Kaohsiung Armed Forces General Hospital

Pingtung Branch of Kaohsiung Armed Forces General Hospital

Discharge Instructions for Patients with Chest Pain

1.What is Chest Pain?
Chest pain refers to any pain or discomfort felt in the chest area or thoracic cavity. It may feel like pressure, tightness, stabbing pain, dull ache, or a heavy weight pressing on the chest. The pain may also spread to the arms, shoulders, back, upper abdomen, neck, or even the jaw.
2.Possible Causes of Chest Pain

• Cardiac causes: Heart attack (myocardial infarction), angina (reduced blood flow to the heart), or aortic dissection.
• Respiratory causes: Pulmonary embolism, pneumonia, pleurisy, or pneumothorax.
• Gastrointestinal causes: Acid reflux (GERD), peptic ulcer, or gallstones.
• Other causes: Cervical spine disorders (e.g., degenerative arthritis, spinal tumor) or psychological conditions such as panic attacks.

3.What to Do When Chest Pain Occurs

• Stay calm. Stop all activities and rest in a sitting or lying position.
• Loosen any tight clothing, especially around the neck.
• If you have home oxygen, start oxygen therapy immediately.
• Sit or lie down and take one nitroglycerin (NTG) sublingual tablet under the tongue. Do not swallow it. A mild burning or tingling sensation is normal.
  • If symptoms persist after 5 minutes, you may take another tablet.
  • You may take up to three tablets in total.
  • If pain does not improve, have someone accompany you or call 119 (emergency services) immediately.
• Avoid constipation or straining, such as during bowel movements.
• Avoid beverages that are very hot, very cold, or contain caffeine.
• Remain calm in a quiet environment and avoid emotional stress.
• Ensure someone stays with the patient to provide emotional and physical support.

4.Important Reminders

• Attend follow-up appointments as scheduled and take medications as prescribed. Do not adjust medication doses on your own. If you experience any side effects or discomfort, return to the emergency department or clinic promptly.
• If chest pain becomes more frequent or severe, or if you experience dizziness, shortness of breath, sweating, or loss of consciousness, go to the emergency department immediately.
• Keep NTG tablets in their original brown bottle, away from direct sunlight, and carry them with you.
  • If the tablet does not cause a tingling sensation under the tongue, it may be expired or ineffective.
  • Shelf life: approximately 6 months. Store below 25°C (room temperature). Replace expired tablets.
• Exercise moderately according to your condition and maintain a positive attitude.
• Manage stress and avoid an overly busy or tense lifestyle.
• Get enough sleep and avoid staying up late.
• Engage in regular exercise and avoid smoking.
• Maintain healthy eating habits—avoid overly salty, sweet, or fatty foods.
• If you have high blood pressure, high cholesterol, or diabetes, take your medication regularly as prescribed to prevent complications such as atherosclerosis.
• Do not ignore chest pain, even if it eases after taking medication. Stay calm and seek medical attention promptly.
  • Individuals with multiple cardiovascular risk factors (e.g., advanced age, hypertension, hyperlipidemia, diabetes, smoking, or family history of heart disease) should be especially cautious.
• Call 119 or go to the hospital immediately if any of the following occur:
  • No relief after taking three NTG tablets.
  • Chest pain occurs even at rest.
  • Fainting, loss of consciousness, or difficulty breathing.