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Angina

WHAT YOU NEED TO KNOW:

Angina is pain, pressure, or tightness that is usually felt in your chest. Chest pain may come on when you are stressed or do physical activities, such as walking or exercising. Angina is caused by decreased blood flow and oxygen to your heart. These are often caused by atherosclerosis (hardening of the arteries). If left untreated, angina may get worse, increase your risk for a heart attack, or become life-threatening.


DISCHARGE INSTRUCTIONS:

Call 911 if:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Trouble breathing
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing
  • You have chest pain that does not go away after you take medicine as directed.
  • You lose feeling in your face, arms, or legs, or you suddenly feel weak.

Return to the emergency department if:

  • Your angina is happening more frequently, lasting longer, or causing worse pain.

Contact your healthcare provider if:

  • You are dizzy or nauseated after you take your medicine.
  • You have shortness of breath at rest.
  • You have new or worse swelling in your feet or ankles.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
  • Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Other medicines may be given to open the arteries to your heart, slow your heartbeat, or decrease your blood pressure or cholesterol.
  • Do not take certain medicines without asking your healthcare provider first. These include NSAIDs, herbal or vitamin supplements, or hormones (estrogen or progestin).
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your healthcare provider as directed:

Keep a record or a calendar with details about your chest pain. Every time you have pain or symptoms, record what the pain is like, how long it lasts, and how severe it is. Also record what you are doing when the pain starts, and what makes it go away. Bring this with you every time you see your healthcare provider. Write down your questions so you remember to ask them during your visits.

Cardiac rehabilitation:

Your healthcare provider may recommend that you attend cardiac rehabilitation (rehab). This is a program run by specialists who will help you safely strengthen your heart and prevent more heart disease. The plan includes exercise, relaxation, stress management, and heart-healthy nutrition. Healthcare providers will also check to make sure any medicines you are taking are working. The plan may also include instructions for when you can drive, return to work, and do other normal daily activities.

Manage angina:

  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause heart and lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Maintain a healthy weight. When you weigh more than is healthy for you, your heart must work harder. You are at higher risk for serious health problems if you are overweight. Ask your healthcare provider how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.
  • Ask about activity. Your healthcare provider will tell you which activities to limit or avoid. Ask about the best exercise plan for you.
  • Eat heart-healthy foods. Include fresh fruits and vegetables in your meal plan. Choose low-fat foods, such as skim or 1% fat milk, low-fat cheese and yogurt, fish, chicken (without skin), and lean meats. Eat two 4-ounce servings of fish high in omega-3 fats each week, such as salmon, fresh tuna, and herring. Do not eat foods that are high in sodium, such as canned foods, potato chips, salty snacks, and cold cuts. Put less table salt on your food.
  • Avoid activities that cause angina. Pay attention to your symptoms and find out what seems to make your angina worse.
  • Ask if you should have a flu vaccine. The flu vaccine will decrease your risk for an infection. An infection can put more stress on your heart and worsen your angina.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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