When to Call 911 Immediately
Call 911 if chest pain is accompanied by ANY of these symptoms—even if you're not sure it's your heart:
- • Pressure, squeezing, tightness, or crushing sensation in the chest
- • Pain spreading to jaw, left arm, back, neck, or stomach
- • Shortness of breath or difficulty breathing
- • Nausea, vomiting, or cold sweats
- • Lightheadedness or sudden dizziness
- • Extreme fatigue or weakness
- • Sense of impending doom or severe anxiety
🚨 Don't drive yourself. Call 911. Paramedics can start treatment immediately.
Classic Heart Attack Symptoms
Typical Presentation
Most common description: “Feels like an elephant sitting on my chest” or “a tight band around my chest.”
- • Location: Center or left side of chest
- • Duration: Lasts more than a few minutes or goes away and comes back
- • Character: Pressure, squeezing, fullness, or pain
- • Radiation: May spread to shoulders, arms, back, neck, jaw, or stomach
- • Associated symptoms: Shortness of breath, cold sweat, nausea, lightheadedness
Women & Heart Attacks: Different Symptoms
Important: Women often experience different heart attack symptoms than men, which can lead to delayed treatment.
Women are more likely to have:
- • Unusual fatigue (may begin days before)
- • Shortness of breath
- • Upper back or jaw pain
- • Nausea or vomiting
- • Indigestion or “heartburn”
- • Dizziness or lightheadedness
- • Pain that comes and goes
Women may have little or no chest pain at all. Trust your instinct—if something feels wrong, call 911.
Other Serious Causes of Chest Pain
Pulmonary Embolism (Blood Clot in Lung)
Symptoms:
- • Sudden sharp chest pain that worsens with breathing
- • Shortness of breath
- • Rapid heart rate
- • Coughing (may include blood)
- • Recent surgery, long flight, or prolonged bed rest
Aortic Dissection (Tear in Major Artery)
Symptoms:
- • Sudden, severe “tearing” or “ripping” pain in chest or back
- • Pain that moves as the tear extends
- • More common with history of high blood pressure
Pneumothorax (Collapsed Lung)
Symptoms:
- • Sudden sharp chest pain
- • Shortness of breath
- • Often occurs at rest in tall, thin individuals
Non-Emergency Chest Pain (Still See Doctor)
These causes are less urgent but still need medical evaluation:
- Acid Reflux/GERD: Burning sensation, worse after eating or lying down, may taste acid
- Costochondritis: Sharp pain when pressing on ribs, worsens with movement or deep breathing
- Muscle Strain: Tenderness, recent physical activity, worsens with movement
- Anxiety/Panic Attack: Often comes with rapid breathing, tingling, sense of panic
- Shingles: Burning pain in a band pattern, may have rash
Note: Even if you think it's one of these, don't self-diagnose. See a doctor to rule out heart problems.
Red Flags: Always Get Immediate Help
Call 911 if you have chest pain PLUS:
- • History of heart disease or previous heart attack
- • High blood pressure, diabetes, high cholesterol, or smoking
- • Family history of heart disease (especially early onset)
- • You're over 40 (men) or 50 (women)
- • Chest pain during physical activity
- • Chest pain that's different from usual
What NOT to Do
- ✗Don't wait to see if it goes away. Every minute matters in a heart attack.
- ✗Don't drive yourself. Call 911—paramedics can start treatment en route.
- ✗Don't worry about being embarrassed. Better to have a false alarm than miss a heart attack.
- ✗Don't take nitroglycerin unless prescribed to you. It can be dangerous if used incorrectly.
While Waiting for 911
- ✓Chew an aspirin (unless allergic) - 325mg regular or 4 baby aspirin
- ✓Sit or lie down in a comfortable position
- ✓Loosen tight clothing around neck and chest
- ✓Stay calm and try to relax (anxiety can worsen symptoms)
- ✓Unlock your door so paramedics can get in
Medical Review
Reviewed by: Ricardo Hamilton, MD
Last Updated: November 26, 2025
Sources: American Heart Association, American College of Cardiology, National Heart, Lung, and Blood Institute, Mayo Clinic Emergency Medicine Guidelines