year more than eight million Americans visit the ER because of chest pain. It’s the second biggest cause of ER visits.

Our team at NJ Cardiovascular Institute, which includes board-certified cardiologist Dr. Kunal Patel, knows that chest pain can be scary. But we also know that not all cases of chest pain warrant a trip to the ER. So let’s discuss when you should go to the ER for chest pain.

Common causes of chest pain

While chest pain is a telltale sign of heart problems, it could be from a different medical condition, including:

Panic attack
Pulmonary embolism
Peptic ulcers
Myocarditis
Muscle strains, which cause inflammation in the ribs

Some medical conditions may feel like a heart attack. Myocarditis, for example, has similar symptoms to a heart attack. So, knowing if your chest pain is from a heart attack or other heart conditions is important.

Coronary artery disease

Coronary artery disease is a serious condition that can lead to a heart attack. It occurs when your arteries become narrow or blocked by plaque build-up. Long-term high cholesterol often causes coronary artery disease.

The main symptoms of coronary artery disease are chest pain and angina. Angina causes a crushing or squeezing feeling in your chest. It also causes chest pain that can spread to your arms, neck, and jaw. Go to the ER immediately if you experience these symptoms.

Chest pain not caused by heart disease

Chest pain that’s caused by a muscle strain isn’t the same as heart-related pain. It’s likely that your chest pain is not from heart disease if:

It happens with certain movements
It can be pinpointed
Pain occurs with deep breaths
The pain goes away after a few seconds

Never dismiss chest pain — no matter what’s causing it. If your chest pain is severe and it concerns you, go to the ER. Don’t take any chances when it comes to your health.

When to visit the ER for chest pain

You should go to the ER if you experience chest pain along with other symptoms. This usually indicates a heart attack . Call 911 or get to the ER right away if you experience chest pain with:

Shortness of breath
Nausea or vomiting
Arrhythmia (irregular heartbeats)
Chest pain that moves to include your arms, neck, or jaw
Symptoms last more than five minutes
Angina (squeezing, tightness, or crushing sensation in your chest)

Heart attacks are often fatal and can cause permanent damage to your heart. That’s why if you experience heart attack symptoms, get medical help. The sooner it’s treated, the less damage it does.

Treating your chest pain

As mentioned, not all occurrences of chest pain need emergency medical help. However, it can eventually lead to more serious problems and put you at a greater risk for heart attacks.

Treating your chest pain at NJ Cardiovascular Institute , located in Newark and Secaucus, New Jersey, can prevent serious complications. To set up your appointment with Dr. Patel, use our online booking tool or call the office.

You Might Also Enjoy...

5 Simple Changes to Boost Your Heart Health

The Link Between Hormonal Changes and Heart Palpitations

Are Varicose Veins Dangerous to My Health?

I'm Nervous About My Stress Test: What Can I Expect?

The Dangers of High Blood Pressure

Chest Pain During Cardio: What You Need to Know

You are using an outdated browser. Please upgrade your browser to improve your experience.

Skip to Site Navigation Skip to Page Content

Physician Referrals
Patient Resources
Why UT Southwestern

Refine your search: Find a Doctor Search Conditions & Treatments Find a Location

Appointment New Patient Appointment or Call 214-645-8000

New chest pain guidelines to improve ER heart attack diagnoses

November 17, 2021

Chest pain is often the first sign of a heart attack. However, crushing or radiating pain in the chest, shoulder, or jaw also can indicate non-cardiac medical emergencies, such as a pulmonary embolism or other thoracic pathologies.

According to the Centers for Disease Control and Prevention (CDC), chest pain is the most common reason for trips to the ER, resulting in more than 7 million annual visits. Before October 2021, emergency care professionals had to determine the cause of chest pain by ordering several tests and imaging studies that cost patients time and money.

Now, hospitals around the world have a new set of guidelines regarding how best to diagnose the cause of chest pain – faster, more precisely, and with fewer unnecessary tests.

Published simultaneously on Oct. 28 in Circulation and the Journals of the American College of Cardiology , the new chest pain guidelines were spearheaded by the American Heart Association (AHA) and American College of Cardiology (ACC) Joint Committee on Clinical Practice Guidelines.

My colleague, Deborah Diercks, M.D. , Chair of the UT Southwestern Department of Emergency Medicine, and I were members of the multidisciplinary team that wrote and refined the guidelines over two years.

The recommendations are infused with cutting-edge clinical data, targeted protocols, and recommendations on the use of an advanced blood test – high-sensitivity troponin – that can determine quickly whether someone is having a heart attack. That test, developed in part at UT Southwestern, has been a valuable tool that the Emergency Department teams at UTSW’s Clements University Hospital and Parkland have used for several years.

Specifically, the AHA/ACC guidelines were designed to clearly and rapidly narrow the diagnostic possibilities and develop advanced testing standards. The guidelines emphasize three distinct facets of patient care:

Defining precise, patient-centered terminology

Reducing unnecessary tests and interventions, debunking myths around women’s chest pain.

Chest pain used to be classified as typical (consistent with heart attack) or atypical (not consistent with heart attack), and acute or stable. However, these vague terms don’t address the full range of heart attack symptoms, consider the patient’s overall risk profile, or provide clear next steps for evaluation and management, especially when the pain is not clearly heart-related.

The AHA/ACC Joint Committee writing team employed more precise terms that create a higher level of urgency and identify clear next steps for obvious and less-obvious symptoms. Following the new guidelines, chest pain should be categorized as:

Cardiac: The heart or a blocked blood vessel is the clear cause of the patient’s symptoms. This category could include heart attack symptoms or angina , an indicator of coronary artery disease .
Possible cardiac: It’s unclear whether the pain is heart-related. This could include severe, persistent, or come-and-go pain, or other worrisome symptoms that can’t immediately be identified as heart-related pain.
Non-cardiac: The pain is clearly not of cardiac ischemic origin. It could be a mild problem, such as inflammation of the pectoral tissue or an anxiety attack, or a life-threatening condition such as a pulmonary embolism or ruptured aorta.

Under the new guidelines, providers can use these more accurate, patient-centered definitions – along with a specific, high-tech blood test – to reduce unnecessary imaging or procedure-based tests.

Related reading: How PCI stenting can reduce chest pain and heart attack damage – without surgery

Chest pain guidelines

"The new chest pain guidelines sunset the case-by-case diagnostic process of ordering myriad tests and invasive procedures that cost patients time and money.”

– Jose Joglar, M.D.

The new guidelines recommend that all patients with chest pain get a specific blood test to diagnose or rule out a heart attack.

Developed in part at UT Southwestern, the high-sensitive serial assessment of cardiac troponin (cTn) blood test can detect troponin T in the blood. This protein shows whether the patient is having a heart attack, had one recently, or has incurred heart muscle damage.

Providers can then order appropriate tests by combining information from the patient’s cTn results, category of chest pain, and personal heart disease risk factors, such as:

Age, since cardiovascular risk increases over time
History of coronary artery disease, a major risk factor for heart disease
Overall health
Persistent chest pain despite previous medical treatment
Symptom severity

The blood test results are typically available in about an hour, so this personalized approach can reduce wait times in the ER, overall saving hours of wait time. Patients quickly receive customized care, saving time and money.

Related reading: Medication as effective as stents, bypass for treating blocked arteries

Medical publications have suggested that women’s heart attack symptoms are vastly different from men’s. The most persistent myth is that women’s chest pain is less likely than men’s to be heart-related.

The new guidelines debunk this myth. AHA and ACC Joint Committee research shows that approximately 70% of women and men experience chest pain during heart attacks . Women, however, also feel more associated symptoms than men, such as radiating pain in the shoulder, arm, and jaw.

Chest pain should always be treated as an emergency. These guidelines explicitly state that patients and providers should never assume chest pain is not heart-related simply because the patient is a woman.

According to the guidelines: “Chest pain is the most common symptom among both men and women diagnosed with acute coronary syndrome (ACS). However, women more commonly have accompanying symptoms including nausea, palpitations, and shortness of breath.”

The bottom line

If you or a loved one experience chest pain, radiating torso pain, or sudden symptoms such as nausea, vomiting, or sweating, call 911 or immediately go to your closest hospital .

Emergency care teams are trained to stabilize you and quickly determine the best next steps – such as transferring you to a specialized heart center.

The new chest pain guidelines, which were developed with the expertise of the AHA, ACC, and care teams at specialized centers such as UT Southwestern, will standardize and streamline the level of patient care – and help providers make timely decisions when patients need advanced treatment

For non-emergency questions or to talk with a doctor about your personal heart disease risk factors, call 214-645-8300 or request an appointment online .

