In case of an emergency

Have a plan in place

Because angina can be a precursor to a heart attack, you need to be ready for an emergency. A little advance planning will ease a lot of worry.

Here's how to come up with an emergency action plan:

*Talk to the doctor about what to do in case of an emergency. If the person you're caring for has been prescribed nitroglycerin or other emergency medication, make sure you have detailed instructions on how it should be used.

*Write down the signs and symptoms of a heart attack, instructions for using nitroglycerin or other emergency medication, emergency phone numbers, and the location of the nearest hospital that offers 24-hour emergency cardiac care.

*Go to your neighborhood copy center and make several copies of this information. You may want to have the copies laminated.

*Place copies of the emergency information by each phone in your home. And make sure both of you carries a copy with you at all times.

*Discuss the emergency information with all family members and caregivers. Give them copies to carry with them.

Know when to call 911

If you and the patient are familiar with the pattern of his stable angina, you'll be able to tell if his symptoms change. Even so, it's not always easy to tell the difference between unstable angina and a heart attack. Call 911 if he experiences any of the following:

• Chest pain or discomfort that isn't relieved by three nitroglycerin tablets in succession, each taken five minutes apart
• Chest pain or discomfort that lasts for more than 20 minutes
• Chest pain or discomfort that's more severe than a typical angina episode
• Light-headedness, nausea, sweating, or pale skin

In general, it's best to call 911 if you have any reason to think he's having a heart attack. He may try to talk you out of it, but waiting even an hour or two may limit his chances of surviving. Don't wait longer than 20 minutes to see if his symptoms go away.