Chest pain can be confusing. This quick guide helps you know when symptoms are serious and what to do next.
February 19, 2026
Contributed by: Thomas Collins MD, FACEP, FAEMS / Emergency Medicine
When Chest Pain is an Emergency
When chest pain strikes, knowing what to do can save your life.
We’ve created this easy chest pain guide to help you know what to do. It shows the warning signs that mean you should call 911 right away. Keep reading to learn how symptoms can differ in men and women, why calling 911 is safer than driving yourself and how MetroHealth teams care for people during a heart emergency.
Consider taking a screenshot of this checklist and saving it to your photos so you can find it fast.
Chest Pain Emergency Checklist: When to Call 911
If you check even one box, call 911 right away. Do not drive yourself.
How the chest pain may feel
- Persistent — lasts more than 5 minutes or keeps coming back
- Pressure‑like — feels tight, heavy, squeezing, or full
- Sudden or severe — starts fast or feels intense
- Different than usual — not your normal heartburn or anxiety
Where the pain may spread
- Arm or shoulder
- Neck or jaw
- Back
Other symptoms to watch for
- Shortness of breath
- Sweating
- Nausea
- Dizziness or sudden tiredness
- Lightheadedness or feeling like you may pass out
When symptoms may occur
- With activity — worse when moving, better with rest
- With risk factors — age 40+, diabetes, high blood pressure, high cholesterol, smoking, or family history
- At rest — can still signal a heart attack
Heart Attack Symptoms Can Vary in Men and Women
Chest pain or pressure is the most common sign of a heart attack for both men and women. Men often have strong, intense chest pain.
Women may have milder or unusual symptoms that feel more like indigestion. Women can have a heart attack even without bad chest pain. Women may notice:
- Nausea
- Jaw or back pain
- Shortness of breath
- Extreme tiredness
- Feeling lightheaded
Why Immediate Care is So Important
Always call 911 in a heart emergency. Do NOT drive yourself or have anyone else drive you.
Paramedics can:
- Start treatment right away
- Check your heart rhythm and give lifesaving care on the way to the hospital
- Alert the emergency department so the heart team is ready when you get there
Driving yourself (or having someone else drive you) is dangerous and slows down treatment.
Heart muscle can start to die within 20 minutes of a blocked artery. The longer you wait, the more damage occurs. Some patients arrive too late for lifesaving treatments that could have opened their arteries.
Heart attacks are serious, but help is ready when you need it. Emergency teams work fast to protect your heart. If something feels wrong, call 911 right away.
According to Dr. Collins, “When it comes to chest pain, it’s always better to be safe. Even mild or unusual symptoms can signal a serious problem, and calling 911 ensures you get care the moment you need it.”
What to Expect at the Emergency Department
When chest pain is serious, fast care matters. MetroHealth Emergency Departments are ready to evaluate chest pain and start treatment right away.
When you arrive, the experienced emergency care team will:
- Check your heart and vital signs
- Perform an electrocardiogram (EKG) to look at your heart’s electrical activity
- Run blood tests or imaging studies to look for signs of a heart attack.
If the care team finds a heart issue, they’ll begin treatment right away. Our emergency medicine providers work with heart specialists to restore blood flow, ease symptoms and protect your heart from further damage.
MetroHealth offers four Emergency Departments in Greater Cleveland:
Know Your Risk: Talk with a MetroHealth Doctor About Prevention
Knowing your risk for heart disease can help you stay healthy and prevent emergencies. Your MetroHealth primary care provider can explain your risks and help you make a plan to stay healthy.
During a visit, your primary care provider may recommend:
- Heart health screenings
- Blood pressure checks and management
- Cholesterol testing and treatment
- Healthy diet and exercise guidance
- Help with quitting smoking
To schedule an appointment with your primary care provider, call 216-My-Metro or schedule online.
Your Questions Answered
Q. How do I know if chest pain is serious?
A. If chest pain lasts more than a few minutes, feels like pressure, spreads or comes with shortness of breath, nausea, sweating or dizziness, call 911 — even if you’re not sure.
Q. Why is calling 911 safer than driving to the emergency department?
A. Every minute counts during a heart attack. Driving delays care and puts you in danger. Paramedics can:
- Check you right away
- Monitor your heart
- Give lifesaving treatment on the way to the hospital
- Alert the Emergency Department to tell the team you are coming.
Q. Should I get screened for heart disease?
A. Yes. Finding heart disease early can help save your life. Routine heart screenings check your blood pressure and cholesterol and spot problems before symptoms start.
Based on your health and family history, your provider may suggest more testing. One option is a CT heart screening. This quick, painless test looks for calcium build-up in your heart arteries.
Talk to your primary care provider or cardiologist about which heart screenings are right for you.
Q. What heart services are available at MetroHealth?
A. MetroHealth offers comprehensive heart and vascular services if you need more specialized care. Your primary care doctor can refer you to the program and the team can get you to the care you need — from Afib to screening and cardiac rehab.
For more information, visit Heart Care at metrohealth.org/heart.
