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Discharge Instructions for Angina

You have been diagnosed with a type of chest pain called angina. Angina occurs when too little oxygen reaches the heart muscle. It is most often felt under your breastbone, in your left shoulder, or down your left arm. The pain may even spread to your jaw or back. Exercise, increased activity, emotional upset, or stress can trigger this pain. With proper treatment and lifestyle changes to reduce risk factors, most people with angina are able to maintain a full and active life.

Managing Risk Factors

Your health care provider will work with you to modify lifestyle factors as needed to help prevent progression of atherosclerotic cardiovascular disease (ASCVD), which may be the cause of your angina. Factors you may need to work on include: 

Diet

Your health care provider will give you information on dietary changes that you may need to make, based on your situation. Your provider may recommend that you see a registered dietitian for help with diet changes. Changes may include:  

  • Reducing fat and cholesterol intake 

  • Reducing sodium (salt) intake, especially if you have high blood pressure 

  • Increasing your intake of fresh vegetables and fruits 

  • Eating lean proteins, such as fish, poultry, and legumes (beans and peas) and eating less red meat and processed meats

  • Using low-fat dairy products 

  • Using vegetable and nut oils in limited amounts 

  • Limiting sweets and processed foods such as chips, cookies, and baked goods 

Physical activity

Your health care provider may recommend that you increase your physical activity if you have not been as active as possible. Depending on your situation, your provider may recommend that you include moderate to vigorous intensity physical activity for at least 40 minutes each day for at least 3 to 4 days per week. A few examples of moderate to vigorous intensity physical activity include: 

  • Walking at a brisk pace, about 3 to 4 miles per hour

  • Jogging or running

  • Swimming or water aerobics

  • Hiking

  • Dancing

  • Martial arts

  • Tennis

  • Riding a bicycle or stationary bike

  • Dancing 

Weight management

If you are overweight or obese, your health care provider will work with you to lose weight and lower your BMI (body mass index) to a normal or near-normal level. Making diet changes and increasing physical activity can help.  

Smoking

If you smoke, break the smoking habit. Enroll in a stop-smoking program to improve your chances of success. 

Stress

Learn stress management techniques to help you deal with stress in your home and work life. 

Managing Medication

  • Keep a record of your episodes of chest pain. Take these with you when you see your doctor.

  • Take your medication exactly as directed. Don’t skip doses.

Taking Nitroglycerin

  • Keep your nitroglycerin with you at all times.

  • If you’re on nitroglycerin, don’t take medications used to treat impotence at all. These medications can react with nitroglycerin and cause your blood pressure to drop to a dangerous or even life-threatening level.

  • If you use nitroglycerin to prevent angina attacks, follow your doctor’s instructions for your kind of nitroglycerin (pill, spray, or skin ointment).

  • If you use nitroglycerin to stop an angina attack, follow these steps:

    • Sit down (you may become dizzy).

    • Place 1 tablet under your tongue, or between your lip and gum, or between your cheek and gum. Let the tablet dissolve completely; do not chew or swallow the tablet.

    • If you use a spray, then spray once on or under your tongue. Do not inhale. Close your mouth. Wait a few seconds before you swallow and don't rinse your mouth for 5 to 10 minutes.

    • After taking 1 tablet or spraying once, continue sitting for 5 minutes.

    • If the angina goes away completely, rest awhile and follow your doctor's orders about returning to your normal routine.

    • If the chest pain or pressure continues, CALL 911 immediately. Do NOT delay. You may be having a heart attack (acute myocardial infarction, or AMI)!

    • You may be told by your doctor to CALL 911 after taking 2 or 3 tables or sprays of nitroglycerin (spaced 5 minutes apart) and the chest pain or pressure is still present 5 minutes after the last dose. Do not take more than 3 tablets, or spray more than 3 times, within 15 minutes. 

When to Call Your Doctor

Call your doctor immediately if you have any of the following:

  • Severe headache

  • Severe dizziness, or fainting

  • Nausea or vomiting

  • Fast heartbeat (higher than 100 beats per minute)

  • Swollen ankles

  • Weakness

  • Angina attacks that last longer, occur more often, or are more severe than in the past

Online Medical Reviewer: Foster, Sara, RN, MPH
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Last Review Date: 2/26/2014
© 2000-2014 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.