Broken heart syndrome is mysterious, but real

Sharon Reimold, M.D.

February 12, 2024

Heart; Kidneys

CKM syndrome: The intersection of obesity, diabetes, heart and kidney diseases

Amit Khera, M.D.

February 1, 2024

It’s time to get heart failure patients the medications they need

Jennifer Thibodeau, M.D.

November 3, 2023

Heart; Men's Health; Prevention; Women's Health

Lipid apheresis helps control chronic high cholesterol and FSGS

September 22, 2023

What to do if someone collapses (or crumples) during exercise

Ben Levine, M.D.

July 26, 2023

Brain; COVID; Heart

POTS or Long COVID? How to tell the difference

Meredith Bryarly, M.D.
Steven Vernino, M.D., Ph.D.

June 12, 2023

Heart; Prevention

Beyond weight loss: GLP-1 RAs reduce heart attack, stroke risk for Type 2 diabetes patients

April 17, 2023

Three parallel advances usher in new age of cardiac amyloidosis care

Justin Grodin, M.D., M.P.H.

March 24, 2023

Appointment New Patient Appointment or 214-645-8000

Share via Facebook facebook
Share via Twitter twitter
Share via LinkedIn linkedin
Share via Email email
Print this page print

PATIENT PORTAL
BOOK AN APPOINTMENT

Is My Chest Pain Serious Enough To Go To The ER?

Chest pain of any kind can understandably be frightening. While some episodes of chest pain may be harmless, other times, chest pain may indicate a serious problem that requires almost immediate medical attention. The expert team of board-certified ER physicians and professional medical staff at iCare ER & Urgent Care provide prompt diagnosis, effective treatment, and potentially life-saving care for patients experiencing chest pain in Frisco or Fort Worth, TX. Use this helpful information to better understand what may be causing your symptoms and when it is appropriate to visit an emergency room for chest pain.

What causes chest pain?

Acute, prolonged, or recurrent chest pain can be caused by a number of conditions, ranging from harmless to life-threatening. Some of the most common causes of chest pain include:

Cardiac condition
Stress and anxiety
Costochondritis
Lung problems
Heart attack

In addition, pain in the chest can range from mild to severe and can be characterized by burning, stinging, stabbing, aching, throbbing, pressure, compression, sharpness, tightness, or dullness.

Is chest pain dangerous?

Not all instances of chest pain are associated with a dangerous problem or condition, though some certainly are, which can make it difficult to understand when a trip to the ER is warranted. To further complicate matters, the severity of chest pain symptoms does not always equate to the severity of the underlying process. For example, chest pain associated with a relatively harmless condition, such as heartburn, might feel severe enough to make a person think he or she is experiencing a cardiac problem. Because the cause of chest pain can be particularly difficult to self-diagnose, patients should always visit their nearest ER when experiencing unexplained, severe, prolonged, or otherwise concerning chest pain.

When should I go to the ER for chest pain?

A visit to the ER for chest pain can potentially save your life. If you are experiencing chest pain that is accompanied by any of the following symptoms, immediate diagnosis and treatment in the ER may be critical:

Difficulty breathing
Nausea or vomiting
Vertigo or dizziness
Pressure, tightness, or squeezing sensation in your chest
Pain radiating to the arms, back, or jaw
Abnormally high or low heart rate
Heart beating rapidly at rest
Loss of color (paleness)
Loss of consciousness

If you have unexplained, severe, or prolonged chest pain, if your chest pain is accompanied by any of the above symptoms, or if you are concerned about your chest pain, visit your nearest ER immediately. iCare ER & Urgent Care offers two convenient locations in Fort Worth and Frisco, TX with a unique dual-hybrid structure, allowing patients to obtain prompt care and get the most appropriate, cost-effective form of treatment.

How do I know if I’m having a heart attack?

Without a doubt, the most common sign or symptom of a heart attack is chest pain. However, you may be surprised to learn that some men and women experience heart attacks without chest pain. With or without severe chest pain, a heart attack can still be life-threatening and requires immediate attention. Common signs and symptoms of a heart attack include:

Shortness of breath or difficulty breathing
Pain that radiates to the arms, back, or jaw
Sweating or cold/clammy feeling

It is important to keep in mind that a heart attack does not feel the same for everyone. If you think you may be having a heart attack or have had a heart attack, visit your nearest ER as soon as possible.

Chest pain shouldn’t be ignored. Visit your nearest Frisco or Fort Worth ER for chest pain now

When it comes to chest pain , every second can count. Don’t leave your health, safety, and comfort to chance. If you are having chest pain, visit your nearest iCare ER & Urgent Care facility in Fort Worth or Frisco to receive the most advanced care and treatment available by our exceptional team of board-certified ER physicians.

When Should I Go to the ER for Chest Pain?

Chest Pain & Heart Attack

Nov 17, 2020

If you’re experiencing a medical emergency please don’t hesitate to call 911 for immediate medical attention. The best person to help you assess what is going on is your medical provider or an emergency department if it’s an acute need.

The following advice should only serve as a guideline and to help facilitate a conversation with your healthcare provider for your unique situation.

Do not get behind the wheel if you think you’re having a heart attack . Call 911 for immediate assistance or have someone drive you to the nearest Complete Care Emergency Room.

Common causes of chest pain

Not every instance of chest pain is related to heart disease or a heart attack, common, less serious chest pain causes include:

Pulling a muscle
Acid reflux

* If you know you are an anxious person or have been diagnosed with anxiety, try something to help you rule out a heart attack. If you can run up and down some stairs without abnormal shortness of breath, then you’re probably alright.

A common misconception is that heart attacks always occur suddenly. However, in reality, many patients have signs that something is wrong with their heart for weeks or even months before they actually have a cardiac event.

Taking note of any mild symptoms and seeking medical guidance from a healthcare provider can help prevent areas of concern when it comes to heart health: worsening heart disease or heart attacks. In addressing your heart concerns with a provider, you can often answer the question of “should I go to the ER for chest pain?” with a little less worry.

The most common signs of a heart attack

Pain in your chest

A gradual onset of pain that lasts for a long amount of time is more likely to be a sign of a heart attack than a few seconds of a sharp stabbing pain. Heart attack chest pain also gradually diffuses outward with a constant pain in the middle. Heart-attacks are often associated with a pain that is an intense pressure — almost like someone is sitting on your chest. This pain will go beyond an uncomfortable sensation of pressure, squeezing, or fullness. The pain can also radiate to your throat, jaw, or left arm.

Sudden nausea, cold sweating or heat/flushing

Nausea, cold sweats, or intense sweating accompanied with chest pain should prompt you to take immediate medical attention and call 911 or get to the ER as quickly as possible.

Shortness of breath that gets worse lying down

Feeling like you can’t catch your breath, especially if it gets worse with movement or exercise, can be a sign of a heart attack as well. The breathlessness also gets worse when you lie down and improves when sitting up, and is due to your heart not being able to pump enough blood to meet your body’s needs.

Dizziness, lightheadedness or fainting

During a heart attack your brain gets less blood due to a drop in blood pressure. This drop in pressure can cause dizziness.

Abnormal heartbeats

A feeling as if your heart beats are too fast or slow for what is typical can be an indication of heart disease or heart attack. If you have a history of heart disease, it is wise to invest in a device that monitors your heart rate so you can discuss what you’re experiencing with your healthcare provider.

Risk factors for a heart attack

Some people are more likely to have a heart attack based on genetics and lifestyle. You should schedule an appointment with a cardiologist before a potential incident occurs if you have any of the following.

High cholesterol
High blood pressure
Addiction to smoking
Family history of heart disease
You are over 40 years old

Signs you might not need an ER visit for chest pain

How do I know if my chest pain is serious? It’s difficult to provide a definite set of signs and symptoms that indicate emergency treatment is necessary (or not). Anything that is out of the ordinary for you should be followed up with a healthcare provider as soon as possible. Less serious signs of chest pain include:

Your pain lasted for a short period of time (e.g, quickly went away)
Your chest pain is not accompanied with any other symptoms
Your pain only occurs when you move a certain way
You were cleared by a medical professional when experiencing similar pain recently

What is the emergency room chest pain protocol?

When you arrive at a healthcare facility, any symptom that sounds like it might be a heart attack will lead to a standard set of tests and examinations. The first thing done is an EKG upon your arrival at Complete Care to monitor for abnormalities.

The next step is an evaluation by a doctor who will review your medical history and current complaints (details about the location, duration, and intensity of your symptoms).

A blood test will be ordered to look for other causes and to measure troponin, a protein that rises in response to heart muscle damage. Depending on your chief complaints, chest x-rays can also be ordered to look for alternative causes of chest pain, such as pneumonia.

