Am I Having a Heart Attack? What to Expect in the Emergency Department

**By Julianna T. Yu, MD, FACEP**

As an emergency medicine physician, I am trained to prepare for every potential scenario. Conversely, most people do not plan ahead prior to coming to an emergency department for an urgent medical condition. A few simple, proactive steps can help ensure you receive the best care in an urgent situation, especially for any suspected heart-related concern.

ER stretcher
How do I tell if it’s a heart attack? 

For many people, it is not always clear when to seek emergency care. Heart attack symptoms are not always obvious. According to current American Heart Association guidelines, most heart attacks that warrant immediate medical attention involve:

  • Discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
  • Cold sweat, nausea or lightheadedness.

If you have any of these symptoms, call 911 immediately.

What to bring to an emergency department

Ideally, create a personal health file in advance and update it regularly. It should fit into a wallet or purse and include:

  • Chronic health conditions and previous surgeries
  • Results of recent medical tests
  • Medication allergies
  • List of current medications, vitamins or herbal supplements
  • Names and contact information for your doctors, family and friends who may need to be alerted in the event of an emergency health issue
  • Advance directives

What to expect when you arrive at an emergency department

Emergency departments operate on a triage basis, which means team members treat the most serious illnesses or injuries first. If you are brought to an emergency department with a suspected cardiovascular condition, such as heart attack or stroke, you will be rapidly evaluated and treated. A team of clinicians – emergency medicine physicians and nurses – will work as a team to take your medical history and do a physical exam, confirm your diagnosis, relieve your symptoms and consult with appropriate specialists.

Depending on your symptoms and diagnosis, you may receive one or more of the following:

  • Intravenous (IV) fluids
  • Electrocardiogram (EKG or ECG)
  • Blood tests
  • Oxygen
  • Medications
  • Consultation with a cardiologist

A heart attack occurs when there is a blood vessel blockage that reduces blood and oxygen flow to the heart muscle. Rapid treatment by an experienced team is especially important because the longer an artery is blocked, the greater the chance of permanent damage to the heart muscle.

A little prevention can go a long way

The best way to avoid an emergency department visit for a cardiac condition is to reduce your risk factors for heart disease. I strongly encourage you to make some time soon to review your cardiac risk factors with your doctor. Your chances of having a heart attack are lower if you:

  • Treat high blood pressure and diabetes
  • Lower high cholesterol
  • Maintain ideal body weight
  • Exercise regularly (30 minutes of moderate intensity aerobic activity at least five days per week, under the supervision of your doctor)
  • Stop smoking
  • Reduce stress
  • Eat a well-balanced diet high in fruits and vegetables

To calculate your personal heart attack risk, visit

After meeting with your doctor, I recommend creating your personal health file and carrying it with you whenever you leave home.

I hope this information will help improve your heart health and assist you in becoming a more informed health care consumer.

Julianna T. Yu, MD, FACEP, is board certified in Emergency Medicine and medical director of the Emergency Department at Virginia Mason, located at the intersection of Spring Street and Boren Avenue (1010 Spring St.) on First Hill in Seattle. 


  1. Great information!

  2. J George says:

    Very helpful and I shall take action now.

  3. With emergency medical care, you really need to know what to expect when you arrive at the hospital. As you said here, you might be given any of the things that you did list out. I’d expect the best care from any kind of emergency service.

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