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When chest pain is not relieved by nitroglycerin, alert to a heart attack
Chest pain is a common clinical symptom, which is numerous, including but not limited to cardiovascular diseases, respiratory diseases, digestive diseases, etc. Among the many chest pains**, heart disease is of particular concern because of its suddenness, severity and potentially life-threatening illness. This article will focus on the application of nitroglycerin in heart disease chest pain and its limitations, reminding readers to be vigilant against heart attacks.
1. Application of nitroglycerin in heart disease and chest pain.
Nitroglycerin is a drug widely used in cardiovascular diseases, and its main effect is to dilate blood vessels, reduce cardiac pre- and post-load, and relieve angina. Nitroglycerin can be administered sublingually, sprayed, intravenously, and other routes. During an angina attack, nitroglycerin quickly relieves chest pain and is a regular medication in a first aid kit.
However, nitroglycerin is not effective for all chest pains. When nitroglycerin does not relieve chest pain, a high index of suspicion for a heart attack should be achieved.
2. Nitroglycerin cannot relieve the cause of chest pain.
1.Nitroglycerin is not effective for some heart conditions**.
Nitroglycerin mainly acts on the coronary arteries, dilates the coronary arteries, increases the blood supply to the heart, and thus relieves angina. However, nitroglycerin may not be effective for the following heart conditions**:
1) Acute myocardial infarction: In myocardial infarction, the coronary arteries are completely occluded, and nitroglycerin cannot dilate the occluded blood vessels, so it cannot relieve chest pain.
2) Aortic dissection: When the aorta is dissected, the intima of the blood vessel is torn, forming a true and false lumen, and nitroglycerin is ineffective for this lesion.
3) Pulmonary embolism: When pulmonary embolism occurs, the pulmonary artery is blocked, and nitroglycerin cannot improve pulmonary circulation and relieve chest pain.
2.Improper use of nitroglycerin.
The use of nitroglycerin has certain dosage and frequency requirements. Improper use may lead to increased drug tolerance, which can affect efficacy.
3.Co-existing medical conditions.
For example, liver disease, hypotension, etc., may affect the metabolism and effect of nitroglycerin, resulting in no obvious relief of chest pain.
3. Be alert for a heart attack.
When nitroglycerin does not relieve chest pain, a high index of suspicion for a heart attack should be achieved. The following symptoms suggest a possible heart attack:
1.Chest pain persists for more than 15 minutes and is ineffective with nitroglycerin.
2.Chest pain is accompanied by symptoms such as difficulty breathing, sweating, nausea, vomiting, etc.
3.Chest pain radiates to the left shoulder, neck, jaw, upper abdomen, etc.
4.The patient has risk factors for cardiovascular disease such as hypertension, diabetes, and hyperlipidemia.
5.Patients are >50 years of age.
Fourth, countermeasures.
1.Call First Aid** immediately for professional attention.
2.Keep quiet and avoid strenuous exercise to reduce the burden on your heart.
3.If possible, nitroglycerin is given sublingually, and chest pain changes are observed.
4.Cooperate with the doctor to carry out relevant examinations, such as electrocardiogram, cardiac enzyme spectrum, etc., to confirm the diagnosis.
In conclusion, nitroglycerin has an important role in heart disease chest pain**, but it is not a panacea. When nitroglycerin does not relieve chest pain, you should be highly alert for a heart attack and seek medical attention in time to avoid delaying the condition.
References: 1 fihn sd, gardin jm, abrams j, et al. 2012 accf/aha/acp/aats/pcna/scai/sts gu
2. montalescot g, sechtem u, achenbach s, et al. 2013 esc gu
Note: The above references are in English, and the following is a Chinese translation).
1.Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF AHA ACP AATS PCNA SCAI STS Guidelines for the Diagnosis and Management of Stable Ischemic Heart Disease: American College of Cardiology** American Heart Association Practice Guidelines Committee Report, and American College of Physicians, American College of Thoracic Surgeons, Society for Preventive Cardiovascular**, Society of Cardiovascular Imaging and Intervention, and Society of Thoracic Surgeons. Journal of the American College of Cardiology. 2012;60(24):e44-e164.
2.Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC Guidelines for the Management of Stable Coronary Artery Disease: European Society of Cardiology Task Force for the Management of Stable Coronary Artery Disease. European Heart Journal. 2013;34(37):2949-3003.
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