Call 911 or visit your nearest Complete Care ER for help

Now that you know when you should go to the ER for chest pain, pay close attention to your symptoms. Seconds can save lives.

The professional and patient-centered team at Complete Care is here to help you, whether it’s for chest pain or other emergencies. Our stand-alone facilities are fully equipped to handle the same emergencies as any ER attached to a hospital, but without the typical wait time.

If you or someone you love is experiencing chest pain and aren’t sure what to do, visit our nearest location for fast and reliable treatment. No appointment, no wait.

Share this on

The website will be down for maintenance from 6:00 a.m. to noon CDT on Sunday, June 30.

Am Fam Physician. 2023;107(2):204-206

Author disclosure: No relevant financial relationships.

Key Points for Practice

• Attempt to perform 12-lead ECG in patients with chest pain within 10 minutes of arrival to a clinic or emergency setting.

• Use a clinical decision pathway to identify patients with low-risk chest pain who can be discharged from the emergency department.

• If available, use CCTA preferentially over stress testing for patients with intermediate-risk chest pain to determine the need for invasive coronary angiography. For patients with high-risk chest pain, provide referral for invasive coronary angiography.

• In patients with known CAD, focus on controlling blood pressure and cholesterol. Consider CCTA to document CAD progression in patients with previous testing demonstrating nonobstructive lesions.

From the AFP Editors

Chest pain leads to about 4 million outpatient visits per year and is the second most common reason for emergency department care, with nearly 7 million visits per year. Although most chest pain is noncardiac, more than 18 million people in the United States have coronary artery disease (CAD), leading to more than 1,000 deaths per day. The American Heart Association/American College of Cardiology (AHA/ACC) updated guidelines for management of chest pain, which are endorsed by five other cardiology groups. The guidelines provide new recommendations on what to consider chest pain and when to avoid testing in patients at low risk, and they endorse use of published decision pathways to determine the order and extent of workup.

Initial Evaluation

Chest pain can present as pain, pressure, tightness, or discomfort in the chest, shoulders, arms, neck, back, upper abdomen, or jaw and less commonly as shortness of breath, nausea, or fatigue without pain. Chest pain is considered acute with new onset or if it involves a change in pattern, intensity, or duration; it is considered stable if it is chronic with unchanging triggers such as exertion or emotional stress. Patients commonly describe ischemic chest pain as pressure, squeezing, heaviness, tightness, exertional, stress-related, or retrosternal. Pain that is sharp, fleeting, pleuritic, positional, or shifting locations is less likely to be of cardiac origin. These guidelines suggest describing chest pain as cardiac; possible cardiac; or noncardiac. The descriptor atypical is no longer used because it can be interpreted by patients as being benign.

Initial evaluation should focus on ruling out life-threatening illnesses such as acute coronary syndrome (ACS), aortic dissection, and pulmonary embolism, which are often not indicated by pain severity. Response to nitroglycerin is not an accurate means of ruling in cardiac chest pain. Patients with diabetes mellitus, women, and older patients more often present with associated nausea, fatigue, and shortness of breath. ACS should be considered when patients older than 75 years present with shortness of breath, syncope, mental impairment, or abdominal pain, or if they experience an unexplained fall.

People from ethnic and racial minorities experience delays in diagnosis of a cardiac cause and treatment of chest pain. A higher proportion of Black patients presenting with chest pain have a cardiac etiology, but they are less likely to receive appropriate diagnostic testing and urgent treatment. Treatment disparities are also found in Hispanic and South Asian patients and in people who are uninsured or are insured by Medicaid.

Diagnostic Evaluation

Initial evaluation should involve 12-lead electrocardiography (ECG), which is recommended within 10 minutes of arrival in clinic and emergency settings. Because up to 6% of patients with cardiac ischemia are discharged from the emergency department after a single normal ECG, repeat testing should be considered in patients with normal ECG but a higher index of suspicion. Adding leads V7 to V9 should be considered on repeat testing to assess for posterior wall ischemia. ST elevation, hyperacute T waves, left bundle branch block, and ST depression are the most concerning findings for cardiac chest pain.

Physical examination can sometimes demonstrate life-threatening causes of chest pain, including diaphoresis and tachypnea suggesting ACS, tachycardia and dyspnea suggesting pulmonary embolism, and subcutaneous emphysema suggesting esophageal rupture. Chest tenderness on palpation or pain with inspiration suggests a noncardiac etiology.

Radiography can demonstrate chest pain etiologies such as pneumonia, pneumothorax, and rib fracture. Although it may suggest aortic dissection, lack of a widened mediastinum cannot rule out dissection. Prompt transthoracic echocardiography is recommended, if available, for rapid evaluation of cardiac function.

High-sensitivity cardiac troponin is the most accurate and early marker of cardiac injury. The creatine kinase myocardial isoenzyme and myoglobin are not useful for myocardial injury diagnosis or prognosis.

Risk Stratification Testing

Cardiac computed tomographic angiography (CCTA) can be used to identify obstructive CAD that increases the risk of major coronary events in patients younger than 65 years or without known obstructive CAD. Stress testing should be considered for patients older than 65 years, those with inconclusive anatomic studies, or when more obstructive CAD is suspected.

Anatomic testing with CCTA and invasive coronary angiography demonstrates the extent of obstructive disease. Adding a calculation of fractional flow reserve with computed tomography to CCTA provides an estimation of lesion-specific ischemia. Invasive coronary angiography identifies obstructive stenosis and allows revascularization. CCTA has an effective dose of 3 to 5 mSv, compared with 4 to 10 mSv for angiography. CCTA without stenosis or plaque has a warranty period of two years for similar symptom frequency and negative troponin testing.

Stress imaging can include exercise or pharmacologic stress and assessment with ECG, echocardiography, nuclear imaging with positron emission tomography, single photon emission computed tomography, or cardiovascular magnetic resonance imaging (MRI). Positron emission tomography is more accurate than single photon emission computed tomography and should be used if available. Cardiovascular MRI can also accurately assess global and regional left and right ventricular function, detect and localize myocardial ischemia and infarction, and determine myocardial viability in patients not able to exercise. A normal stress test has a warranty period of one year for similar symptom frequency and negative troponin testing.

Exercise can be used for any patient who is not frail and can achieve at least five metabolic equivalents, which is required to do many activities of daily living. Patients who cannot meet both requirements should receive pharmacologic stress testing. Exercise ECG testing should be avoided in patients with ECG findings of 0.5-mm ST depression, left ventricular hypertrophy, paced rhythm, left bundle branch block, Wolff-Parkinson-White pattern, or digitalis use. Exercise ECG testing is equally predictive of future events as stress imaging, despite lower sensitivity for obstruction. Failure to exceed five metabolic equivalents or to achieve 85% of predicted heart rate suggests a poor prognosis, whereas exceeding 10 metabolic equivalents confers a low risk of cardiac events. Positive exercise ECG results can be further clarified by CCTA or functional fractional reserve testing.

All risk stratification modalities have a low radiation risk to the fetus and can be used in pregnant patients. Iodinated contrast enters fetal circulation and should be used with caution in pregnant patients. Patients can continue to breastfeed because only 1% of iodinated contrast is excreted into breast milk and absorbed. Gadolinium contrast in cardiovascular MRI should be used only when necessary.

Clinical Decision Pathways

Decision pathways based on high-sensitivity troponin levels, such as the HEART Pathway, EDACS, mADAPT, NOTR, or the 2020 European Society of Cardiology pathway, should be used to determine the need for testing and hospitalization. Using these pathways can decrease hospital admission and unnecessary testing by up to 43%. A second high-sensitivity troponin test should be ordered one to three hours following the first.

Low-risk patients with acute chest pain do not benefit from stress testing or cardiac imaging within 30 days of initial visit. Coronary artery calcium scoring is not routinely needed; a score of 0 denotes low risk, although positive scores do not reliably identify patients at increased risk.

For patients without known CAD at intermediate risk, CCTA is recommended with a negative or inconclusive ACS workup and for patients with a mildly abnormal stress test within the past year. CCTA allows for rapid diagnosis and discharge with similar outcomes as stress testing. CCTA decreases time to diagnosis by 50% compared with nuclear stress testing. Negative stress testing rules out the need for anatomic testing. Exercise ECG testing and stress echocardiography are most likely to reduce length of stay.

Intermediate-risk patients with known CAD and acute chest pain should have blood pressure and cholesterol management maximized before additional testing. CCTA can document CAD progression in patients with previous testing demonstrating nonobstructive lesions. Patients with a history of high-risk CAD or worsening frequency of symptoms who have optimized blood pressure and cholesterol management should be evaluated with invasive coronary angiography.

