5 Heart Problems You Should Go to A&E For

5 Heart Problems You Should Go to A&E For 

When it comes to the heart, the difference between a minor scare and a life-threatening emergency can be a matter of minutes.

Whilst it’s natural to want to ‘wait and see’ if a pain passes, certain cardiac symptoms require the immediate diagnostic tools and specialist intervention only found in an Accident & Emergency (A&E) department.

Here are five heart-related red flags that demand an immediate 999 call (or 911 in the US) or a trip to A&E (or the ER in the US).

1. Heart Attack (Myocardial Infarction) – Picture

A heart attack occurs when a coronary artery becomes blocked, starving the heart muscle of oxygen. The longer the blockage lasts, the more heart tissue dies.

• The Sensation: It isn’t always a sharp stabbing pain. Many describe it as a heavy crushing weight, tightness, or squeezing in the center of the chest.

• Radiating Pain: The discomfort often spreads to the left arm, but can also move to the right arm, jaw, neck, back, or stomach.

• Associated Signs: Sudden sweating, nausea, vomiting, lightheadedness, and a feeling of intense anxiety (often described as a ‘sense of impending doom’).

2. Acute Heart Failure (Pulmonary Oedema) – Picture

When the heart suddenly fails to pump effectively, fluid can back up into the lungs. This is a respiratory and cardiac emergency known as pulmonary oedema.

• The Sensation: Extreme, gasping shortness of breath that comes on quite quickly.

• Postural Changes: You may find it impossible to breathe while lying flat and feel the need to sit bolt upright to catch your breath.

• Associated Signs: Dry cough or coughing up frothy sputum that may be tinged pink with blood; palpitations (due to tachycardia).

3. Aortic Dissection – Picture

The aorta is the body’s ‘superhighway’ for blood. A dissection happens when the inner layer of this massive vessel tears, allowing blood to surge between the layers of the artery wall.

• The Sensation: This is often described as a sudden, ‘tearing’ or ‘ripping’ pain.

• Location: Unlike a heart attack, this pain is frequently felt most intensely in the back between the shoulder blades or in the chest.

• The Danger: If left untreated, the aorta can rupture, which is frequently fatal. A&E teams use CT scans to identify this immediately for emergency cardiothoracic surgery.

4. Dangerous Arrhythmias (e.g. Ventricular Tachycardia) – Picture

While ‘palpitations’ are often harmless (caused by caffeine or stress), a sustained, rapid, or irregular heartbeat can prevent the heart from filling with blood, leading to a total collapse of circulation.

• The Sensation: A sustained racing heart (tachycardia) that feels like a ‘drummer in the chest’ and does not slow down with rest.

• The Red Flags: If the racing heart is accompanied by fainting, chest pain, or severe dizziness, it indicates the heart is struggling to maintain blood pressure.

5. Cardiac Syncope (Sudden Fainting) – Picture

Fainting (syncope) can happen for many reasons, like dehydration or seeing blood. However, ‘cardiac syncope’—fainting caused by a heart issue.

It has several causes including aortic stenosis and bradycardia (e.g. complete heart block). It is a major warning sign of sudden cardiac arrest.

• When to Worry: If you faint during physical exertion or exercise, it is a major red flag.

• No Warning: Unlike a typical faint where you might feel ‘weak’ first, cardiac syncope often happens suddenly and without warning (a ‘drop attack’).

• Palpitations: If you feel your heart racing or skipping beats immediately before losing consciousness, you need an urgent ECG in A&E.

What to do while waiting for help

If you suspect someone is having a heart attack:

1. Call 999 immediately.

2. Rest: Have them sit on the floor, leaning against a wall with knees bent. This reduces the strain on the heart.

3. Aspirin: If they are not allergic, the operator may advise them to slowly chew a 300mg aspirin.

4. Stay Calm: Stress increases the heart’s oxygen demand; try to keep the environment quiet.