What to Do During an Acute Angina Attack: Self-Rescue Measures
Jun 13, 2019
Source: Cainiu Health
Dr. Shen Yonghua
Introduction
During acute angina pectoris attacks, emergency management focuses on reducing myocardial oxygen demand and increasing oxygen supply to resolve the imbalance between supply and demand. Specific measures to reduce oxygen demand include ceasing physical activity, sitting or lying down to rest, and stabilizing emotions. Specific measures to increase oxygen supply include sublingual administration of nitroglycerin. Nitroglycerin dilates the coronary arteries, thereby enhancing blood flow and oxygen delivery to the myocardium.
Angina pectoris is primarily caused by coronary artery disease (CAD). The underlying pathological basis of CAD is the formation of atherosclerotic plaques within the walls of the coronary arteries—the vessels that supply blood to the heart—leading to narrowing of the arterial lumen, arterial wall hardening, and reduced vascular elasticity.
During physical activity, exertion, or emotional stress, myocardial oxygen demand increases. However, narrowed and hardened coronary arteries cannot deliver sufficient blood and oxygen, resulting in a mismatch between supply and demand—triggering angina. Therefore, emergency management of angina focuses on reducing myocardial oxygen consumption and increasing oxygen supply to resolve this imbalance. Specific measures to reduce oxygen demand include immediately ceasing activity, sitting or lying down to rest, and calming emotions. To increase oxygen supply, sublingual nitroglycerin administration is recommended.
Nitroglycerin dilates the coronary arteries, thereby enhancing blood flow and oxygen delivery to the myocardium. It may be administered sublingually every five minutes, one tablet per dose, up to a maximum of three doses. If symptoms persist despite this regimen, prompt medical attention is essential.
