Acute chest pain
With the improvement in the treatment of heart attacks there is an even greater need to alert the emergency services if you develop chest pain. Speed is of essence if patients are to gain the best possible outcome from the modern treatments.
Many studies have shown that where delay occurs it is during the time taken for a member of the public to realise the significance of the symptom.
If patients have never experienced chest pain before, they are advised to call 999 early. Many campaigns have been run to increase the public awareness which often results in an increase for a short while of patients seeking help; this is to be encouraged
One point that is not stressed enough is the use of the word pain. If you develop a new chest symptom that is some where from and an ache, discomfort to recognised pain, that is not relieved by sitting for a short while, then call 999.
Many patients already have experienced chest pain and may be treated with a sublingual nitrate spray. The use of such sprays complicates the issue as to when an ambulance should be called as the use of sublingual nitrate sprays may promptly relieve the pain of stable angina. (spasm in the coronary artery and not a heart attack).
There is conflicting advice about the use of GTN sprays and when it is best to call an ambulance. To resolve this dilemma the advice we offer has been taken from the British Medical Journal. Based on action of sublingual nitrates and the benefit of early presentation and therefore treatment, we advise patients with known ischaemic heart disease or at high risk of myocardial infarction who have been prescribed a sublingual spray to carry it at all times.
Should they develop acute chest pain, they should take two metered doses immediately. If the pain persists at five minutes they should call an ambulance and take another dose. There is nothing to be gained by first calling a friend or relative and they should not drive themselves to the emergency department
