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Angina - stable - Management
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When should I refer someone with suspected angina?
- Consider hospital admission for people with the following symptoms, as they may have unstable angina:
- Pain at rest (which may occur at night).
- Pain on minimal exertion.
- Angina that seems to be progressing rapidly despite increasing medical treatment.
- Refer urgently all people with suspected angina to a chest pain evaluation service, for confirmation of the diagnosis and assessment of the severity of coronary heart disease.
In depth
How should I treat a person with suspected angina while waiting for specialist referral?
- Provide the person with glyceryl trinitrate (sublingual spray or tablets) to use for the relief of symptoms while they are waiting for specialist referral.
- Instruct the person that if they experience chest pain they should:
- Stop what they are doing and rest.
- Use their glyceryl trinitrate spray or tablets as instructed.
- Take a second dose after 5 minutes if the pain has not eased.
- Take a third dose after another 5 minutes if the pain still has not eased.
- Call 999 for an ambulance if the pain has not eased after another 5 minutes, or earlier if the pain is intensifying or the person is unwell.
- If clinically confident of the diagnosis, start aspirin.
In depth
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