What should I do until my cardiology appointment if I'm experiencing severe cardiac symptoms?

Immediate Action for Severe Cardiac Symptoms While Awaiting Cardiology Appointment

If you are experiencing severe cardiac symptoms, call 9-1-1 immediately and do not wait for your scheduled cardiology appointment on the 30th. 1

Recognizing Severe Cardiac Symptoms Requiring Immediate Attention

• Chest discomfort/pain at rest lasting more than 20 minutes requires immediate emergency department evaluation 1
• Hemodynamic instability (including lightheadedness, dizziness, or feeling faint) warrants immediate medical attention 1
• Recent syncope (fainting) or presyncope (near-fainting) are high-risk features requiring immediate evaluation 1
• Shortness of breath, cold sweat, nausea associated with chest discomfort should prompt immediate medical attention 1

Immediate Actions to Take

• Call 9-1-1 and request emergency medical services (EMS) transport rather than having friends or relatives drive you 1

• While waiting for EMS arrival, if you have previously been prescribed nitroglycerin:

  • Take one dose of sublingual nitroglycerin for chest discomfort 1
  • If symptoms are unimproved or worsening after 5 minutes, do not take additional nitroglycerin before EMS arrives 1
  • For chronic stable angina patients only: if symptoms significantly improve after one dose, you may repeat nitroglycerin every 5 minutes for a maximum of 3 doses, but still call 9-1-1 if symptoms don't completely resolve 1

• If you have no history of aspirin allergy, emergency dispatchers may advise you to chew 162-325 mg of non-enteric coated aspirin while awaiting EMS arrival 1

Warning Signs That Cannot Wait

• Chest pain with radiation to the arm, jaw, or back requires immediate evaluation 1, 2
• Symptoms accompanied by nausea, vomiting, or profuse sweating suggest a potentially life-threatening condition 1
• Sudden onset of severe chest pain described as tearing or ripping may indicate aortic dissection, which is immediately life-threatening 1
• Symptoms accompanied by shortness of breath, especially at rest or with minimal exertion, require urgent evaluation 1, 2

High-Risk Scenarios Requiring Immediate Action

• If you have known coronary heart disease and experience new, worsening, or unstable symptoms 1
• If you have diabetes, which may mask typical cardiac symptoms 1, 2
• If you have a history of previous heart attack or heart failure 3, 4
• If symptoms occur with minimal exertion or at rest (as opposed to only with significant physical activity) 1

Common Pitfalls to Avoid

• Do not delay seeking care due to uncertainty about symptoms or fear of embarrassment if it turns out to be non-cardiac 1
• Do not self-medicate with multiple doses of nitroglycerin without calling 9-1-1, as this can delay critical care 1
• Do not drive yourself to the hospital; EMS can begin life-saving treatment immediately upon arrival 1
• Do not dismiss symptoms as "indigestion" or "muscle pain" without proper medical evaluation, especially if you have risk factors for heart disease 1
• Do not wait to see if symptoms resolve on their own if they have persisted for more than 5 minutes 1

Remember that time is critical in cardiac emergencies - every minute delay can increase the risk of permanent heart damage or death. The American Heart Association and American College of Cardiology strongly recommend immediate action for severe cardiac symptoms rather than waiting for a scheduled appointment 1.