Home » Health & Fitness » 5 Times You Really, Seriously Need to Go to the ER

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Maybe you’ve got a weird pain in your jaw or a searing headache. Maybe you simply don’t feel right. When something is off in your body, you can’t always tell whether it’s worth it to call the doctor, let alone rush to the ER. “It’s easy to say, ‘Oh I’m young, I’m healthy, I can’t be having an emergency, so why should I go in?'” says Megan Fix, MD, assistant professor at the University of Utah School of Medicine. But serious medical crises—concussions, appendicitis, even a stroke—can happen to healthy women of any age.

With that in mind, we asked doctors what symptoms they would tell their friends to head to the ER for. Here are five times you shouldn’t think twice.

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Think about: A heart attack. Everyone knows that crushing chest pain is a hallmark of a heart attack. But that shouldn’t be the only symptom on your radar. Signs can be more subtle in women than in men, says Heather Rosen, MD, medical director of UPMC Urgent Care in North Huntingdon, Penn. As a result, young women tend to brush off early symptoms and avoid seeking help, sometimes mistaking the pain of a heart attack for indigestion or acid reflux. Watch out for uncomfortable pressure in your chest (not necessarily in the middle—and not everyone experiences this), as well as non-chest pain symptoms, such as discomfort in one or both arms, nausea or dizziness, which are more common in women, per a study in JAMA Internal Medicine. Cold sweats, shortness of breath, and pain in the back, neck, shoulder, or jaw are other possible symptoms.

What to do: Anytime you suspect a heart attack, “err on the side of caution and call 911,” advises Dr. Rosen. Once the ambulance arrives, the paramedics can perform an EKG and give you aspirin or another treatment en route to the hospital. Don’t go to urgent care or your family doctor; they won’t be able to run the necessary tests to evaluate your heart.

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Think about: Appendicitis or an ovarian cyst. Belly pain can be caused by anything from a bad fish taco to a chronic condition like ulcerative colitis, making it difficult to recognize a true emergency. Confusing matters more, appendicitis doesn’t always start with the classic pain in the right lower quadrant of your abdomen. You might have pain around your belly button, be queasy, lose your appetite, or feel discomfort when you move, explains Dr. Fix. “These are all signs of an irritation of the lining of your abdomen, which can signal that something serious is going on,” she says. The pain can feel smoldering but will usually get sharper and more severe—think pain you’ve never felt before.

A large ovarian cyst can create similar sensations in the abdomen. Other cyst-specific clues: pelvic pain on one side or general pelvic pain that radiates into your lower back or thighs. A large cyst ups your risk of ovarian torsion, in which the ovary twists, cutting off its own blood flow. The cyst can also rupture, causing internal bleeding.

What to do: Head to the ER if belly pain comes on suddenly or is getting worse; if it keeps you from sitting, walking, eating, or drinking; if it moves to the lower right quadrant of your abdomen; or if you also get a fever or start vomiting.

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Think about: A concussion or worse. Whether you fell and bumped your noggin or got beaned by a baseball, doctors don’t mess around with head injuries. Depending on your symptoms, they’ll want to rule out rare but serious possibilities like brain bleeding. They’re also on the lookout for concussion: “Today, there’s so much attention and focus on concussion,” notes Shawn Evans, MD, emergency medicine physician at Scripps Health in San Diego. Loss of consciousness, repeated vomiting, and a worsening headache warrant immediate attention. But you should also be evaluated if you’ve hit your head and have any neurological symptomes, like dizziness, or issues with balance or vision—no matter how insignificant they may seem.

What to do: Go to the ER if you were knocked out, regardless of how you feel afterward. And get examined if you have a severe headache or neck pain, fluid or blood is leaking from your nose, or you feel confused or very sleepy (all possible signs of serious injury). If you hit your head and develop dizziness or balance problems, you should suspect a concussion but don’t have to rush to the ER—just see a doc within 12 hours, advises Dr. Evans.

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