Many people think of “angina pectoris” and “myocardial infarction” when they mention chest pain, and take nitroglycerin as soon as they have a chest pain attack at home. In fact, chest pain is not only a symptom of coronary heart disease, but also a trivial chest wall pain or stomach acid. The first thing to do when chest pain occurs is to judge it correctly before treating it. Taking nitroglycerin also depends on the situation.
First, not all chest pain is angina pectoris.
Chest pain, which may also be a disease unrelated to heart disease, may be a disease of whistling, thoracic surgery or even dermatology: pneumonia, pulmonary embolism, intercostal neuralgia, aortic entrapment, pneumothorax, herpes zoster …… If it is one of these diseases, nitroglycerin certainly does not work, and taking it may also produce side effects.
Second, which chest pain is more like angina pectoris?
Patients themselves are more difficult to judge, the following performance can be used as a reference, of course, not absolute, but also need a doctor for professional judgment.
1.More like angina pectoris (or myocardial infarction)
(1) A history of coronary heart disease, or high-risk factors (hypertension, diabetes, hyperlipidemia, smoking, etc.)
(2) Chest tightness and shortness of breath.
(3) Sore or tight throat.
(4) The pain is “all over the place”.
(5) Pain spreading to the back of the shoulder.
(6) Pain lasting several minutes or longer.
(7) Aggravated by activity and relieved by rest.
2.Comparatively unlike angina pectoris
(1) Clear trauma.
(2) Pinprick-like pain.
(3) The pain is “a point” and can be pinpointed with the finger.
(4) The pain is relieved within a few seconds.
(5) Whistle-related, e.g., painful when inhaling deeply.
(6) Position-related, e.g., pain is only apparent in a certain position, but improves with a change of position.
(7) Activity can reduce the symptoms.
Third, not all angina pectoris (myocardial infarction) can take nitroglycerin.
The human heart is divided into the left heart and the right heart, the supply of the left heart and the right heart are different coronary arteries, the lesion mechanism is different. Nitroglycerin mainly dilates veins and has its own hypotensive effect. For coronary artery lesions involving the left heart, nitroglycerin can be used; for coronary artery lesions involving the right heart, do not use nitroglycerin because it may cause severe hypotension and aggravate the condition.
So how to determine it at home? The easiest way: take your blood pressure! If the blood pressure is already below 90/60mmHg before taking the drug, or if it is above this value but significantly lower than usual, do not use nitroglycerin.
Fourth, how to take nitroglycerin?
Find a peaceful environment, such as sitting on a bed, never standing. If it is a tablet, take it under the tongue, do not swallow it; if it is a spray, spray it under the tongue; it usually takes 1-3 minutes to take effect, if it is not effective after taking one tablet for 3-5 minutes, you can take another tablet, if it is still not effective three times, stop using it and seek medical attention quickly.
Except for the diagnosis of stable angina, and each attack nature, degree, trigger conditions, the frequency of attacks are relatively fixed, you can self-administer nitroglycerin. In all other cases, the sooner you seek medical attention, the better, do not “wait for the rain to stop”, “wait for the dawn”, “wait for the children to leave work”.