Quick Answer: If you're experiencing severe, crushing chest pain, pain radiating to your arm or jaw, shortness of breath, sweating, nausea, or dizziness, call 911 immediately — these are signs of a heart attack. For mild chest discomfort related to movement, indigestion, or muscle strain, urgent care can evaluate and treat your symptoms safely.

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Key Takeaways:

• Call 911 for severe, crushing chest pain or pain with shortness of breath, sweating, or nausea
• Heart attack symptoms can differ significantly in women — watch for unusual fatigue, jaw pain, or nausea
• Urgent care can treat mild chest pain from muscle strain, acid reflux, or anxiety
• Never drive yourself to the ER if you suspect a heart attack — call 911
• "Time is muscle" — every minute counts during a heart attack
• Texas Health Breeze Urgent Care and Emergency Departments work together across North Texas to get you the care you need right away

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Chest pain is scary. When it strikes, your mind races: Is this a heart attack? Should I call 911? Can I wait and see if it goes away? Should I go to urgent care or the ER?

Making the right decision quickly matters — but knowing the difference between life-threatening chest pain and less serious causes can be confusing. This guide will help you understand when chest pain is an emergency and when urgent care is the right choice.

Understanding Chest Pain: Not All Chest Pain is a Heart Attack

According to the American Heart Association (AHA), more than 6.5 million Americans visit emergency departments for chest pain each year. Despite the prevalence of cardiovascular disease, more than half of these visits have non-cardiac causes, but that doesn't mean chest pain should ever be ignored.

Chest pain can have many causes:

• Heart-related: Heart attack, angina (reduced blood flow to the heart), pericarditis (heart lining inflammation)
• Lung-related: Pulmonary embolism (blood clot in lungs), pneumonia, pleurisy
• Digestive: Acid reflux/GERD, esophageal spasm
• Musculoskeletal: Muscle strain, rib injury, costochondritis
• Anxiety: Panic attacks can cause chest tightness and pain

The challenge? Some of these conditions are life-threatening emergencies, while others can be safely evaluated at urgent care.

When to Call 911 or Go Directly to the ER

Call 911 immediately if you experience:

• Severe, crushing chest pain or pressure — described as feeling like "something sitting on your chest"
• Chest pain radiating to your left arm, right arm, jaw, neck, or back
• Shortness of breath or difficulty breathing
• Sudden, severe chest pain that comes on quickly
• Sweating, nausea, or vomiting with chest pain
• Lightheadedness, dizziness, or fainting
• Feeling of impending doom or that "something is very wrong"
• Pain that gets worse with deep breathing or lying down (could indicate pericarditis or pulmonary embolism)

Important: Do not drive yourself to the ER if you suspect a heart attack. Call 911.

Emergency medical technicians can start treatment immediately and alert the hospital before you arrive.

Heart Attack Symptoms Are Different in Women

"Women, especially younger women, are less likely to recognize they are having a heart attack," says Nina Asrani, M.D., a cardiologist on the medical staff of Texas Health Fort Worth and at Texas Health Heart and Vascular Specialists, a Texas Health Physicians Group practice. "They often attribute their symptoms to less life-threatening conditions, such as acid reflux, the flu or aging."

Women experiencing a heart attack are more likely to have:

• Pain in the neck, jaw, or between the shoulder blades
• Nausea or vomiting
• Unusual fatigue
• Shortness of breath without significant chest pain
• An ache in either arm (not just the left)

In fact, fewer than 30% of women report having chest pain before their heart attacks, and 43% report having no chest pain at all.

"Time is Muscle"

"Time is muscle," explains John Lee, M.D., an interventional cardiologist at Texas Health Heart & Vascular Specialists, a Texas Health Physicians Group practice in Plano. "The sooner you present, are diagnosed and treated, the less injury it will be to your heart."

During a heart attack, heart muscle begins to die when blood flow is cut off. Every minute without treatment means more permanent damage to your heart.

