Oklahoma State Department of Health 01-2018Revised

CHEST PAIN/PRESSURE

Cardiac and non-cardiac conditions cause chest pain including angina, myocardial infarction, hyperventilation, anxiety, muscle strain, pulmonary embolism or dissecting aortic aneurysm.

History:

 Risk factors for heart disease  Past history of heart attack  Past history of angina; treatment  Determine time of onset  Quality of pain, sharp, dull, aching, stabbing, burning etc.  Location of pain  Severity of pain (0-10 scale)  Additional symptoms; shortness of breath, unexplained sweating, nausea, radiating to arms, neck or back, rapid heart rate with shortness of breath, cough that may produce blood-streaked sputum, fainting,  Anxiety or panic attacks  Medications (Nitroglycerin)  Medication Allergies (aspirin)

Assessment:

 Obtain vital signs o Listen to heart-rate, rhythm, lungs (for breath sounds) o Check pulse in all extremities and compare  Assess for: o Shortness of breath o Skin condition (cold, clammy, sweaty) o Pain with cough or deep breathing o Sudden difficulty speaking, loss of vision, weakness, or paralysis of one side of the body

Treatment:

 If the person is standing, assist them to a sitting or lying position  Loosen tight clothing  Assist individual with prescribed nitroglycerin tablet. They should not bite or chew nitroglycerin. It should be placed under the tongue to dissolve. Prescribed nitroglycerin may be taken as 1 tablet or spray under the tongue every 5 minutes up to 3 tablets in 15 minutes  Encourage individual to chew a 325mg uncoated aspirin

Call EMS:

 Unexplained chest pain lasting more than a few minutes  New cases of chest pain  Unresolved pain after their normal treatment  Pain associated with fever and shortness of breath

Reference

WebMD. Chest Pain Treatment. Retrieved electronically October 13, 2017 at https://www.webmd.com/first-aid/chest-pain-treatment

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