Q&A: When should I seek emergency care for chest pain?

You can determine the seriousness of chest pain based on multiple factors, including the length and location of the pain and a person’s risk factors. Chest pain persisting for many minutes and radiating to the neck and arms requires immediate emergency care. If chest pain lasts for only a few seconds, it is not likely due to a heart attack.

Chest pain can have many causes. Heart attack, angina, inflammation of the lining surrounding the heart (known as pericarditis) and blockages of lung arteries (known as pulmonary embolisms) are among the most severe and lethal causes of chest pain.

Those most at risk for severe chest pain are older adults with underlying health conditions, such as hypertension, high cholesterol, diabetes, a history of smoking, and family history of heart disease.

Someone experiencing severe chest pain should call 911 immediately. Emergency services will arrive to assess the patient’s vital signs, perform a physical, draw blood, and make a decision about care. If they determine a possible heart attack to be the cause, the patient will be taken to a local hospital.

Medical staff will work to determine the cause of the chest pain. If it is caused by a blockage, a cardiology team will most likely open the blockage, using a balloon and stent.

Heart attacks do not always cause intense chest pain. They can cause subtle or unusual symptoms, including fatigue, dizziness, and shortness of breath that can easily be confused for less serious health conditions. Approximately half of all heart attacks are unrecognized at the time, making regular visits with a cardiologist essential for older adults with risk factors for a cardiac event.

Even if chest pain does not meet the criteria for emergency care, still visit your family physician. A primary-care physician can help patients manage cardiac risk factors reducing the risk of a heart attack or stroke. Your physician may refer you to a cardiologist for more advanced cardiac care.

Over the last few months, many people have been delaying or avoiding emergency care for serious heart conditions due to fears about COVID-19 at hospitals. Emergency departments and EMS staff are taking precautions to limit a patient’s exposure to the virus. The risk of delaying emergency cardiac care greatly outweighs the low risk of contracting COVID-19 in a health-care setting.

If you are experiencing severe chest pain, call 911 immediately. If your chest pain is not severe, talk to your primary-care physician.

Martin O’Riordan is the chief of cardiology at Mercy Catholic Medical Center.