I have discussed with you in great detail your emergency room cardiac (heart) workup and while that work-up did not reveal an acute heart attack today it HAS NOT completely ruled a heart attack out as the cause of your symptoms.  What we have done in the emergency department (ER) is only the beginning; this work-up will need to be continued by a cardiologist. Unfortunately, not all diagnosis can be made during an ER evaluation and in some conditions, such as yours, further testing will need to be continued by a specialist as an outpatient.   We have performed a series of tests, which while negative, have only lowered the probability that your current symptoms could be coming from a heart attack. The risk that your symptoms are being caused by a heart attack or impending heart attack, after the testing you have had in the emergency department, is still approximately 1/400 (one in four hundred).  To rule out a heart attack you must be seen by the cardiologist for more testing to make absolutely sure that you are not experiencing symptoms which could be caused by your heart. What that means is that it is much less likely now that your heart is causing your symptoms or that you will have a heart attack in the next six weeks, but it is still possible. You are leaving with the understanding that your heart could still be the cause of your symptoms.   For that reason it is extremely important, as we discussed, that you see a cardiologist within the next 3 days to complete the work-up we have started for you today in the emergency department. If you cannot see the cardiologist in the next 3 days you should return to the emergency department and we will be glad to help you arrange follow-up for you. Without proper follow up with a cardiologist you could still have a FATAL EVENT (you could die) from a heart attack.