Angina

WHAT YOU SHOULD KNOW:

Angina is the chest pain, pressure, or feeling of tightness you feel when your heart does not get enough oxygen. Angina can be a warning sign that you are at risk for a heart attack.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• If you are taking nitroglycerin medicine, you should not take certain drugs. Some drugs used to treat certain sexual or impotence problems may interact with nitroglycerin. Ask your caregiver if any of your medicines contain nitroglycerin.
  
  
• If you do not get treatment, your angina may get worse and further increase your risk of a heart attack and death

WHILE YOU ARE HERE:

Activity:

You may need to rest in bed until your chest pain is treated. Your caregiver will tell you when it is okay to get out of bed. Call your caregiver before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away. Then call your caregiver.

Call button:

You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Tests:

You may need one or more of the following tests. The results of these tests help caregivers plan the best way to treat you.

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Echocardiogram: This test is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.
  
  
• Nuclear medicine scan: A special x-ray machine uses a computer to take pictures of your heart. Before taking the pictures, you are given a safe amount of radioactive dye. The dye is given through an IV in your vein. The dye helps your heart show up better in the pictures.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Exercise stress test: This test helps caregivers see the changes that take place in your heart during exercise. It checks for blockages in the arteries of your heart. An EKG is done while you ride an exercise bike or walk on a treadmill. Caregivers will ask you how you are feeling during the test. They want to know if you have chest pain or trouble breathing.
  
  
• Medicine stress test: This is a test that does not use exercise but still lets caregivers see heart changes. You are given medicine in your IV that makes your heart beat faster and opens heart arteries. An EKG is taken at the same time. Be sure to tell your caregiver how you are feeling during the test.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Urine sample: For this test you need to urinate into a small container. You will be given instructions on how to clean your genital area before you urinate. Do not touch the inside of the cup. Follow instructions on where to place the cup of urine when you are done.

Medicines:

• Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.
  
  
• Blood thinners: This medicine helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.
  
  
• Diuretics: This medicine is given to decrease edema (excess fluid) that collects in a part of your body, such as your legs. Diuretics can also remove excess fluid from around your heart or lungs and decrease your blood pressure. It is often called water pills. You may urinate more often when you take this medicine.
  
  
• Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.
  
  
• Nitroglycerin: This medicine may also be called nitro.
  
  
  • Nitroglycerin opens the arteries to your heart so the heart gets more oxygen. After taking nitroglycerin, your pain may get better or go away. Nitroglycerin may give you a headache or make you dizzy. Make sure you are sitting or lying down when you take your nitroglycerin. Also, get up slowly after taking nitroglycerin.
    
    
  • You may get your nitroglycerin as a pill. It also can be put on your body as a patch or paste. If you are taking nitroglycerin pills, put the nitroglycerin pill under your tongue. It slowly melts and moves into your blood. If you are using a nitroglycerin patch or paste, put the patch or paste on your chest, arm, or back. The medicine soaks through your skin and goes into your blood.
  
  
• Other pain medicine: Caregivers may give you other medicine to take away or decrease your chest pain. Tell caregivers if the pain does not go away or comes back.

Treatment options:

Your treatment may change if your angina is not being controlled. This is often decided after you have tests. You may have some of the following treatments alone or together.

• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
  
  
• Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).
  
  
• Angioplasty and stenting: For this procedure, your caregiver makes a small puncture into an artery (usually in the groin area). A small wire with a balloon on the end is sent up into a coronary artery. The caregiver inflates the balloon to push the plaque (fatty deposits) against the artery wall. This makes more room for blood to flow. This process is called angioplasty. Sometimes a stent is placed during an angioplasty procedure. A stent is a metal mesh tube that is placed in the artery to keep it open.
  
  
• Heart bypass surgery: You may need surgery to help your chest pain or to keep you from having a heart attack. A coronary artery bypass graft (CABG) can improve blood flow to the heart by sending blood around a blocked artery. This is also known as open-heart surgery.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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