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Chest pain (angina
pectoris)
occurs when an area of the heart
muscle (myocardium) is
not receiving enough
oxygen-rich blood. This could
possibly due to narrowed
coronary arteries which
reduce the supply of
oxygenated blood to the
heart muscle.
Chest pain is caused by temporary blockage of one or more of
the coronary arteries.
If not treated, it can lead
to a
heart attack
(myocardial infarction).
Stable chest pain is
usually relieved within
a few minutes by resting
and/or by taking
prescribed medicines but may
last as long as 20
minutes. It
makes a heart attack
more likely in the
future.
In contrast, people
with unstable
chest pain
may experience pain on
minimal exertion or even
at rest. Such
condition is more
prolonged and severe.
The
pain is not relieved promptly with
medications. Immediate
medical attention is
required as it is a sign
that a heart attack may
happen soon.
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Signs and
Symptoms of
Chest Pain |
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Mild to severe
griping pain over
the chest.
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Pain may be
described as
pressure or
tight/squeezing
feeling in the
chest. It may
also spread to
the entire chest.
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The pain may pass to
the left or both
shoulders and arms
and occasionally up
the neck to the jaw
or even the teeth.
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The person may also
complain of
weakness, indigestion,
heartburn,
dizziness,
sweating, nausea,
cramping and
shortness of breath. |
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Glyceryl
Trinitrate (GTN)
Tablet |
GTN is used to stop or
prevent chest pain
caused by
narrowing coronary
arteries which supply
oxygenated blood to the
heart muscle.
It works by relaxing
the blood vessels and
lowering blood pressure,
hence helps to
increase blood flow to
the blocked or narrowed
arteries, thereby
relieving chest pain.
If the person is
prescribed with GTN
tablets, please note the
followings:
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GTN tablet is to be placed
under the tongue
(sublingual) and
allow to dissolve
completely.
This route allows
the medicine to be absorbed
into the body very
quickly.
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It is advisable to
take GTN 2 to 3
minutes prior to
activities which are
known to trigger chest
pain.
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If pain occurs, GTN
tablet should be given
at the first sign of
chest pain. Do
not wait until
severe pain
develops.
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The person will
experience a
tingling feeling on
the tongue when
first taken.
Other side-effects
include headache,
flushing, mild
fullness, and
warmth. These
side-effects usually
diminish with
continued use.
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The person should obtain relief
in 1-2 minutes after
taking the tablet.
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One
tablet is to be given at a time.
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If pain is not
relieved within 5
minutes, a second
tablet can be given.
If pain continues
for another 5
minutes, give a
third tablet.
Note that GTN can be
given up to 3 doses
(each time 1 tablet) at 5
minute intervals.
A doctor should be
called if there is
still no relieve of
pain. Do Not
give multiple doses
to get quick relief
of pain.
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GTN is
affected by both
light and heat and
should be properly
stored. Do
Not carry
them close to the
body as the body
temperature can
damage the tablets. Advise
the person to carry
them in a purse or
bag. Those
that are not carried
should be stored in
cool, dark place.
Keep the tablets in
a dark
glass container and
close tightly.
Do Not store
them in the
refrigerator because
the moisture can
spoil the tablets.
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In the Event of
Chest Pain |
When
chest pain occurs:
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Stops whatever
activity the person
may be engaged in.
Never attempt to
push through the
pain.
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Ensure that he is
sitting down and
resting. Prop
up his feet.
These would
facilitate blood
flows and
reduce the strain on
the heart.
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If the person is
stressed or anxious,
calm him down by
instructing him to
take slow and deep
breaths. This
may help to control
his stress and stop
the pain.
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Assist the person in
taking
GTN
tablets.
Placed it under his
tongue and allow it
to dissolve.
If the chest pain
continues in the
next 5 minutes, you
should give another
tablet under his
tongue. If
there is still no
relief of chest pain
after taking 3 GTN tablets
(each at 5 minute
intervals),
you should
immediately call an
ambulance.
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Monitor his heart
beats, breathings
and blood pressure.
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Stable chest pain
has a regular
pattern. Learn
to recognise the
pattern and predict
when the pain will
occur.
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Some activities and
factors that can
bring on chest pain
include excessive
exercise, anxiety,
severe emotional
stress, heavy meals
and cold weather.
During these
periods, the heart
muscle demands more
oxygenated blood
than the narrowed
coronary arteries
can deliver.
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Advise on avoiding
strenuous physical
exertion and
emotional outbursts
which increases the
workload of the
heart.
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It is important
for the person to
remain active.
Help him to identify
and modify those
activities that
trigger chest pain instead of
avoiding them
completely.
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Exercise such as
walking on regular basis
is encouraged. However,
they must be moderated
below the point of
producing pain. For
example, you can advise the person
to begin with short
walks on level ground
and gradually increase
the distance over a
period of weeks.
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Advise
the person to slow
down his peace in any
activity for a couple of
hours after a full meal.
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In cold weather,
advise the person to
dress himself warmly and
perform activities more
slowly than usual.
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Encourage a slow
peace morning
routines, especially
if the person is an
elderly. It
has been noted that
the early hours of
the day are the most
dangerous for the
heart. Forcing
into the morning
hours might put in
unnecessary pressure
on the heart,
triggering chest
pain.
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Discourage smoking
which increase the
progression of the
disease.
Smoking absorbs
oxygen out of the
blood and nicotine
constricts the blood
vessels.
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Advise the person to carry with
him the GTN tablets at all times.
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GTN may causes
headache or flushing
which will usually
disappear within a
few minutes.
If the headache is
severe or do not go
away, consult your
doctor.
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Remind
the person to
take GTN tablets 2 to 3
minutes prior to
activities which are
known to trigger chest
pain.
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Ensure that the
person takes all his
prescribed medicines as
directed.
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