I've been experiencing radiating chest pain, shortness of breath, and vomiting for the past two days, with a two-week history of symptoms, what could be causing this and what should I do?

You Need Emergency Care Immediately — Call 911 Now

Your combination of radiating chest pain, shortness of breath, and vomiting for two days with two weeks of preceding symptoms represents a potentially life-threatening emergency requiring immediate hospital evaluation — you should not wait for an ultrasound reading or any other test, but should call 911 or go directly to an emergency department by ambulance immediately. 1, 2

Why This Is an Emergency

Your symptom pattern raises serious concern for acute coronary syndrome (ACS), which includes heart attack, because:

• Radiating chest pain is a cardinal feature of cardiac ischemia, particularly when it builds over time and is associated with other symptoms 1, 2
• Shortness of breath (dyspnea) is one of the most common symptoms accompanying myocardial ischemia and significantly increases mortality risk — patients with unexplained dyspnea have more than twice the risk of death compared to typical angina alone 1, 2
• Nausea and vomiting are recognized associated symptoms of ACS, particularly in certain populations 1, 2
• Two-week duration with worsening suggests either progressive cardiac ischemia or another serious condition that has now decompensated 1, 2

What You Must Do Right Now

Call 911 immediately — do not drive yourself or have friends/family transport you 1:

• EMS can provide life-saving interventions en route if you develop cardiac arrest or other complications 1
• EMS can obtain a pre-hospital ECG, which reduces mortality and hospital delay time 2
• EMS can administer aspirin, oxygen, and defibrillation if needed 1

While waiting for EMS (if you have these medications available):

• Take aspirin 162-325 mg (chew it, don't swallow whole) unless you have an aspirin allergy or active bleeding 1, 2
• If you have previously prescribed nitroglycerin and your blood pressure is not low, you may take one dose 1

What Will Happen at the Hospital

The emergency department will perform time-critical evaluations 1, 2:

• 12-lead ECG within 10 minutes to identify heart attack patterns (ST-elevation, ischemic changes) 1, 2
• Cardiac troponin blood test immediately to detect heart muscle injury 1, 2
• Chest X-ray to evaluate for other causes like pneumonia, collapsed lung, or fluid 2
• Continuous cardiac monitoring for dangerous heart rhythms 2

Other Serious Conditions Being Considered

Beyond heart attack, your symptoms could represent 1, 2:

• Pulmonary embolism (blood clot in lungs) — sudden dyspnea with chest pain 1, 2
• Acute aortic syndrome (tear in major artery) — though typically presents with sudden "ripping" pain to the back 1, 2
• Pericarditis (heart lining inflammation) — though pain typically worsens lying flat and improves leaning forward 1

Critical Point About Cost Concerns

If you're worried about hospital costs 2:

• Federal law (EMTALA) requires emergency departments to evaluate and stabilize you regardless of ability to pay 2
• Most hospitals have financial assistance programs and charity care for emergency services 2
• The cost of delayed diagnosis of a heart attack far exceeds the cost of emergency evaluation — untreated heart attacks cause permanent heart damage and death 2

Why Waiting Is Dangerous

Every minute of delay matters 2:

• Heart attack treatment saves 35 lives per 1,000 patients when given within the first hour, but only 16 lives per 1,000 when given 7-12 hours after symptom onset 2
• If you're having a heart attack, the goal is door-to-balloon time <90 minutes or door-to-needle time <30 minutes for clot-busting medication 2
• Patients who delay seeking care have higher mortality rates and more complications 1

Do not attempt to get an ultrasound read or any other outpatient testing first — call 911 now. 1, 2