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Chest Pain/Angina Pectoris

Reversible ischemic event, resulting in decreased oxygenated blood supply to the myocardium.

Signs and symptoms#

  • substernal pain
  • radiating pain to the shoulders, arms, or mandible
  • spontaneously subsides with rest
  • symptoms subside with antianginal medications
  • atypical symptoms in women and diabetics


  • be calm and reassuring
  • discontinue dental treatment
  • place the patient in a slightly upright position
  • evaluate breathing, airway and circulation
  • monitor pulse, blood pressure, and respiration rate every 5 min
  • administer oxygen, 6-8 L/min by nasal cannula or mask
  • administer 0.3 mg nitroglycerin sublingually; repeat up to 3 times every 5 minutes
  • give an aspirin (325 mg), chew and swallow
  • if no relief after 3 administrations of nitroglycerin, assume the patient is having a myocardial infarction. (See Emergency – Myocardial Infarction.)
  • if not a myocardial infarction, arrange for home escort
  • notify the patient’s primary care provider
  • call later to check on patient

Differential diagnosis#

Related Pages#