High-risk patients with acute chest pain should receive invasive coronary angiography.

Evaluation of Patients With Stable Chest Pain

In patients with stable chest pain, the risk algorithm from the CAD Consortium ( https://reference.medscape.com/calculator/287/pre-test-probability-of-cad-cad-consortium ) guides testing. Low-risk patients will not need further testing.

For patients at intermediate or high risk, CCTA is preferred; stress testing involving echocardiography or nuclear testing can be used instead of cardiovascular MRI.

Stress testing should be considered in patients with known obstructive CAD and continuing stable chest pain only if blood pressure and cholesterol management is optimized. Invasive coronary angiography should be considered to help guide pharmacologic therapy in patients with a history of coronary artery bypass grafting and concern for myocardial ischemia and in patients with indeterminate or nondiagnostic stress test results.

In patients with suspected ischemia despite no obstructive cardiac disease, positron emission tomography, cardiovascular MRI, or angiography may help tailor medical therapy to improve quality of life, although they have not been demonstrated to reduce future cardiac events.

Nonischemic Chest Pain

Immediate echocardiography should be used in patients with suspected nonischemic causes of chest pain such as aortic dissection, pericardial effusion, and pulmonary embolism. If echocardiography rules out life-threatening injury, computed tomography or cardiovascular MRI can be used to confirm a suspected diagnosis.

In patients with nonischemic causes of chest pain, gastrointestinal causes, depression, and anxiety should be considered. Up to one-fifth of people presenting with chest pain have a gastrointestinal cause. In patients with low-risk chest pain, depression, anxiety, and gastrointestinal disease each exceed CAD by a factor of 10. Although mental health referrals are rare even when patients report anxiety, psychotherapy for these patients reduces chest pain frequency by one-third.

Guideline source: American Heart Association/American College of Cardiology

Published source: J Cardiovasc Comput Tomogr . January/February 2022;16(1):54–122

Available at: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001029

Editor's Note: These guidelines are an important update because they clarify risk stratification of chest pain in two ways. First, AHA/ACC recommends that testing be guided by cardiac risk using one of the many clinical decision pathways, which are simple risk algorithms that use high-sensitivity troponin and clinical characteristics. If you do not have a favorite risk algorithm, the HEART pathway is easy to use and is available through MDCalc ( https://www.mdcalc.com/calc/3975/heart-pathway-early-discharge-acute-chest-pain ). It optimizes the accuracy of identifying more patients at low risk. Also, these guidelines clarify that CCTA should be our default risk stratification method for intermediate-risk patients with acute chest pain because it saves time compared with nuclear stress testing with lower cost and radiation exposure compared with invasive angiography.—Michael J. Arnold, MD, Contributing Editor

The views expressed are those of the authors and do not necessarily reflect the official policy or position of the U.S. Department of the Navy, Uniformed Services University of the Health Sciences, U.S. Department of Defense, U.S. Department of Veterans Affairs, or the U.S. government.

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, Assistant Medical Editor.

A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide .

Continue Reading

More in AFP

10 Symptoms That Warrant A Trip To The ER

It can be hard to tell when your best bet is to rush to the emergency room.

When you wake up in the middle of the night with an alarming symptom—maybe it's a high fever or splitting headache—it's hard to know whether to rush to the emergency room or not. You don't want to overact, but you definitely don't want to underreact either. So how do you know when that stomach pain needs to be treated ASAP or if that numb feeling can wait until morning to deal with? We spoke to Ryan Stanton, MD, a board-certified emergency physician and spokesman for the American College of Emergency Physicians to find out.

Head to the ER if... the pain is intense and sudden. "Is it the worst headache of your life? Did it come on suddenly like you were struck by lightning or hit in the head with a hammer?" says Stanton. "These are the two major questions we will ask to gauge the risk for a potentially deadly cause of headache known as subarachnoid hemorrhage." A headache is also worrisome if it is accompanied by a fever, neck pain, or stiffness and a rash, which could signal meningitis.

Abdominal Pain

From tummy aches to belly bloat, abdominal pain is the number one non-injury reason for adult emergency room visits, according to the National Hospital Ambulatory Medical Care Survey. The pain can be caused by a number of factors from gas or a pulled muscle to the stomach flu or more serious conditions like appendicitis or urinary tract infections.

Head to the ER if... you're experiencing intense localized pain, especially in the right lower part of your abdomen or your right upper region, explains Stanton, as this could hint at an issue with your appendix or gallbladder that may require immediate surgery. Other concerning symptoms are abdominal pain accompanied by an inability to keep down any food or fluids; blood in the stool; or a severe and sudden onset of the pain.

With heart attacks as the number one killer for both American men and women, it's no surprise that sudden chest pain can be scary and is one of the leading causes of emergency room visits for adults. "Heart attacks are at the top of the list due to their frequency and potential risk," says Stanton.

Head to the ER if... you are experiencing chest pain along with shortness of breath, decreased activity tolerance, sweating, or pain that radiates to the neck, jaw, or arms—especially if your age or family history puts you at a higher risk for heart attacks. "This is not a time for the walk-in or urgent care clinic," says Stanton. "They will just take a look and send you to the ER since they don't have the ability to deal with cardiac-related issues."

Infection can run the spectrum from a simple infected skin wound to serious forms such as kidney infections. The vast majority of infections are viral, which means they won't respond to antibiotics and can be treated at home with over-the-counter symptom management until the virus passes. The key then is to look at the severity of the symptoms. "The more severe infections are sepsis (infection throughout the body), pneumonia , meningitis, and infections in people who have weakened immune systems," says Stanton.

Head to the ER... based on the severity of your symptoms. "You want to show up at the ER if there are any concerns, such as confusion, lethargy, low blood pressure , or inability to tolerate any oral fluids," says Stanton. "These may suggest a more sinister infection or may just need a little emergency room TLC, such as medications to help with symptom management, fluids, or possibly antibiotics, to turn the corner."

Blood in your stool or urine

Blood shouldn't ever be found in your stool or urine, so even if your symptoms don't require a trip to the ER, it's important to make an appointment with your physician as soon as possible to determine the source and decide on a treatment plan. "Blood in the urine is usually caused by some kind of infection such as a urinary tract or kidney infection or kidney stones," says Stanton. "When it comes to stool, it's often benign, but it can be the sign of something very dangerous." The number one cause is hemorrhoids followed by fissures, infections, inflammation, ulcers, or cancer. If you have a little blood with no other symptoms, make an appointment to talk with your doctor.

Head to the ER if... you have large amounts of blood in your stool or urine, or if you have blood in your stool or urine in addition to other symptoms such as a fever, rash or fatigue, intense pain, or evidence of a blockage.

Difficulty Breathing

"Shortness of breath is one of the most common emergency department presentations," says Stanton. The most common causes are asthma, Chronic Obstructive Pulmonary Disease ( COPD ) from smoking or infections such as pneumonia. When it comes to shortness of breath, it's pretty straightforward, says Stanton. "If you can't breathe, get to the ER."

Head to the ER ... always.

Cuts, Bumps & Falls

Whether it's a knife accident chopping veggies for dinner or a misstep off the deck stairs, many cuts, bumps, and bruises can be handled at home with ice or a home first aid kit supplies.

Head to the ER if... what's supposed to be on the inside is on the outside, or what's supposed to be on the outside is on the inside, says Stanton. If you can see muscle, tendons, or bone, it requires more than just a BandAid. "It's important to get these addressed because they are fraught with potential secondary complications from infection to loss of function and ischemia [reduced blood flow]," warns Stanton.

While not pleasant, vomiting is a common symptom that can be caused by various conditions, most often viral gastroenteritis ("stomach flu") or food poisoning. Usually, vomiting can be managed with home care and a check-in with your primary care doctor.

Head to the ER if... there is blood in the vomit, significant stomach pain, or dark green bilious vomit which could suggest bowel obstruction. Another important factor with vomiting is dehydration. "If you are unable to keep anything down, you will need to get medication or treatments to help you stay hydrated," explains Stanton. "Young children can become dehydrated rather quickly, but most healthy adults can go several days before significant dehydration becomes an issue."

"Rarely is a fever anything other than an indication that you are ill," Stanton explains. It's actually a healthy sign that your body is responding to an infection. The concern then is not with the fever itself, but with what infection is causing the fever. Don't hesitate to treat it with over-the-counter medicines such as ibuprofen.

