When Should You Go to the ER?

The question that always plagues any survivor of a traumatic medical event or someone living with a chronic illness – when should I go to the ER?  Afraid to be one of those “hypersensitive” types, overreacting to every twitch, pang, and pain, many won’t go to the ER or even contact their doctor. But when should you contact your doctor or ER, and how do you know if something is wrong?

An unexpected heart attack

I suffered a truly unexpected heart attack at age 42, caused by a sudden coronary artery dissection (SCAD). I spent hours uncomfortable, writing on my bedroom floor where I assumed I had overdone a morning workout. But at one moment, I had this impending sense of zoom – something was wrong. The pain and discomfort around my chest, coupled with these new thoughts, made me consider going to the local urgent care (of note, I went to the urgent care! Not the ER). The urgent care assumed I was having a panic attack and sent me to the waiting room. What happened next is a bit of a blur, but I was rushed to the local hospital and Cath lab, fitted with two fat stents in my left ascending and didn’t leave the ICU for a week.

Leaving the hospital felt like I was leaving an overprotective nest, which I wasn’t ready to go. I struggled the next few days, thinking every odd feeling was another heart attack. When my blood pressure plummeted, I freaked out and called one of the cardiologists on call, who couldn’t figure out why I was concerned.

How do you know something is wrong?

How do you know if something is wrong, and must you wait for that impending sense of doom? The answer is that only you know. You have to learn to trust your body to some extent, but it also takes time to understand your body reacts under this new condition and how to respond. Five years out and I am still learning and trying to decipher any pain in my chest to determine what I should do. It is an ever-evolving process.

I have an excellent cardiologist, one that put me back together both physically and mentally. We’ve worked together for five years now, and she explains everything to me and takes my concerns seriously. We’ve talked about my symptoms, the potential outcomes, and how I can know if something may be wrong. She tells me what to look for and how to assess symptoms for my condition. I always end my conversations with her, “What symptoms make me go to the ER vs. calling you?” It’s not an exact science, but I feel more comfortable now and confident in interpreting my symptoms.

Ask questions

The best advice I have for anyone is to have these conversations with your care team as they know you and your condition best. Anytime something happens to me, and I end up in the hospital, see my PCP unexpectedly or start a new medication, I ask two critical questions: “What symptoms bring me to the ER immediately?” and “What symptoms prompt me to call you?”

After every visit, I asked these questions, whether it’s the flu shot, strep throat, or other minor issues. With the recent pandemic, it is imperative to get a sense from your care team how to respond to different symptoms. As we are all different, you and your care team know your condition and are the best at answering this question and advising you.