Chest Pain

Symptoms of Heart Disease

Angina pectoris is a symptom that occurs when blood supply to an area of the heart muscle doesn't meet its needs. Angina may be felt as heaviness below the breastbone which may spread to either arm, to the neck or the back. On occasion, angina can be an indigestion-like discomfort in the upper stomach or a burning or heartburn-like feeling below the breastbone. Angina may occur during physical activity, at rest or it may awaken you when you're asleep. Angina that becomes more frequent or severe, or that occurs at rest and lasts for longer periods of time, is of greater concern. This change in pattern of angina is known as UNSTABLE ANGINA and may be an early warning sign of a heart attack. When angina lasts for longer than 20 minutes, there is a risk that heart damage has occurred. If this occurs, you should call your doctor or, if there is any delay, have someone take you to the nearest hospital's Emergency Department.

Myocardial infarction
Myocardial infarction is the medical term for heart attack. It has also been known as coronary thrombosis or simply as "coronary". The pain of myocardial infarction lasts longer than that of angina pectoris. Generally there is prolonged, sudden crushing chest pain accompanied by shortness of breath, sweating, nausea, vomiting and perhaps lightheadedness. This pain may spread to the arms, neck, jaw, shoulders and back. For some people symptoms of angina and heart attack may be felt only as shortness of breath. For others, heart attacks may occur silently without any symptoms of chest pain or they may be passed off as mild indigestion.

Nitroglycerin is one of the oldest medications available for the treatment of angina and heart disease. Nitroglycerin dilates blood vessels reducing the workload of the heart and improves blood flow to the heart. Nitroglycerin is used under the tongue to treat attacks of angina. Follow these directions for the use of Nitroglycerin.

  1. If you have chest pain: Stop what you are doing.

  2. If the discomfort does not subside within several minutes, take a Nitroglycerin under your tongue. Avoid swallowing while the tablet dissolves. When doing so you should ensure that you are sitting or lying. Nitroglycerin can lower the blood pressure and cause dizziness and you should avoid standing after taking the medication for approximately 20 minutes.

  3. There are two different sizes of Nitroglycerin, 0.3 mg and 0.6 mg. You may take one 0.3 mg every five minutes up to a total of four pills or one 0.6 mg every ten minutes up to a total of two pills. If your angina has not subsided after 20 to 30 minutes, then there is a chance you may be having a heart attack and you should either contact your physician immediately or have someone take you to the nearest hospital.

  4. Nitroglycerin is also available as a spray of 0.4 mg. It should be sprayed under the tongue and then the mouth should be closed. Nitrospray has a much longer shelf life than Nitroglycerin tablets. Nitroglycerin must be fresh to be effective. Cap the bottle quickly and tightly after each use. Replace an opened bottle after three months even if there are tablets left. Protect tablets from light.

  5. You should never use Nitroglycerin while driving. Do not avoid taking the medication if you need it, but pull over first. If you are having angina, you should take the medications.

Contact your physician or have someone take you to the hospital if your chest pain or other cardiac symptoms do not go away.

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  Version 2.0, July 2004
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