Chest Pain Treatment

Self-Care at Home

Heart Attack

If you suspect that you or someone you are with may be having a heart attack, call 911 for emergency services or go to the nearest hospital emergency department.

• While waiting for the ambulance, have the patient chew two baby aspirin or at least half of a regular aspirin - at least 160 mg. There is no evidence that taking more than this helps more, and the patient could have unwanted side effects if they take too much.
  
  
• It is important to chew the aspirin before swallowing it because chewing decreases the time the medicine takes to have an effect.
  
  
• Chewing an aspirin in the early stages of a heart attack may reduce the risk of death and it may also reduce the severity of the attack.

Angina

If the patient has had angina and has nitroglycerin tablets available, have the patient place one under the tongue. This may aid in increasing blood flow to blocked or narrowed arteries.

• If the chest pain continues in the next five minutes, take another tablet under the tongue.
  
  
• If, after three nitroglycerin tablets, the patient does not have relief of the chest pain, immediately call 911 or go to the nearest emergency department.

Esophagus

If the pain is from acid reflux (GERD), it may be relieved with antacids. Even if the patient's pain goes away after taking an antacid, do not assume they are not having a heart attack. The patient should still be evaluated in a hospital emergency department.

Medical Treatment

Heart Attack Treatment

Treatment for a heart attack is aimed at increasing blood flow by opening arteries blocked or narrowed by a blood clot.

• Medicines used to achieve this include aspirin, heparin, and clot-busting (thrombolytic) drugs.
  
  
• Other medications can be used to slow the heart rate, which decreases the workload of the heart and reduces pain.
  
  
• Angioplasty is a way of unblocking an artery. Angiography is done first to locate narrowing or blockages. A very thin plastic tube called a catheter is inserted into the artery. A tiny balloon on the end of the catheter is inflated. This expands the artery, providing a wider passage for blood. The balloon is then deflated and removed. Sometimes a small metal scaffold called a stent is placed in the artery to keep it expanded.
  
  
• Surgery may be required if medical treatment is unsuccessful. This could include angioplasty or cardiac bypass.

Angina Treatment

Treatment of angina is directed at relieving chest pain that occurs as the result of reduced blood flow to the heart.

• The medication nitroglycerin is the most widely used treatment. Nitroglycerin dilates (widens) the coronary arteries. It is often taken under the tongue (sublingually).
  
  
• People with known angina may be treated with nitroglycerin for three doses, five minutes apart.
  
  
• If the pain remains, nitroglycerin is given by IV, and the patient is admitted to the hospital and monitored to rule out a heart attack.
  
  
• Long-term treatment after the first episode of angina focuses on reducing risk factors for atherosclerosis and heart disease.