Patient education: Chest pain in adults – ED discharge instructions (The Basics)

What are discharge instructions? — 

Discharge instructions are information about how to take care of yourself after getting medical care in the emergency department ("ED").

What should I know? — 

You came to the ED for chest pain. Many things can cause chest pain. Some are very serious things like a heart attack ("acute coronary syndrome"), a blood clot in the lungs ("pulmonary embolism"), or a tear in a major artery ("aortic dissection").

In many cases, chest pain is caused by a less serious or not serious problem. Examples include a lung problem, inflammation of the heart lining, muscle or rib pain, heartburn or a stomach ulcer, a spasm in the esophagus, or anxiety.

Often, the exact cause of the pain cannot be found in the ED. Your doctor might not be able to find all serious causes of chest pain the first time they see you. They can tell you your chest pain does not seem to be related to a heart problem, but they often cannot be absolutely sure. So it's important to follow up with your regular doctor and return for care if your symptoms get worse or change.

You might be waiting on test results. The staff will notify you if there are concerning results.

How do I care for myself at home? — 

Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

You should also:

●Call your regular doctor and tell them you were in the ED. Make a follow-up appointment if you were told to.

●Take all your medicines as instructed, even if you feel well. For example, follow all instructions if your doctor suggested an over-the-counter medicine, such as:

•A numbing or pain-relieving medicine called lidocaine or diclofenac – This might come as a patch, cream, or gel you put on your skin.

•Pain-relieving medicine such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin)

•Heartburn medicine, such as antacids or a proton pump inhibitor

●Check with your doctor before taking any new medicines or supplements.

●Keep your blood pressure and cholesterol under control.

●If you have diabetes, make sure you know how to manage it.

●Quit smoking, if you smoke. Your doctor or nurse can help.

●Eat a healthy diet. Talk with your doctor or nurse about how to add healthy foods to your diet.

●Try to keep a healthy weight. If you have excess body weight, it can help to lose weight. Your doctor or nurse can help you do this in a healthy way.

●Use heat or ice, if the doctor suggested this.

•If you use heat, put a heating pad over the painful area for no more than 20 minutes at a time. Never go to sleep with a heating pad as this can cause burns.

•If you use ice, put a cold gel pack, bag of ice, or bag of frozen vegetables on the area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin.

●Take warm, steamy showers to help with a cough if the doctor suggested this. You can also try using a cool mist humidifier.

When should I get emergency help? — 

Call for emergency help right away (in the US and Canada, call 9-1-1) if you:

●Have severe chest pain, pressure, or discomfort with:

•Trouble breathing, sweating, nausea, or cold, clammy skin

•Pain in your arms, back, or jaw

•Worse pain with activity that does not get better after resting for several minutes

•Pain that starts with rest and does not get better after several minutes

●Have a fast or irregular heartbeat

●Feel dizzy, faint, or weak

When should I call the doctor? — 

Call for advice if you:

●Have a fever of 100.4°F (38°C) or higher, or chills

●Are more tired than normal, or have more trouble breathing with activity

●Have pain with activity (like walking up stairs) that gets better with rest for several minutes

●Have new or worsening symptoms

More on this topic

Patient education: Chest pain (The Basics)
Patient education: Pleuritic chest pain (The Basics)
Patient education: Angina (The Basics)

Patient education: Chest pain (Beyond the Basics)
Patient education: Angina treatment — medical versus interventional therapy (Beyond the Basics)