Head to the ER if... a fever is accompanied by extreme lethargy or there are other symptoms of infection present. Most concerning to Stanton are "fevers in kids with lethargy, fevers in adults with altered mental status, and fevers with headache and neck pain ."

Loss Of Function

Numbness in your legs, slack facial muscles, a loss of bowel control—if a certain body part or body function stops working suddenly or over time, it's worth finding out why.

Head to the ER... always, recommends Stanton. "Whether it is due to a trauma or just develops over time, any loss of function requires immediate evaluation." The two most common causes are physical trauma and stroke, both of which are serious and require medical attention. "When something is not working, don't try to 'sleep it off'," advises Stanton. "If it doesn't work, there is a reason, and we need to see if we can diagnose, reverse, or prevent ongoing problems."

The bottom line for any symptom: If you truly can't decide what to do, it's better to be safe than sorry. "Any time you have a concern or emergency, it's always better to get checked than to wait until the problem escalates," recommends Stanton.

Other things to consider

While not symptoms, per say, according to the National Institutes of Health , you should always head to the ER if you:

Inhaled smoke or poisonous fumes
Consumed a toxic substance or overdosed on a medication or drug
Possibly broke a bone
Are having seizures
Suffered a serious burn
Had a severe allergic reaction and are have trouble breathing, swelling, or hives
Are having suicidal thoughts

Weird Health Symptoms

8 Signs of a Blood Clot You Should Never Ignore

Your Hormones May Be Why You Can’t Lose Belly Fat

13 Reasons Your Legs Keep Cramping at Night

swollen fingers computer keyboard and repetitive strain injury

12 Reasons You Have Swollen Fingers

10 Signs of Acid Reflux Everyone Should Know

Everything You Should Know About Hemorrhoids

8 Things Your Body Hair Says About Your Health

Should I Worry About My Eyes Acting Weird?

How Can I Tell if I Have Nerve Damage?

Set of colorful realistic mat helium balloons floating on pink background. Vector 3D balloons for birthday, party, wedding or promotion banners or posters. Vivid illustration in pastel colors.

How to Get Rid of Gas, Pain, and Bloating Fast

9 Lung Cancer Symptoms You Should Never Ignore

Price Transparency
Medical Professionals

Don't delay: 12 signs you should go to the emergency room

Figuring out whether a condition requires emergency care can sometimes be tricky. Here are 12 of the most common symptoms that warrant a trip to the emergency room.

Teen girl listens as doctor explains test results - stock photo

The advice is seemingly everywhere — only go to the emergency room (ER) for a true emergency. But how can you know what’s an emergency and what’s not? We’ve gathered 13 symptoms that are definitely ER-worthy. This list of symptoms is not complete but does cover the most common questions people have when deciding whether to visit an ER.

Remember — If you are alone and experiencing emergency symptoms, don’t try to drive yourself to the ER. Call 911. It’s also a good idea to call for emergency assistance if you are alone with a child having symptoms or if you can’t safely move the person in need or drive them.

1. Some headaches

If you can describe a sudden headache as your “worst headache ever,” call 911. Of course, that “worst headache ever” could just be your first migraine, but it could also be a sign of bleeding in the brain ( aneurysm or stroke ). You don’t want to take that risk.

Even non-severe headaches can be a reason to head to the emergency room. Seek immediate medical attention for any of the following:

Headaches coupled with dizziness, vision problems, slurred speech or loss of balance
Headaches coupled with fever, stiff neck or vomiting
Headaches that appear after you have been sick recently or are taking medications that suppress your immune system
Headaches that emerge after hitting your head
Headaches that feel different or unusual from other migraines or severe headaches that you’ve experienced and are not relieved by your usual treatment methods

2. Sudden or severe dizziness, confusion and/or clumsiness

Mild dizziness or forgetting where you put your glasses (when they’re on your head) don’t qualify. You can bring those up to your doctor at your next office visit, or go to an urgent care for a quick checkup. The important words here are “sudden” or “ severe.”

If any of these symptoms come on suddenly or are severe, call 911 or head to an ER:

Clumsiness, loss of balance or fainting
Difficulty speaking or trouble understanding speech
Unexplained loss of consciousness

3. Seizures (without previously diagnosed epilepsy)

When it comes to seizures, it’s a good idea to lean on the side of caution.

Call 911 or go to the ER in the event of a seizure, unless the person has a diagnosed seizure disorder (e.g., epilepsy) . For people with such disorders, seizures are not usually a cause for alarm. An action plan can help inform family and friends what to do during a seizure and when it's an emergency. Still, if you witness a seizure and don't know if the person has a seizure disorder, play it safe and call 911.

4. Head injury

Any significant bump to the head should trigger a medical visit.

Sometimes, the most serious symptoms don’t start for hours or days after the injury. Head to the ER if you have any of these after a head injury:

Different size pupils (the black portion of the eye)
Dizziness/loss of consciousness
Extreme fatigue or sleepiness
Inability to move arms or legs
Ringing in the ears
Severe headache or neck/muscle stiffness
Severe mood swings

For babies under three months old, any temperature higher than 100.4°F is cause for an ER visit.

Most fevers don’t require emergency care. However, if they match any of the following criteria, call 911 or head to the nearest ER:

Accompanied by other severe symptoms (e.g., racing heartbeat, stiff neck, rash, trouble urinating, swollen legs, weakness, fainting, diarrhea and/or vomiting)
Not responding to over-the-counter medications like acetaminophen or ibuprofen
Over 104°F in adults

6. Chest pain

Chest pain, even if it feels more like pressure or squeezing, is worthy of an ER visit. Severe and sudden chest pain may occur alone or with other symptoms, such as radiating pain to the arm or jaw, sweating, vomiting or shortness of breath. Chest pain can often signal a heart attack . But even if it is not heart attack-related, chest pain can be a sign of other life-threatening conditions, such as a lung infection .

7. Difficulty breathing

People sometimes refer to everything from a mild cough to severe wheezing as a “breathing problem.” To know whether it’s an emergency, consider these questions.

If any of these answers are “yes,” call 911 or head to the ER:

Did it come on suddenly?
Is it severe?
Is it accompanied by chest pain, nausea, vomiting or fainting?
Does it affect the ability to talk?
Are the lips or fingertips turning blue?

People with asthma or chronic lung disease may be directed by their physicians to go to the emergency room, if their regular medical/action plan does not improve breathing.

8. Severe pain

Any sudden and severe pain anywhere in the body is a signal to head to the ER.

Of most concern is any pain in the abdominal area or starting halfway down the back.

9. Cuts and wounds

All animal bites need emergency medical attention.

Head to the ER for any deep cut, especially on the face, eye or genital area. Also, go to the ER for animal bites and any wound that won’t stop bleeding.

10. Burns

Size, severity and the type of burn determine when to go to the ER.

Go to the ER for burns that:

Are electric or chemical
Are on the hands, face, feet, genitals or joints
Char, blister or leave open skin
Cover a large area of skin, even if the burns are mild

Also, go to the ER if there is any reason to suspect that the person inhaled smoke or fumes.

11. Concerning conditions during pregnancy

If you or a loved one is pregnant and experiences any of these concerning conditions, go the ER:

Abdominal pain accompanied by dizziness
Unusually heavy bleeding
Symptoms of shock (such as agitation, confusion or physical signs of lack of oxygen)

Please note that while bleeding or spotting during pregnancy can be scary, it’s also very common and does not always mean miscarriage. The choice to go to the ER depends on your OB/GYN and the time of day. Typically, your doctor will ask you to come in to figure out the best course of action based on your medical history. But if you experience bleeding and are concerned about it outside of your provider’s hours of operation, it’s a good idea to head to the ER.

12. Testicular pain

Since testicles are very sensitive, even a minor injury can cause discomfort.

Pain in one or both of the testicles can have a number of possible causes. Sometimes, pain felt in the testicles is actually a sign of groin or abdominal issues. Other times, pain in the testicle itself is caused from issues with the supporting tube and tissue.

If issues are sudden and severe, this can be a sign of testicular torsion or a twisted testicle. Testicular torsion can cause the body part to lose its blood supply, resulting in loss of the testicle. If you suspect testicular torsion or if testicular pain is accompanied by nausea, fever, chills, or blood in your urine, it’s important to seek medical attention immediately.

Sometimes, it’s obvious that a situation is an emergency; other times, it’s not. If you think you’re experiencing an emergency call 911 or locate an ER new you immediately.

This blog was written for HCA Healthcare in 2022. It was reviewed and repurposed for the HCA Healthcare Capital Division in 2024.

Emergency room versus urgent care: Which should you go to if you’re hurt or sick?

