Chest Pain: When to Go to the ER vs Urgent Care vs a Doctor
Clear red flags for chest pain, when to call 911, and what to expect at different care settings—plus estimated costs.
Fast, private, no sign‑in.
🚨 Call 911 Immediately If You Have:
- Crushing, severe chest pain or pressure
- Pain spreading to arms, jaw, neck, or back
- Shortness of breath with chest pain
- Sweating, nausea, or feeling of impending doom
Don't drive yourself. Call 911 or have someone drive you to the nearest ER.
On this page
Go Now: Red Flags (Call 911)
High-Risk Symptoms
- • Severe, crushing chest pain
- • Pain that feels like "elephant sitting on chest"
- • Pain radiating to left arm, jaw, or back
- • Chest pain with shortness of breath
- • Cold sweats with chest discomfort
- • Nausea or vomiting with chest pain
High-Risk Situations
- • Age 40 or older with new chest pain
- • Known heart disease or previous heart attack
- • Diabetes with chest symptoms
- • Family history of early heart disease
- • Recent chest trauma or surgery
- • Taking blood thinners
When in doubt, choose the ER. Heart attacks can present differently, especially in women, older adults, and people with diabetes.
When ER Is Appropriate
Short answer: choose the ER if your chest pain is severe, new, or accompanied by red‑flag symptoms — the ER can immediately rule out life‑threatening causes.
Tests You Might Get
Standard Workup
- • EKG (electrocardiogram) - immediate
- • Chest X-ray
- • Blood tests for heart enzymes (troponin)
- • Complete blood count and metabolic panel
If Needed
- • CT scan of chest (rule out blood clot)
- • Echocardiogram (heart ultrasound)
- • Stress test (sometimes)
- • Cardiac catheterization (if heart attack)
What to Expect
Wait time: High-risk chest pain gets immediate attention (ESI Level 2)
Monitoring: Continuous heart monitoring until cleared
Observation: May require 6-12 hours for serial heart enzyme tests
When Urgent Care or Doctor Is Reasonable
Short answer: consider urgent care or your doctor only when pain is mild and stable without red flags.
Urgent Care
Consider for:
- • Mild, stable chest discomfort
- • Chest pain clearly related to muscle strain
- • Minor chest pain with cold/respiratory symptoms
- • Chest wall tenderness from coughing
Limitation: Cannot rule out heart attack. May refer to ER if concerned.
Primary Care Doctor
Consider for:
- • Chronic, stable chest discomfort
- • Follow-up after ER clearance
- • Chest pain with anxiety/stress
- • Acid reflux-related chest pain
Best for: Non-urgent evaluation and ongoing management.
Important: If chest pain worsens or you develop red flag symptoms while at urgent care or waiting for a doctor appointment, go to the ER immediately.
Best Place to Go — Quick Comparison
| Care Setting | When to Choose | Tests You'll Get | Typical Cost |
|---|---|---|---|
Emergency Room | Severe/crushing pain, red‑flag symptoms, or high‑risk conditions. | EKG, chest X‑ray, troponin labs; CT or echo if needed. | $1,500–$5,000+ Most comprehensive |
Urgent Care | Mild, stable pain likely musculoskeletal or viral; may refer to ER. | Exam; sometimes EKG; limited labs/imaging. | $200–$500 Basic evaluation |
Doctor (Primary Care) | Chronic/stable symptoms; anxiety/reflux; post‑ER follow‑up. | Exam; outpatient tests ordered as needed. | $150–$300 Ongoing management |
Cost Disclaimer: Estimates are before insurance and vary by location, tests needed, and specific treatments.
Definitions: Charges = provider list price; Allowed amount = insurer‑negotiated price (insurer payment + your cost share); Costs (HCUP) = hospital’s internal expense estimate; Out‑of‑pocket = your deductible/coinsurance/copay.
Sources: KFF Health System Tracker — ED costs & facility fees; KFF — ED out‑of‑pocket amounts; AHRQ HCUP (SB #311) — Treat‑and‑release ED visit costs; AHRQ MEPS — Office‑based visit payments; CMS Physician Fee Schedule (E/M, EKG, CXR); CMS OPPS Addenda — ED facility APCs; CMS Clinical Laboratory Fee Schedule.
Got a bill already? See our Medical Bill Reduction guide for practical steps to lower what you owe.
What to Prepare Before You Go
Information to Have Ready
- Insurance card and photo ID
- List of current medications
- Emergency contact information
- Recent medical records if relevant
- Allergies and medical conditions
Be Ready to Describe
- • When the pain started
- • What the pain feels like
- • What makes it better or worse
- • Associated symptoms
- • Similar episodes in the past
- • What you were doing when it started
Frequently Asked Questions
Should I call 911 for chest pain?
When is urgent care appropriate for chest pain?
How much does ER treatment for chest pain typically cost?
What tests will they do for chest pain in the ER?
Get Personalized Care Guidance
Get the CareRoute app for personalized symptom assessment with provider recommendations, wait times, cost estimates, and tools to reduce medical bills.
Free for reasonable personal use