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Discharge Instructions for Angina

Angina is pain or discomfort in the chest. It often has a squeezing or pressure-like feel. This can also be felt in the shoulders, arms, neck, jaws, or back. Anginal pain usually lasts for no more than 10 minutes. It's relieved by rest or nitroglycerin.

Angina is treated with lifestyle changes and medicines. This helps to lower stress on the heart. If needed, blood flow to the heart can be helped with surgery.

Steps to Take

Home Care

Stable angina is predictable. Your doctor may ask you to track your symptoms and what makes them go away. This will help you find what triggers your angina.

Diet

Eat a well-balanced, heart healthy diet. This will help your heart and blood vessel health. Try to eat more fruits and vegetables. Lower the amount of saturated fat and sugar you eat.

Taking in more vitamin C and folic acid may help boost how your medicines work. L-carnitine and magnesium may help lessen angina. Don't take any of these until you talk to your doctor.

Physical Activity

Exercise will help lower the chances of heart-related events. Aim for 30 to 60 minutes of aerobic activity on most days of the week. This can be as easy as a brisk walk. Don't start anything without talking to your doctor first. You will both come up with a plan that works best for you.

  • Try to stay away from activities that trigger your angina.
  • Ask your doctor when you will be able to return to work.
  • Ask your doctor when it is safe for you to drive.

Medications

Nitroglycerin quickly opens your blood vessels. This helps blood get to your heart. Your doctor may give it to you to use during an angina attack. If you have it:

  • Always carry it with you:
    • Dissolve the tablet under your tongue without swallowing. You can also place it between your cheek and gum.
    • Release the spray into your mouth. Don't shake the container, or inhale or swallow. Close your mouth.
  • Sit down during an attack.
  • Don't smoke, eat, or drink for 5 to 10 minutes after taking nitroglycerin.

You will need a second dose if you're not better within 5 minutes, then a third after another 5 minutes. If you still have problems, call for emergency medical services.

If you have any questions on how to use this medicine, talk to your doctor.

You may also need medicines to:

  • Lower the chances of blood clots
  • Ease the workload of the heart
  • Ease blood pressure
  • Lower cholesterol

If you are taking medicines:

  • Take the medicine as directed. Don’t change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Don’t share your prescription medicine.
  • Medicines can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over-the-counter products and supplements.
  • Plan for refills as needed.

Lifestyle Changes

You and your doctor will work together to help you get better. These will help lower the chances of angina attacks or other heart problems:

  • Pace yourself. Take breaks when you need to.
  • Eat small, frequent meals.
  • Learn how to lower your stress levels.
  • If you smoke, talk to your doctor about ways to quit.
  • Maintain a healthy weight.
  • Get treated for any other health problems such as diabetes or high blood pressure.

Follow-up

Angina needs to be watched. Depending on the course of your angina, how it's treated may be changed. Go to any scheduled appointments.

Call Your Doctor If Any of the Following Occur

Call your doctor if for any changes in how your angina feels.

Call for Medical Help Right Away If Any of the Following Occurs

Call for emergency medical services right away if you are having signs of a heart attack such as:

  • Chest pain that doesn't get better with nitroglycerin.
  • Pain, tingling, or numbness in the left shoulder and arm, the neck or jaw. This can happen in the right arm as well.
  • Problems with your breathing.
  • Sweating or clammy skin.
  • Nausea or vomiting.
  • Lightheadedness, weakness, or fainting.
  • Anxiety, especially feeling a sense of doom or panic without apparent reason.

Unusual symptoms of heart attack (women more likely to have unusual problems):

  • Indigestion or heartburn
  • Stomach pain
  • Back and shoulder pain
  • Problems thinking clearly

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

Family Doctor—American Academy of Family Physicians
https://familydoctor.org

National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

The College of Family Physicians of Canada
https://www.cfpc.ca

REFERENCES:

Angina (chest pain). American Heart Association website. Available at: http://www.heart.org/en/health-topics/heart-attack/angina-chest-pain. Accessed September 24, 2018.

Management of angina. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114265/Management-of-angina. Updated May 25, 2018. Accessed September 24, 2018.

Angina. National Heart Lung and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/angina. Accessed September 24, 2018.

Last reviewed September 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC  Last Updated: 9/24/2018