Going to the ER with chest pain? Here’s what to expect:

Minutes mean muscles. If you decided to go to the ER to get that chest pain evaluated, you made a smart decision.

Sometimes it may not be chest pain, it may be a bad acid reflux that doesn’t want to go away, a strange throat tightness, jaw pain, arm pain, even upper belly pain. Any of those could be a heart problem in disguise.

So you called 911 and you are in ER now. You can expect to be hooked up to a monitor for heart rhythm and have your ECG done. The ER doctor will review the ECG within minutes and let you and the heart team know if you are having a massive heart attack. In that case you may be rushed to a heart catheterization procedure.

In some cases it’s not very clear initially and you may get serial blood tests and ECGs few hours apart to determine if you are having a smaller version of a heart attack. If so, you will be started on blood thinners and some other medications to reduce stress on the heart and to prevent the clot from propagating. You will be admitted to the hospital and can expect to have a heart catheterization ( and other testing) within few days.

Now what if you didn’t have a heart attack? Well, it could be something unrelated to the heart ( like acid reflux or pulled muscle), however, if you have risk factors for heart problems you may want to get evaluated by a cardiologist.

A lot of times the next step would be a stress test, although sometimes ( depending on your risk and how concerning the story was), you may be asked to get a heart catheterization, or a CT angiogram of the heart.

You should also expect the cardiologist to help you understand your risk of having a heart attack and give you personalized advise on steps you can take to reduce the risk.

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