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Patient Instructions

You were having angina. Angina is chest pain, chest pressure, or shortness of breath that occurs when your heart muscle is not getting enough blood and oxygen. You did not have a heart attack.

You may feel sad or low. You may feel anxious and that you have to be very careful about what you do. All of these feelings are normal. They go away for most people after 2 or 3 weeks.

You may also feel tired when you leave the hospital. You should feel better and have more energy 5 weeks after you are discharged from the hospital.

Know the signs and symptoms of your angina:

• You may feel pressure, squeezing, burning, or tightness in your chest.
• You may also have pressure, squeezing, burning, or tightness in your arms, shoulders, neck, jaw, throat, or back.
• Women may feel discomfort in their back, shoulders, and stomach area.
• You may have indigestion or feel sick to your stomach.
• You may feel tired and be short of breath, sweaty, lightheaded, or weak.
• You may have these symptoms during physical activity, such as climbing stairs, walking uphill, lifting, and engaging in sexual activity.
• You may have symptoms more often in cold weather.
• You can also have symptoms when you are resting, or when wake you up from your sleep.

Askyour doctor or nurse how to treat your chest pain when it happens. See also: Angina - when you have chest pain

Take it easy at first. You should be able to talk easily when you are doing any activity. If you cannot, stop the activity.

Ask your doctor about returning to work. You may need to work less, at least for a while. If heavy lifting or hard manual labor is part of your job, you may need to change the kind of work you do.

Your doctor may refer you to a cardiac rehabilitation program. This will help you learn how to slowly increase your exercise and how to take care of your heart disease. See also: Being active after your heart attack

Try to limit how much alcohol you drink. Ask your doctor when it is okay to drink, and how much is safe.

Do not smoke cigarettes. If you do smoke, ask your doctor for help quitting. Do not let anyone smoke in your home.

Learn more about what you should eat for a healthier heart and blood vessels. Avoid salty and fatty foods. Stay away from fast-food restaurants. Your doctor can refer you to a dietitian, who can help you plan a healthy diet.

Try to avoid stressful situations. If you feel stressed, sad, tell your doctor or nurse. They can refer you to a counselor.

Ask your doctor about sexual activity. Men should not take Viagra, Levitra, Cialis, or any herbal supplements for erection problems without checking with their doctor first. These drugs are not safe when used with nitroglycerin.

Have all of your prescriptions filled before you go home. You should take your drugs the way your doctor and nurse have told you to. Ask your doctor or nurse if other prescription drugs, herbs, or supplements you have been taking are okay to keep taking.

Take your drugs with water or juice. Do NOT drink grapefruit juice (or eat grapefruit), since they may change how your body absorbs certain medicines. Ask your doctor or pharmacist about this.

You may be taking 1 or more of the following drugs. These can help prevent a heart attack:

• Aspirin or clopidogrel (Plavix) can help keep your blood from clotting.
• Beta-blockers or an ACE inhibitors can lower your blood pressure and help protect your heart. See also: ACE inhibitors
• Statins or other drugs can help lower your cholesterol.

See also:

• Clopidogrel (Plavix)
• Aspirin and heart disease
• Cholesterol - drug treatment

Never just stop taking any of these drugs, or any other drugs you may be taking for diabetes, high blood pressure, or any other medical conditions you may have.

If you are taking a blood thinner, such as warfarin (Coumadin), you may need to have extra blood tests to make sure your dose is correct.

Call your doctor if you feel:

• Pain, pressure, tightness, or heaviness in the chest, arm, neck, or jaw
• Shortness of breath
• Gas pains or indigestion
• Numbness in your arms
• Sweaty, or if you lose color
• Lightheaded

Changes in your angina may mean your heart disease is getting worse. Call your doctor if your angina:

• Becomes stronger
• Occurs more often
• Lasts longer
• Occurs when you are not active or when you are resting
• If drugs do not help ease your angina symptoms as well as they used to

Chest pain - discharge; Stable angina - discharge; Chronic angina - discharge; Variant angina - discharge; Angina pectoris - discharge; Accelerating angina - discharge; New-onset angina - discharge; Angina - unstable - discharge; Progressive angina - discharge; Angina - stable - discharge; Angina - chronic - discharge; Angina - variant - discharge; Prinzmetal’s angina - discharge

Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol. 2007 Aug 14;50(7):e1-e157.

Antman EM, Hand M, Armstrong PW, Bates ER, Green LA, Halasyamani LK, Hochman JS, et al. 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee. Circulation. 2008 Jan 15;117(2):296-329. Epub 2007 Dec 10.

Updated by: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.