Ambulance outside A&E

You may have been waiting longer than usual for a checkup or appointment, or feel like you're struggling to get an appointment. We explain which symptoms are really important to get checked.

If you experience symptoms that could be a heart attack or stroke, or any of the symptoms listed below where the guidance is to call 999, it's important that you seek medical help immediately by calling for an ambulance. If you delay, you are more likely to suffer serious damage and more likely to need intensive care and to spend longer in hospital.

You may have read that some ambulance services have been experiencing delays in responding to calls. Despite this, it's still better to call 999 first rather than just going straight to hospital. Calling an ambulance will mean the paramedics can let the hospital know you are coming so they can get ready to treat you quickly, and may be able to give you some initial tests or treatment on the way. If the call handler thinks that you should do something different rather than wait for an ambulance, they will be able to tell you.

Don’t delay getting help because you think the NHS is too busy, or because you've had trouble getting an appointment. The NHS has systems in place to treat people who need urgent heart or stroke treatment.

Signs that you need to seek emergency help:

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Sudden pain or discomfort in your chest that does not go away

If you start to feel a sudden pain or discomfort in your chest, call 999 immediately. This can be a symptom of a heart attack, and it’s vital that you seek medical help without delay.

It’s important to remember that discomfort can be felt in different ways. For instance, you may feel a sensation of pressure, tightness or squeezing in the centre of your chest.

Pain that spreads to your right or left arm, neck, jaw, back or stomach

This can be another symptom of a heart attack, and it is important that you call 999 for medical help immediately. For some the pain or tightness is severe, while for others it’s uncomfortable.

Suddenly feeling sick, sweaty or light-headed

These can be symptoms of other less-serious conditions, such as food poisoning or panic attacks, and can pass quickly. However, they can also be a symptom of a heart attack. If you experience a new and sudden feeling of sickness, sweatiness or light-headedness it is important you call 999 straight away

Supporting you to get the care you need

We know that many of you are experiencing delays to treatment, or are finding it difficult to get an appointment. We've created this set of information to help you with these issues.

Increasing swelling of feet, ankles or lower legs

Increasing swelling below your knees can be a sign of heart failure. This symptom occurs because your heart is not able to pump blood around the body efficiently, leading to fluid retention.

Increasing swelling below your knees can be a sign of heart failure.

If you notice this swelling, make an appointment with your GP to discuss, so you can be assessed and tested as needed. Many of these tests can be done at the GP surgery, so it’s unlikely you will need to go into hospital. It’s important that you see your GP straight away, as delaying any treatment risks your symptoms getting worse.

Weight gain over a short period of time

If you have been diagnosed with heart failure, it is important to weigh yourself regularly. Any sudden weight gain may suggest too much fluid is building up in your body and could be a sign that your condition is worsening or that you may need your medication adjusted. 

Although many people are finding themselves putting on weight while in ‘lockdown’, it’s still worth making a note of any weight gain you notice. If you notice a sudden weight gain of more than two or three pounds in a 24-hour period or more than five pounds in a week, phone your GP or healthcare provider.

Shortness of breath

There are a number of causes for shortness of breath – but it can be a sign of heart failure. This can be experienced while you’re being active – for instance walking or climbing stairs – or while you’re sitting down or lying flat in bed.  

There are a number of causes for shortness of breath – but it can be a sign of heart failure.

If you experience shortness of breath or notice any worsening in your ability to do your regular activities, make an appointment with your GP to discuss your symptoms.

If you find yourself waking up from sleep struggling to breathe, or even coughing up frothy sputum - a mixture of saliva and mucus – then you should dial 999 immediately as this can be a sign that you are in pulmonary oedema.

If you already have a diagnosis of heart failure

If you or someone you are caring for is living with heart failure, and any of these happen, urgent help is needed - call 999:

  • the person is struggling to breathe
  • or collapses
  • or is in distress
  • or faints or blacks out
  • or experiences sudden chest pain or discomfort that doesn't go away.

If you have heart failure, tell your family, friends or carers that they should call 999 if any of these happen to you.

Facial weakness

Can you smile? Has your mouth or eye dropped? Facial weakness can be a symptom of a stroke, and so it is vital that you call 999 immediately for urgent medical help.

Speech problem

Can you speak clearly, or are you having difficulty finding words or speaking in clear sentences? These symptoms could be a sign that you are having a stroke. Act quickly by calling 999 straight away.

Sudden memory loss or confusion, and dizziness or a sudden fall 

You need urgent medical help if it’s a sudden memory loss or confusion that’s not related to a condition you (or the person you’re caring for) already have. It’s important to note that these symptoms can be caused by other conditions, and if they’re not sudden they may not need to be treated urgently.

But if the memory loss or confusion is unusual and sudden, it could be an emergency such as a stroke. Seek medical help by calling 999 immediately.

Sudden severe headache

A severe headache can be caused by many things, but if it comes on quickly and suddenly, it could be a sign of a stroke. A stroke headache can also be associated with the loss of sensation, such as vision or feeling, but not always. Call 999 for medical help.

Sudden sight problems

Sight problems can refer to anything from blurred vision to the loss of sight in one or both eyes. Experiencing any of these suddenly can be a sign of a stroke. Don’t delay – call 999 immediately.

Weakness or numbness on one side of the body

If you experience a sudden weakness or numbness on one side of the body, call 999 straight away as you may be experiencing a stroke. This sudden weakness or numbness can be felt anywhere in the body, including in the legs, hands or feet.

Fainting or blackouts

Around 40 per cent of people faint at least once in their life, but it’s usually not dangerous. However, if you are worried about your fainting or blackout episodes, then you should make an appointment with your GP. They will be able to diagnose or rule out any medical problems, such as an abnormal heart rhythm.

It may be possible for a heart rhythm monitor – known as a Holter monitor or ambulatory ECG monitoring - to be sent to you to avoid you having to go into hospital. This is worn for at least 24 hours and can be for up to a week and monitors your heart rhythm throughout. This can help your medical professional diagnose any problem with your heart.

This is not a complete list of all symptoms that mean you need urgent care. Whatever the symptoms, if you feel unable to manage them you should seek medical help.

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Updated September 2022

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