T hree months ago, I got out of bed, took two steps, and collapsed. I had COVID, which combined with chronic low blood pressure (hypotension) and dehydration, caused me to faint.

I woke up on the floor wondering what happened.

My wife and I immediately began weighing our options. Should I go to a hospital emergency room? An urgent care center? My primary care physician’s office?

We went to the ER. Which was a good choice because I whacked my head when I fell and needed to be checked for internal bleeding. All the tests came back negative and, after being hydrated with saline solution, my blood pressure went up and I went home.

The whole episode opened my eyes to the choices consumers must make when suddenly sick or injured, and how our choices in those stressful moments have serious financial consequences.

Here are some things to know:

Isn’t the ER always the best choice?

No, not if you don’t need it. Going to the ER is very expensive. Under my insurance plan, for example, my trip to the ER in September cost $480 out of pocket. That’s because, for ER visits, my plan requires me to pay my annual $500 deductible before my full coverage kicks in. (I’m covered through my wife’s employer by one of the biggest insurers in the state. I’m including details of my coverage to illustrate the kind of issues many of us face.)

What does the ER cost after your deductible is paid?

My ER copay is $100 — once I’ve met my deductible, which is relatively low. An increasing number of consumers are opting for so-called high-deductible health plans in exchange for lower monthly premiums. For 2023, an HDHP is any plan with a deductible of at least $1,500 for an individual or $3,000 for a family. Consider your health and age in determining what makes sense for your deductible.

Does it matter whether I go to an in-network vs. out-of-network ER?

Actually, no, there is an important exception for ERs: the in-network/out-of-network distinction doesn’t apply to them. Under a federal law called the No Surprises Act , you get whatever coverage you’re entitled to at an in-network ER even if you go out of network. The law, which went into effect in 2022, recognizes that when you’re in urgent need of medical assistance, you usually don’t have the time or presence of mind to consider the network status of the nearest ER.

Does the No Surprises Act apply to urgent care centers?

No, and therefore it’s really important to know the status of the urgent care center you intend to go to. The No Surprises Act covers hospital ERs and licensed independent emergency departments, but generally not urgent care centers.

How much cheaper is it to go to an urgent care center compared with an ER?

A lot cheaper. Under my plan, I pay only a $20 copay for a visit to an in-network urgent care center, and my deductible doesn’t apply. Compare that with my $100 copay for an ER visit (after meeting my deductible).

Why is there such a big cost difference between ERs vs. urgent care centers?

It costs a lot more to run an ER. Yet research shows a large percentage of people who go to ERs don’t need that high level of care. The proliferation of urgent care centers in recent years is motivated by cost savings. Keeping the ER for only those who need it makes good financial sense for all of us.

How do I know which urgent care centers are in-network under my plan?

I recommend logging into your account on your insurer’s website to find a list of in-network urgent care centers. It’s good information to have before an emergency arises. I live in an urban area and my insurer lists several nearby in-network urgent care centers.

How do urgent care centers compare with ERs?

ERs have more physicians and diagnostic tools than an urgent care center, plus the resources of an entire hospital, including specialists. A physician is usually on duty at an urgent care center, but most patients are seen by nurse practitioners and nurses. Urgent care centers usually have an x-ray machine.

What are the differences in hours?

The ER where I went is open 24 hours, 7 days a week. The nearby urgent care center where my wife and I once went to stitch a cut finger is open 8 a.m. to 8 p.m., 7 days a week.

One possible advantage to urgent care centers is that they usually treat patients on a first-come, first-serve basis. At an ER, long waits are common as caregivers prioritize the most urgent cases.

Are there alternatives to ERs and urgent care centers?

Yes, CVS, Walgreens, and other retailers offer care. I routinely go to a CVS MinuteClinic for COVID vaccines and flu shots. My insurer covers these visits at no charge. It also provides treatment for ear and sinus infections, colds, flu, strep throat, and other minor illnesses, plus minor wounds such as non-severe cuts, blisters, and skin abrasions. My copay is $20.

What’s the difference between an urgent care center and a retail clinic?

Both are “walk-in” clinics that don’t require an appointment. Clinics are usually staffed with a nurse practitioner and don’t have the same kinds of diagnostic tools as an urgent care center. Personnel at both can write prescriptions.

What about an office visit with my PCP?

When you are sick or injured, you may want to first call your primary care physician for advice on where to go (presuming the office is open). Your PCP should be familiar with your health history and give personalized advice. Maybe it’s appropriate to deal with your issue by coming into the office. Maybe it’s enough for your PCP to call in a prescription.

After my collapse, my wife called my PCP’s office. A nurse listened to what happened, checked my medical records, then told us to go to the ER because I needed a CT scan to check for a possible brain bleed.

Under my plan, the copay for an office visit is $20 and the deductible doesn’t apply. And there’s no charge for a telephone consultation.

What ailments are generally appropriate for an ER?

To be sure, if you think you’re having a heart attack or stroke, call 911 or get to the nearest ER as fast as possible.

Here’s one list I found online of conditions most likely appropriate for an ER: severe chest pain; severe abdominal pain; wheezing or shortness of breath; paralysis; intestinal bleeding; high fevers or rash, especially among children; vaginal bleeding with pregnancy; repeated vomiting; poisoning; severe head or eye injuries; allergic reactions; and unconsciousness. This is not meant to be a complete list. When in doubt, seek the highest level of care.

What ailments are appropriate for an urgent care center?

As a general guideline, according to a list I found online, these are appropriate: fevers; flu or cold symptoms; ear infections; animal or insect bites; seasonal allergies; bronchitis; sprains and broken bones (most urgent care centers can splint and cast broken bones); cuts and bleeding that may require stitches; vomiting or diarrhea; breathing discomfort, such as moderate asthma; urinary tract infections; x-rays and lab tests; abdominal pain; and minor back pain.

Can I get assistance by phone?

Yes, some insurers (including mine) offer a 24-hour nurse line for questions about symptoms, complications from medication, and advice on where to go for treatment. Check the back of your member ID card or online for more information.

What if I have no insurance?

Federal law requires anyone arriving at a hospital emergency room to be stabilized and treated, regardless of their insurance status or ability to pay.

Medicare pays for 80 percent of ER costs but most people have supplemental insurance to cover this gap. Medicaid covers all ER costs.

What about going to an urgent care center without insurance?

Most urgent care centers and retail clinics require some form of payment at the time of service.

Why do people go to the ER instead of urgent care? It depends largely on what kind of treatment they need.

Skip to main content
Keyboard shortcuts for audio player

Your Health
Treatments & Tests
Health Inc.
Public Health

Bill Of The Month

It’s called an urgent care emergency center — but which is it.

Renuka Rayasam

Emily Siner

In severe pain and uncertain of its cause, Tieqiao Zhang of Dallas says he didn’t want to wait for an appointment with his regular doctor, but he also wasn’t sure if he needed emergency care. He visited a clinic on the campus of Dallas’ largest public hospital — and was charged 10 times what he expected. Laura Buckman/KFF Health News hide caption

One evening last December, Tieqiao Zhang felt severe stomach pain.

After it subsided later that night, he thought it might be food poisoning. When the pain returned the next morning, Zhang realized the source of his pain might not be as “simple as bad food.”

He didn’t want to wait for an appointment with his regular doctor, but he also wasn’t sure if the pain warranted emergency care, he said.

Zhang, 50, opted to visit Parkland Health’s Urgent Care Emergency Center, a clinic near his home in Dallas where he’d been treated in the past. It’s on the campus of Parkland, the city’s largest public hospital, which has a separate emergency room.

Bill of the Month is a crowdsourced investigation by KFF Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it !

He believed the clinic was an urgent care center, he said.

A CAT scan revealed that Zhang had a kidney stone. A physician told him it would pass naturally within a few days, and Zhang was sent home with a prescription for painkillers, he said.

Five days later, Zhang’s stomach pain worsened. Worried and unable to get an immediate appointment with a urologist, Zhang once again visited the Urgent Care Emergency Center and again was advised to wait and see, he said.

Two weeks later, Zhang passed the kidney stone.

Then the bills came.

The patient: Tieqiao Zhang, 50, who is insured by BlueCross and BlueShield of Texas through his employer.

Medical services: Two diagnostic visits, including lab tests and CAT scans.

Service provider: Parkland Health & Hospital System. The hospital is part of the Dallas County Hospital District.

Total bills: The in-network hospital charged $19,543 for the two visits. BlueCross and BlueShield of Texas paid $13,070.96. Zhang owed $1,000 to Parkland — a $500 emergency room copay for each of his two visits.

What gives: Parkland’s Urgent Care Emergency Center is what’s called a freestanding emergency department .

