Call 911. When they send an ambulance, take the ambulance.

Heart attack is tough, especially the first time someone has one:

- The pain is usually dull and can even be subtle

- The pain usually is better with rest and worse with exertion, so you can convince yourself that it was some minor thing that is passing

- The pain is usually not so bad that you'd think you'd have a problem driving, taking the subway, etc.

But, heart attack doesn't kill you via pain. It kills you via arrhythmia, which happens because that ischemic heart tissue is electrically active.

If you have a cardiac arrest from your heart attack and you're in an ambulance, they're going to defibrillate you. If you have a cardiac arrest from your heart attack and you're driving yourself to the hospital, you're going to crash your car and it's unlikely that anyone will figure out what happened in time to defibrillate you.

Now, people who have established angina with known coronary anatomy will get more specific advice from their doctors. But in general, if someone without known disease develops symptoms that sound like a heart attack, they need to be evaluated.

Call 911 and chew (chewing it up is important) 4 tablets of 81mg baby aspirin. If you don't have baby aspirin then chew up a regular 325mg adult aspirin.

Typical chest pain is on the left side but atypical chest pain often experienced by diabetics or women can be abdominal pain, right sided chest, vague discomfort, or can be completely silent/missed. Sadly not everything behaves exactly the same.

If you're very worried, you're having symptoms, and the EKG comes back reassuring, just ask for a set of cardiac enzymes. However, ED doctors often don't want to get enzymes because it means they have to do it 3x in a row spaced 6-8 hours from each other - so it might get you an observation unit stay.

Anyways, I'm not an ED doctor but I worked in one for a month during residency and I can assure you - there are plenty of providers who are not great at interpreting EKGs. There is pretty high variability in EKG interpretation skill between them. So if someone with weak EKG sensitivity uses that test to screen you out, then that's pretty poor care.

Call 911.

https://www.doylestownhealth.org/dialogue-online/2017/februa...

(No, I am not a doctor.)

I've heard a 911 dispatcher say take aspirin if you can