Please call 911 immediately if you are having chest pain, difficulty breathing, severe bleeding, sudden weakness or numbness, or if you think you have a medical emergency.

Chest Pain Treatment

Self-Care at Home

If you suspect that you may be having a heart attack, call 911 for emergency services or go to the nearest hospital emergency department.

• While you are waiting for the ambulance, chew 2 baby aspirin or at least half of a regular aspirin—a total of at least 160 mg. There is no evidence that taking more than this helps more, and you could have unwanted side effects if you take too much.
• It is important to chew the aspirin before swallowing it because chewing decreases the time the medicine takes to have an effect.
• Chewing an aspirin in the early stages of a heart attack may reduce the risk of death by as much as 23%.

If you have had angina and have nitroglycerin tablets available, place one under your tongue. This may aid in increasing blood flow to blocked or narrowed arteries.

• If your chest pain continues in the next 5 minutes, you should take another tablet under the tongue.
• If, after 3 nitroglycerin tablets, you do not have relief of the chest pain, you should immediately call 911 or go to the nearest emergency department.

If the pain is from acid reflux (GERD), it may be relieved with antacids. Even if your pain goes away after you take an antacid, you should not assume you are not having a heart attack. You should still be evaluated in a hospital emergency department.

Medical Treatment

Treatment for a heart attack is aimed at increasing blood flow by opening arteries blocked or narrowed by a blood clot.

• Medicines used to achieve this include aspirin, heparin, and clot-busting (thrombolytic) drugs.
• Other medications can be used to slow the heart rate, which decreases the workload of the heart and reduces pain.
• Angioplasty is a way of unblocking an artery. Angiography is done first to locate narrowing or blockages. A very thin plastic tube called a catheter is inserted into the artery. A tiny balloon on the end of the catheter is inflated. This expands the artery, providing a wider passage for blood. The balloon is then deflated and removed. Sometimes a small metal scaffold called a stent is placed in the artery to keep it expanded.
• Cardiac bypass surgery may be required if medical treatment is unsuccessful.

Treatment of angina is directed at relieving chest pain that occurs as the result of reduced blood flow to the heart.

• The medication, nitroglycerin, is the most widely used treatment. Nitroglycerin dilates (widens) the coronary arteries. It is often taken under the tongue (sublingually).
• People with known angina may be treated with nitroglycerin for 3 doses, 5 minutes apart.
• If the pain remains, nitroglycerin is given intravenously, and the person is admitted to the hospital and monitored to rule out a heart attack.
• Long-term treatment after the first episode of angina focuses on reducing risk factors for atherosclerosis and heart disease.

Suspected aortic dissection often is treated with medications that reduce blood pressure.

Medications that slow the heart rate and dilate the arteries are the most widely used.

• Close monitoring is required to avoid lowering the blood pressure too much, which can be dangerous.
• Surgical repair is required for any dissection that involves the ascending (upward) portion of the aorta.

Anyone with a presumed or documented pulmonary embolism requires admission to the hospital.

• Treatment usually includes supplemental oxygen and medication to prevent further clotting of blood, typically heparin.
• If the embolism is very large, clot-busting medications are given in some situations to dissolve the clot.
• Some people undergo surgery to place an umbrellalike filter in a blood vessel to prevent blood clots from the lower extremities from moving to the lungs.

Spontaneous pneumothorax without symptoms involves 6 hours of hospital observation and repeat chest X-rays.

• If the size of the pneumothorax remains unchanged, you usually are discharged with a follow-up appointment in 24 hours.
• If you develop symptoms or the pneumothorax enlarges, you will be admitted to the hospital. You will undergo catheter aspiration or have a chest tube inserted to restore negative pressure in the lung sac.

Any disruption or perforation of the intestinal tract (viscus) is a potentially life-threatening emergency. Immediate surgery may be required.

Viral pericarditis usually improves with 7-21 days of therapy with nonsteroidal anti-inflammatory agents such as aspirin and ibuprofen (Motrin, for example).

Mitral valve prolapse is usually treated conservatively, which means with surgery or other invasive treatments.

• Medications to control palpitations and chest pain are the usual treatment.
• When the condition is severe and does not respond to medical treatment, an operation to replace the valve is needed.
• If you have mitral valve prolapse, you should take antibiotics before any high-risk surgery or dental work.
• This reduces the risk of endocarditis, an infection of the heart valves.

Pneumonia is treated with antibiotics, and pain medication is given for chest wall tenderness.

Costochondritis is usually treated with nonsteroidal anti-inflammatory medication such as ibuprofen.

The 3 major esophageal disorders that cause chest pain—acid reflux (GERD), esophagitis, and esophageal spasm—are treated with antacid therapy; antibiotic, antiviral, or antifungal medication; medication to relax the muscles of the esophagus; or some combination of these.

Chest Pain  Chest Pain Treatment  Chest Pains