The number of freestanding emergency rooms in the United States grew tenfold from 2001 to 2016 , drawing attention for sending patients eye-popping bills. Most states allow them to operate, either by regulation or lack thereof . Some states, including Texas, have taken steps to regulate the centers, such as requiring posted notices identifying the facility as a freestanding emergency department.

Urgent care centers are a more familiar option for many patients. Research shows that, on average, urgent care visits can be about 10 times cheaper than a low-acuity — or less severe — visit to an ER.

But the difference between an urgent care clinic and a freestanding emergency room can be tough to discern.

Generally, to bill as an emergency department, facilities must meet specific requirements, such as maintaining certain staff, not refusing patients and remaining open around the clock.

The freestanding emergency department at Parkland is 40 yards away from its main emergency room and operates under the same license, according to Michael Malaise, the spokesperson for Parkland Health. It is closed nights and Sundays.

(Parkland’s president and chief executive officer, Frederick Cerise, is a member of KFF’s board of trustees. KFF Health News is an editorially independent program of KFF.)

The hospital is “very transparent” about the center’s status as an emergency room, Malaise told KFF Health News in a statement.

Malaise provided photographs of posted notices stating, “This facility is a freestanding emergency medical care facility,” and warning that patients would be charged emergency room fees and could also be charged a facility fee. He said the notices were posted in the exam rooms, lobby and halls at the time of Zhang’s visits.

Zhang’s health plan required a $500 emergency room copay for each of the two visits for his kidney stone.

When Zhang visited the center in 2021 for a different health issue, he was charged only $30, his plan’s copay for urgent care, he said. (A review of his insurance documents showed Parkland also used emergency department billing codes then. BCBS of Texas did not respond to questions about that visit.)

One reason, “I went to the urgent care instead of emergency room, although they are just next door, is the copayment,” he said.

The list of services that Parkland’s freestanding emergency room offers resembles that of urgent care centers — including, for some centers, diagnosing a kidney stone, said Ateev Mehrotra, a health care policy professor at Harvard Medical School.

Having choices leaves patients on their own to decipher not only the severity of their ailment, but also what type of facility they are visiting all while dealing with a health concern. Self-triage is “a very difficult thing,” Mehrotra said.

Zhang said he did not recall seeing posted notices identifying the center as a freestanding emergency department during his visits, nor did the front desk staff mention a $500 copay. Plus, he knew Parkland also had an emergency room, and that was not the building he visited, he said.

The name is “misleading,” Zhang said. “It’s like being tricked.”

Parkland opened the center in 2015 to reduce the number of patients in its main emergency room, which is the busiest in the country , Malaise said. He added that the Urgent Care Emergency Center, which is staffed with emergency room providers, is “an extension of our main emergency room and is clearly marked in multiple places as such.”

Malaise first told KFF Health News that the facility isn’t a freestanding ER, noting that it is located in a hospital building on the campus. Days later, he said the center is “held out to the public as a freestanding emergency medical care facility within the definition provided by Texas law.”

The Urgent Care Emergency Center name is intended to prevent first responders and others facing life-threatening emergencies from visiting the center rather than the main emergency room, Malaise said.

“If you have ideas for a better name, certainly you can send that along for us to consider,” he said.

Putting the term “urgent” in the clinic’s name while charging emergency room prices is “disingenuous,” said Benjamin Ukert, an assistant professor of health economics and policy at Texas A&M University.

When Ukert reviewed Zhang’s bills at the request of KFF Health News, he said his first reaction was, “Wow, I am glad that he only got charged $500; it could have been way worse” — for instance, if the facility had been out-of-network.

The resolution: Zhang said he paid $400 of the $1,000 he owes in total to avoid collections while he continues to dispute the amount.

Zhang said he first reached out to his insurer, thinking his bills were wrong, before he reached out to Parkland several times by phone and email. He said customer service representatives told him that, for billing purposes, Parkland doesn’t differentiate its Urgent Care Emergency Clinic from its emergency department.

BlueCross and BlueShield of Texas did not respond to KFF Health News when asked for comment.

Zhang said he also reached out to a county commissioner’s office in Dallas, which never responded, and to the Texas Department of Health, which said it doesn’t have jurisdiction over billing matters. He said staff for his state representative, Morgan Meyer, contacted the hospital on his behalf, but later told him the hospital would not change his bill.

As of mid-May, his balance stood at $600, or $300 for each visit.

The takeaway: Lawmakers in Texas and around the country have tried to increase price transparency at freestanding emergency rooms, including by requiring them to hand out disclosures about billing practices.

But experts said the burden still falls disproportionately on patients to navigate the growing menu of options for care.

It’s up to the patient to walk into the right building, said Mehrotra, the Harvard professor. It doesn’t help that most providers are opaque about their billing practices, he said.

Mehrotra said that some freestanding emergency departments in Texas use confusing names like “complete care,” which mask the facilities’ capabilities and billing structure.

Ukert said states could do more to untangle the confusion patients face at such centers, like banning the use of the term “urgent care” to describe facilities that bill like emergency departments.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.  

Emmarie Huetteman of KFF Health News edited the digital story, and Taunya English of KFF Health News edited the audio story. NPR's Will Stone edited the audio and digital story.

emergency department
bill of the month
medical bill

IMAGES

Having Chest Pain? What To Expect At The Emergency Room
What to Expect When You Go to the Emergency Room With Chest Pain
Emergency Chest Pain Treatment
Chest Pain: Causes and Signs of Emergency
New Chest Pain E.R. at Shands provides patients fast, compassionate
Emergency Department Assessment of Acute-Onset Chest Pain

VIDEO

USE THIS On Your Next CHEST PAIN Call
2ND EMERGENCY ROOM VISIT OF THE NIGHT *worse than labor pain
Understanding the Emergency Room
Malpractice Claim Rates Are Associated With Admission of Low Risk Chest Pain
Health news: Contact lens injuries, teen pregnancies, CPR
Preventing Emergency Room Visits: Travis Stork, M.D

