Chest Pain – Angina vs Heart Attack. 2011 Guidelines.

The material posted in this blog on Chest Pains, Heart Attacks and Angina is for information purposes only. If you want to learn to recognize and treat heart attack and angina victims take first aid training in the Lower Mainland with Vancouver First Aid Ltd. First Aid and CPR classes in Surrey are now available.

Heart disease is the number one killer in North America. Thousands of people die every year in Canada from heart disease and stroke. Most patients die before reaching the hospital. Without a quick response from a trained CPR and AED rescuer the chances of recovery can be drastically reduced.

To prevent heart disease one should:

  • Lower intake of  high cholesterol and saturated fats
  • Be active and exercise regularly
  • Do not smoke
  • Limit alcohol consumption

Angina occurs when there is a temporary or partial blockage of the arteries supplying blood to the heart. This is caused by blood clots or deposits on the walls of the artery’s. The signs and symptoms that are common to angina and not common signs and symptoms of heart attacks are:

  • Chest Pain Lasts 20 to 30 minutes.
  • Oxygen therapy, rest and medication can relieve the pain.

Heart attacks occur when there is a complete blockage of the arteries supplying blood to the heart. With a complete blockage, parts of the heart begin to die as they no longer receive oxygen. This can lead to cardiac arrest. Signs and symptoms that are common to heart attacks and not Angina include:

  • Chest pain lasts longer than 30 minutes.
  • Neither oxygen therapy or rest can relieve the pain.

Heart attacks and angina have very similar symptoms. The following is a list of symptoms that are common to both heart attack and angina victims:

  • Denial
  • Anxiety
  • Fear
  • Confusion
  • Shortness of breath
  • Weak and rapid pulse (can be difficult to find as victim may be suffering from shock and have weaker heart rate. Check pulse using carotid artery.)
  • Pale, cool and clammy skin.
  • Chest pain (can feel excessive pressure and squeezing around heart)
  • Radiating pain (pain can radiate up to jaw, down the back, neck, shoulders and arms)
  • Nausea
  • Vommitting
  • Weakness
  • Fatigue

The treatment for victims of chest pain includes scene assessment, determining the location and mechanism of the pain (was it from a fall?, etc.) and asking the patient if they have any medication. The rescuer should also assist the victim to sit on the floor or in a comfortable position. Loosen any tight clothing around the victims neck or chest area. If the rescuer is trained to administer oxygen, do so. Treat the patient for shock and monitor vital signs. Contact EMS, and complete primary and secondary surveys. If the patient has medication assist them in taking it. Follow workplace guidelines and policies as to whether the rescuer can administer medication for the patient.


Nitroglycerine is a medication that causes the vessels to dilate which allows any blockage to pass. It comes in either tablet or spray form or it can come as a medication patch. A rescuer should not give a patient Nitroglycerine if the patient is unresponsive or if the patient has taken erectile dysfunction / performance enhancing drugs such as Viagra or Levitra within the past 25 hours or Cialis within the past 96 hours. A maximum of three doses can be given at 5 minute intervals. If the patients nitro does not work or they are wearing the patch contact EMS immediately. Patients who have prescribed Nitroglycerine may also take or need to take ASA.

ASA (Aspirin / acetylsalicylic acid)

ASA, normally called Aspirin is a popular medication for prevention and treatment of cardiac disease. It is a anticoagulant that is a beneficial treatment for heart attacks and angina. Rescuers should follow the following “4 A” protocol prior to assisting the victim to take the medication:

  • Allergic – Ask patient if he or she is allergic to ASA or ibuprofen
  • Asthma – Ask patient if he or she has a history of asthma because asthma and ASA can cause serious negative health complications.
  • Approved – Ask patient if he or she has been approved to take the medication.
  • Active ulcer – Ask the patient if he or she has an active ulcer or stomach bleed or a recent head injury.

The patient is not allowed to substitute any medication such as Tylenol instead of using an ASA. The patient typically takes 1 adult ASA tablet or 2 children’s ASA tablets. It is important to have good communication with the victim so that the appropriate dosage and medication is taken. Do not play doctor. Make sure the victim follows his or her doctors guidelines and medications.

If you want to learn more about heart attacks and angina and how to recognize and treat them take first aid training with Vancouver First Aid ltd. We have many flexible and conveniently located first aid and CPR courses throughout the Lower Mainland. New first aid and CPR classes in Surrey are now available. We offer the cheapest courses in the lower mainland and we try our best to accommodate everybody by rarely cancelling a course or capping our classes. To register for a course select the desired course from the menu bar or from the side bar and choose the course date and time of your choosing. If you have any questions or concerns please feel free to ask via our “contact us” page, via email at or by calling us at 778.709.9180. We can’t wait to each you how to save a life!











2 Responses to “Chest Pain – Angina vs Heart Attack. 2011 Guidelines.”

  1. Beryl Freudenthal June 7, 2013 at 10:40 AM #

    There is a weak relationship between severity of pain and degree of oxygen deprivation in the heart muscle (i.e., there can be severe pain with little or no risk of a Myocardial infarction (commonly known as a heart attack), and a heart attack can occur without pain). In some cases Angina can be extremely serious and has been known to cause death. People that suffer from average to severe cases of Angina have an increased percentage of death before the age of 55, usually around 60%.^’:`

    Have fun

  2. Leland Natcher June 15, 2013 at 10:20 PM #

    Chest pain may be a symptom of a number of serious conditions and is generally considered a medical emergency. Even though it may be determined that the pain is non-cardiac in origin, this is often a diagnosis of exclusion made after ruling out more serious causes of the pain.,’.*

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