Should I call for an ambulance if I have chest pain?

The development of new or different chest pain may be an indication of an acute heart problem or heart attack. If you experience symptoms that could be the warning signs of a heart attack, call Triple Zero (000) immediately and ask for an ambulance.

Symptoms of a heart attack can come on suddenly or develop over minutes and get progressively worse. They usually last for at least 10 minutes. However, warning signs of a heart attack may not be what you think. They can vary from person to person, and they may not always be sudden or severe. It is vital to get treatment fast, to limit damage to your heart.

Symptoms to watch out for include:

• Discomfort or pain in your chest. This can often feel like a heaviness, tightness or pressure. People who have had a heart attack have commonly described it as like “an elephant sitting on my chest”, “a belt that’s been tightened around my chest” or “bad indigestion”.
• Discomfort in your arm(s), shoulder(s), neck, jaw or back
• Choking feeling in your throat.
• Arms may feel heavy or useless
• Other symptoms may include shortness of breath, nausea, cold sweat, dizziness or lightheadedness
  Some people have also described feeling generally unwell or “not quite right”.

People often delay seeking help for a heart attack because they think the symptoms are not serious or will go away. When they do that, they risk permanent damage to their heart – or even death. If you experience the warning signs of heart attack for 10 minutes, if they are severe or get progressively worse, call Triple Zero (000) immediately and ask for an ambulance.

Is chest pain the only important symptom of a heart attack?

Although chest pain or discomfort is a common symptom of a heart attack, some people will not experience chest pain at all, while others will experience only mild chest pain or discomfort. Others may experience 1 symptom, while some experience a combination.

Women need to be especially aware of early warning signs of heart attack as they often do not experience chest pain as the main symptom. Research has shown that up to 40% of women with heart attack do not have chest pain. Women need to be aware of symptoms of pain, pressure, heaviness or tightness in areas that include the chest but also the jaw, shoulders, neck, arms and back. They may also feel nauseated, sweaty, dizzy or short of breath. If these symptoms persist for more than 10 minutes, are severe or getting worse, call Triple Zero (000) immediately and ask for an ambulance.

Is heart attack the only cause of chest pain?

Having chest pain does not necessarily mean you are having a heart attack. Most people who go to the emergency room with chest pain are not having a heart attack. Their pain is usually caused by less serious problems, such as muscle pain, heartburn, or anxiety. There are also several other causes of chest pain that are due to problems other than the heart. Nevertheless, you should not take any chances.

What will happen if I go to the emergency department?

The people treating you in the emergency department will examine you and then do tests to try to find the cause of your pain. But don’t be surprised if you do not find out right away why you have pain. The cause of chest pain is not always easy to find. Even so, doctors can usually tell if your heart is in trouble.

The tests you might have include:

• electrocardiogram (ECG) – measures the electrical activity in your heart. It can help doctors find out if you are having a heart attack.
• blood tests – the main blood test for heart attack is called troponin. If the level becomes raised (usually within 2-3 hours) it usually means that a heart attack has occurred. However, there are other causes of raised troponin and your treating doctors will evaluate if your blood test results indicate a heart problem.
• stress test – exercising on a treadmill or exercise bike while monitoring your ECG is a common way that doctors screen for coronary heart disease (blockages in your heart coronary arteries).
• coronary angiogram – an invasive test where a thin tube (catheter) is inserted into your body and advanced to your heart. Dye is injected through the catheter into the coronary arteries and X-ray pictures are taken. It is the best test to diagnose coronary artery disease and is often performed in people with suspected heart attack.

What if I am having a heart attack?

In hospital, you will receive treatments that help relieve any pain, reduce damage to your heart and prevent future problems. You may need a procedure to alleviate any heart coronary artery blockages. This may include coronary and stent implantation or bypass surgery. Your doctors will discuss these options with you and your family if they look like they are needed.

The sooner you get treated for a heart attack, the better treatment will work. Every minute counts when it comes to keeping your heart muscle alive!