When Urgent Care is the Right Choice

Urgent care can safely evaluate and treat chest pain that's likely non-cardiac. Consider urgent care if your chest pain has these characteristics:

Appropriate for Urgent Care:

• Mild to moderate discomfort (not severe or crushing)
• Pain related to movement or posture (gets better/worse when you change position)
• Burning sensation (especially after eating — likely acid reflux)
• Pain following an injury (like lifting something heavy)
• Brief, intermittent discomfort (comes and goes, lasts only seconds to minutes)
• No difficulty breathing or other alarming symptoms
• You're under 40 with no heart disease risk factors

What Urgent Care Can Do

Texas Health Breeze Urgent Care centers can:

• Perform physical examinations
• Check vital signs (blood pressure, heart rate, oxygen levels)
• Order EKGs to evaluate heart rhythm
• Perform X-rays to rule out lung issues
• Run blood tests
• Diagnose and treat conditions like:
• Acid reflux/GERD
• Muscle strain
• Costochondritis (rib cartilage inflammation)
• Anxiety-related chest tightness
• Minor rib injuries

If urgent care providers suspect a cardiac issue or find concerning results, they'll arrange immediate transport to the nearest emergency department.

Common Non-Cardiac Causes of Chest Pain

Acid Reflux and GERD

Gastroesophageal reflux disease (GERD) is one of the most common causes of non-cardiac chest pain, according the AHA. When stomach acid moves back up into your esophagus, it creates a burning sensation in your chest, especially after eating or when lying down.

Key differences from heart attack:

• Burning quality (not crushing pressure)
• Worsens after eating or when lying flat
• Often accompanied by sour taste in mouth
• Improves with antacids

Musculoskeletal Pain

Chest wall pain from muscle strain or rib injury can feel intense but isn't life-threatening.

Key differences from heart attack:

• Changes with movement or breathing
• You can point to a specific tender spot
• Often follows physical activity or injury
• Sharp or stabbing (not crushing pressure)

Anxiety and Panic Attacks

"The mind-body connection is very powerful," notes Matthew Dickson, M.D., a cardiologist on the medical staff of Texas Health Presbyterian Hospital Dallas and at Texas Health Heart & Vascular Specialists, a Texas Health Physicians Group practice. Anxiety can trigger heart palpitations and chest tightness that mimic heart attack symptoms.

Key differences from heart attack:

• Associated with feelings of panic, fear, or stress
• May include rapid heartbeat, tingling in hands/feet
• Usually passes within minutes to an hour
• No physical exertion trigger

However, if you're unsure whether symptoms are from anxiety or a heart problem, seek emergency evaluation. It's better to be safe.

Know Your Heart Attack Risk

Asrani emphasizes the importance of knowing your cardiovascular risk factors: "Heart disease is so common and it is preventable, so it is very important to know your numbers. Those numbers include blood pressure (and what is the normal range for you), blood sugar, cholesterol and body mass index."

Traditional heart disease risk factors include:

• High blood pressure
• Diabetes
• High cholesterol
• Smoking
• Overweight/obesity
• Family history of heart disease
• Age (men over 45, women over 55)

The AHA estimates that 80% of heart disease is preventable through lifestyle management. If you have multiple risk factors, take chest pain seriously — even if it seems mild.

Bottom Line

Chest pain always deserves medical evaluation, but the urgency depends on your symptoms, risk factors, and overall presentation.

Trust your instincts. If something feels seriously wrong, call 911. Emergency responders would rather evaluate you and find nothing serious than have you delay care during a real heart attack.

For mild, non-emergency chest discomfort, Texas Health Breeze Urgent Care offers convenient, affordable evaluation with the peace of mind that emergency care is available if needed.

Sources:

• Yale Medicine. Should You Go to the Emergency Department—or Urgent Care?
• Premier Family Medical. Can I Go to Urgent Care for Chest Pain?
• Bayhealth. Can You Go to Urgent Care for Chest Pain?
• American Heart Association. Chest Pain and Heart Attack Symptoms. Circulation. 2022.