COMMENTS

Approach to the adult with nontraumatic chest pain in the emergency
Chest pain is a common emergency department (ED) complaint. Patients present with a spectrum of signs and symptoms reflecting the many potential etiologies of chest pain. Diseases of the heart, aorta, lungs, esophagus, stomach, mediastinum, pleura, and abdominal viscera may all cause chest discomfort. Clinicians in the ED focus on the immediate ...
When Chest Pain Is an Emergency and When It's Not
An aortic dissection, which is a tear along the vessel that delivers blood to the rest of your body, also causes chest pain. The pain can sometimes be a warning sign of a lung blood clot called a ...
What happens when you go to the emergency room for chest pain symptoms
Calling 911 for Chest Pain. A visit to the ER for chest pain can be life-saving. When your chest pain persists, is severe, or is accompanied by shortness of breath, nausea, radiating pain, and changes in heart rate and blood pressure, call 911 immediately.
Do You Need to Go to the ER for Chest Pain?
Certain chest pain symptoms can be more worrisome for a serious condition. But even mild chest pain can be a sign of something life-threatening, like a heart attack. If you are concerned about chest pain, it is best to go to the nearest emergency room for a medical evaluation. Healthcare providers can run tests to tell if your pain is a sign of ...
When Do Chest Pains Warrant a Trip to the ER?
Chest pain is a common symptom in the United States. Each year more than eight million Americans visit the ER because of chest pain. It's the second biggest cause of ER visits. Our team at NJ Cardiovascular Institute, which includes board-certified cardiologist Dr. Kunal Patel, knows that chest pain can be scary. But we also know that not all cases of chest pain warrant a trip to the ER.
New chest pain guidelines to improve ER heart attack diagnoses
According to the Centers for Disease Control and Prevention (CDC), chest pain is the most common reason for trips to the ER, resulting in more than 7 million annual visits. Before October 2021, emergency care professionals had to determine the cause of chest pain by ordering several tests and imaging studies that cost patients time and money ...
Women and Black adults wait longer to be seen in the ER for chest pain
Chest pain is responsible for more than 6.5 million U.S. emergency room visits and 4 million outpatient visits each year, according to chest pain guidelines issued in 2021 by the American College of Cardiology, American Heart Association and others. The recommendations aim to help doctors identify those at highest risk for heart attacks and ...
Heart Attack: What to Expect in the Emergency Room
Pain and discomfort that extend beyond your chest to other parts of your upper body, such as one or both arms, back, neck, stomach, and jaw. Unexplained shortness of breath, with or without chest ...
Chest pain: 27 causes, symptoms, and when to see a doctor
Chest pain is the second biggest cause of emergency room (ER) visits in the United States, leading to over 8 million ER visits every year. Worldwide, chest pain affects 20-40% of the general ...
3 Signs Your Chest Pain Isn't a Heart Attack
Sometimes, chest pain doesn't signal a heart attack. A study of emergency room visits found that less than 6% of people arriving with chest pain had a life-threatening heart issue. That doesn ...
Is My Chest Pain Serious Enough To Go To The ER?
Use this helpful information to better understand what may be causing your symptoms and when it is appropriate to visit an emergency room for chest pain. What causes chest pain? Acute, prolonged, or recurrent chest pain can be caused by a number of conditions, ranging from harmless to life-threatening. Some of the most common causes of chest ...
Emergency Department Volume and Outcomes for Patients After Chest Pain
Background: Chest pain is one of the most common reasons for emergency department (ED) visits in developed countries. Whether higher volume EDs have better outcomes, specifically for patients with chest pain, is unknown and pertinent. Methods and Results: We conducted a study using population-based data on 498 291 patients ≥40 years old, presenting to ED in Ontario, Canada from 2008 to 2014 ...
ACC, AHA Issue Updated Chest Pain Data Standards
WASHINGTON and DALLAS, August 30, 2022 — Chest pain is one of the leading reasons for adult emergency room visits in the United States, accounting for more than 7 million visits annually. Properly identifying and treating dangerous and life-threatening causes of chest pain is critical. The 2021 American Heart Association/American College of Cardiology Guideline for the Evaluation and ...
When Should I Go to the ER for Chest Pain?
The pain can also radiate to your throat, jaw, or left arm. Sudden nausea, cold sweating or heat/flushing. Nausea, cold sweats, orintense sweating accompanied with chest pain should prompt you to take immediate medical attention and call 911 or get to the ER as quickly as possible. Shortness of breath that gets worse lying down.
Women and Black adults waited longer in ER for chest pain evaluation
Embargoed until 4 a.m. CT/5 a.m. ET Wednesday, May 4, 2022. DALLAS, May 4, 2022 — Women (ages 18 to 55) waited longer to be evaluated for chest pain in the emergency room (ER) and received a less thorough evaluation for a possible heart attack than men in the same age range. Similarly, people of color (89% non-Hispanic Black adults in this ...
Chest Pain Evaluation: Updated Guidelines From the AHA/ACC
Chest pain leads to about 4 million outpatient visits per year and is the second most common reason for emergency department care, with nearly 7 million visits per year. Although most chest pain ...
10 Symptoms That Warrant A Trip To The ER
With heart attacks as the number one killer for both American men and women, it's no surprise that sudden chest pain can be scary and is one of the leading causes of emergency room visits for ...
Chest Pain Risk Stratification in the Emergency Department: Current
Introduction. Chest pain is the second leading cause of emergency department (ED) visits in adults in the United States. Each year, there are nearly 11 million chest pain encounters, accounting for approximately 5.5% of all visits to the ED. 1 Although less than 10% of patients with chest pain are diagnosed with acute coronary syndrome (ACS ...
Don't delay: 12 signs you should go to the emergency room
Chest pain, even if it feels more like pressure or squeezing, is worthy of an ER visit. Severe and sudden chest pain may occur alone or with other symptoms, such as radiating pain to the arm or jaw, sweating, vomiting or shortness of breath. Chest pain can often signal a heart attack. But even if it is not heart attack-related, chest pain can ...
Higher Emergency Physician Chest Pain Hospitalization Rates Do Not Lead
Chest pain remains the second most common reason for adult emergency department (ED) visits in the United States, accounting for over 7 million annual encounters. 1 The minority of these visits are related to acute coronary syndrome (ACS). 2 However, stratifying this cohort is challenging with high clinical and medicolegal stakes. 3,4
PDF Most Frequent Reasons for Emergency Department Visits, 2018
The most common specific reasons for treat-and-release ED visits in 2018 were abdominal pain, diarrhea, and other digestive symptoms; acute upper respiratory infections; nonspecific chest pain; and superficial injuries. Six of the 20 most common conditions involved injury—superficial injuries, sprains and strains, open wounds to limbs ...
PDF Emergency Department Visits for Chest Pain and Abdominal Pain: United
centers for disease control and prevention. national center for health statistics. The number of noninjury ED visits rose 22.1%, from 50.5 million in 1999-2000 to 61.7 million in 2007-2008 (not shown). The number of noninjury ED visits for which abdominal pain was the primary reason increased 31.8%, from 5.3 million in 1999-2000 to 7.0 ...
Emergency Department Referral of Patients With Chest Pain for
emergency department visits for chest pain without evidence of acute myocardial injury. These findings further highlight the need for evidence-based guidance regarding the appropriate use of NICT in this population. Key Words: chest pain electrocardiography emergency room visits risk factors troponin
Emergency room versus urgent care: Which should you go to if you ...
Here's one list I found online of conditions most likely appropriate for an ER: severe chest pain; severe abdominal pain; wheezing or shortness of breath; paralysis; intestinal bleeding; high ...
Should You go to Urgent Care or the ER?
When to Visit an Emergency Room Emergency rooms have specialized equipment and procedures to deliver life-saving medical care. If you have a life-threatening injury or illness, the correct medical facility for you is the emergency room. ... you should go to an emergency room right away: Chest Pain. Difficulty breathing. Sudden numbness or ...
It's called an urgent care emergency center
He thought he was walking into an urgent care clinic. Then he got an ER bill : Shots - Health News Suffering stomach pain, a Dallas man visited his local urgent care clinic — or so he thought ...

Learn how UpToDate can help you.

CALCULATORS

When Chest Pain Is an Emergency and When It's Not

Simple or Serious?

When to Consult Your Doctor

When to Call 911

Sharing is Nice

What happens when you go to the emergency room for chest pain symptoms?

Possible Causes of Chest Pain

Heart-Related Causes

Gastrointestinal Causes

Lung-Related Causes

Musculoskeletal Causes

When is chest pain serious enough to go to the ER?

What Happens When You Go to the ER for Chest Pain

Calling 911 for Chest Pain

Questions You May Be Asked in the ER about your Chest Pain symptoms

Tests and Exams for Chest Pain Symptoms

Treatment and Emergency Cardiology Procedures

Treatment for Chest Pain After the ER

Emergency Care Close to Home

When Do Chest Pains Warrant a Trip to the ER?

Common causes of chest pain

Coronary artery disease

Chest pain not caused by heart disease

When to visit the ER for chest pain

Treating your chest pain

You Might Also Enjoy...

5 Simple Changes to Boost Your Heart Health

The Link Between Hormonal Changes and Heart Palpitations

Are Varicose Veins Dangerous to My Health?

I'm Nervous About My Stress Test: What Can I Expect?

The Dangers of High Blood Pressure

Chest Pain During Cardio: What You Need to Know

New chest pain guidelines to improve ER heart attack diagnoses

Defining precise, patient-centered terminology

Chest pain guidelines

The bottom line

More from Heart

Broken heart syndrome is mysterious, but real

CKM syndrome: The intersection of obesity, diabetes, heart and kidney diseases

It’s time to get heart failure patients the medications they need

Lipid apheresis helps control chronic high cholesterol and FSGS

What to do if someone collapses (or crumples) during exercise

POTS or Long COVID? How to tell the difference

Beyond weight loss: GLP-1 RAs reduce heart attack, stroke risk for Type 2 diabetes patients

Three parallel advances usher in new age of cardiac amyloidosis care

Is My Chest Pain Serious Enough To Go To The ER?

What causes chest pain?

Is chest pain dangerous?

When should I go to the ER for chest pain?

How do I know if I’m having a heart attack?

Chest pain shouldn’t be ignored. Visit your nearest Frisco or Fort Worth ER for chest pain now

When Should I Go to the ER for Chest Pain?

Common causes of chest pain

The most common signs of a heart attack

Risk factors for a heart attack

Signs you might not need an ER visit for chest pain

What is the emergency room chest pain protocol?

Call 911 or visit your nearest Complete Care ER for help

Initial Evaluation

Diagnostic Evaluation

Risk Stratification Testing

Clinical Decision Pathways

Evaluation of Patients With Stable Chest Pain

Nonischemic Chest Pain

Continue Reading

More in AFP

10 Symptoms That Warrant A Trip To The ER

Abdominal Pain

Blood in your stool or urine

Difficulty Breathing

Cuts, Bumps & Falls

Loss Of Function

Other things to consider

Weird Health Symptoms

Don't delay: 12 signs you should go to the emergency room

1. Some headaches

2. Sudden or severe dizziness, confusion and/or clumsiness

3. Seizures (without previously diagnosed epilepsy)