What symptoms require immediate medical attention?

Symptoms Requiring Immediate Emergency Medical Attention

Call 9-1-1 immediately if chest discomfort lasts more than 5 minutes, or if you experience severe shortness of breath, syncope, symptoms with cold sweats/nausea/vomiting, or a sense of impending doom 1.

Cardiac Emergency Symptoms

Chest-Related Symptoms Requiring 9-1-1

• Chest pain or discomfort lasting more than 20 minutes at rest requires immediate ambulance transport—do not drive yourself or have family drive you 1, 2.
• Chest symptoms that interrupt your normal daily activities indicate a potentially serious cardiac condition and warrant urgent evaluation 1.
• Any persistent chest pain, oppression, dyspnea, heavy chest sensation, or even slight discomfort that does not resolve requires emergency evaluation 1.
• Discomfort radiating to the arm, jaw, neck, or back significantly increases concern for acute coronary syndrome and requires immediate 9-1-1 activation 1.

Critical 5-Minute Rule for Known Cardiac Patients

• If you have known heart disease or cardiac risk factors and develop chest discomfort, take one nitroglycerin dose if previously prescribed 1.
• Call 9-1-1 immediately if symptoms are unimproved or worsening after 5 minutes—do not take more than one nitroglycerin before calling 1, 2.
• For patients without known cardiac disease experiencing new chest symptoms, call 9-1-1 if symptoms persist beyond 5 minutes 1.

Other High-Risk Cardiac Presentations

• Severe shortness of breath, even without chest pain, requires immediate emergency evaluation—this presentation carries more than twice the mortality risk compared to typical chest pain 2.
• Syncope (fainting) or presyncope (near-fainting) with any cardiac symptoms mandates immediate emergency transport 1, 2.
• Hemodynamic instability (low blood pressure, rapid heart rate, altered mental status) requires immediate 9-1-1 activation 2.
• Palpitations accompanied by chest discomfort, shortness of breath, or lightheadedness require emergency evaluation 2.

While Waiting for Emergency Services

• Chew 162-325 mg of non-enteric-coated aspirin unless you have a documented aspirin allergy 1.
• Remain seated or lying down to reduce cardiac oxygen demand 3.

Neurological Emergency Symptoms

• Activate emergency services for any first-time seizure in any individual 1.
• Call 9-1-1 for seizures lasting more than 5 minutes 1.
• Multiple seizures without return to baseline mental status between episodes require immediate emergency response 1.
• Seizures occurring in water or associated with traumatic injuries or difficulty breathing mandate 9-1-1 activation 1.
• Sudden weakness, slurring of speech, or facial drooping require immediate emergency evaluation as potential stroke symptoms 4.

Severe Abdominal Emergency Symptoms

• Signs of complete intestinal obstruction (severe cramping pain, inability to pass gas or stool, progressive abdominal distension) require immediate surgical assessment 1.
• Severe abdominal pain suggesting ischemic bowel (sudden onset severe pain out of proportion to examination findings, especially in patients with atrial fibrillation or vascular disease) requires emergency evaluation 1.
• New onset severe abdominal pain in cancer patients warrants immediate medical assessment 1.

Infection and Sepsis Warning Signs

• Seek urgent medical evaluation if acute illness with suspected infection is accompanied by any of the following 1:
  • Abnormal vital signs (fever >101°F or <96°F, heart rate >100, respiratory rate >20, blood pressure <90 systolic)
  • Change in mental state or confusion
  • Severe muscle pain
  • Poor urine output (dark urine, decreased frequency)
  • Clammy or sweaty skin despite no exertion

Severe Allergic Reaction Symptoms

• Difficulty breathing or swelling of the face or throat requires immediate emergency help—call 9-1-1 immediately 4.
• These symptoms may represent anaphylaxis, which can be rapidly fatal without treatment 4.

Critical Pitfalls to Avoid

Do Not Wait for Symptoms to Disappear

• Symptom resolution is a poor indicator of risk—many life-threatening conditions have waxing and waning symptoms 1.
• Mortality from acute coronary syndrome increases significantly with treatment delays, even if symptoms temporarily improve 2.

Do Not Self-Transport with Cardiac Symptoms

• Never drive yourself or have family drive you with suspected cardiac symptoms—always call 9-1-1 for ambulance transport 1.
• Emergency medical services can begin life-saving treatment en route and alert the hospital for immediate preparation 2.

Recognize Atypical Presentations

• Women and elderly patients frequently present atypically with dyspnea, fatigue, nausea, or vague discomfort rather than classic chest pain 1, 2.
• Do not dismiss symptoms as "just indigestion" or anxiety—err on the side of caution and seek emergency evaluation 1.

Medication-Related Emergency Symptoms

• If taking NSAIDs (ibuprofen, naproxen) and you develop signs of gastrointestinal bleeding (black tarry stools, vomiting blood or coffee-ground material, severe abdominal pain), seek immediate emergency care 4.
• Stop NSAIDs immediately and seek emergency evaluation if you develop any type of rash with fever, as this may represent a life-threatening drug reaction 4.