What is the immediate at-home treatment for angina if nitroglycerin (NTG) is not available?

Immediate At-Home Treatment for Angina Without Nitroglycerin

If nitroglycerin is not available, call emergency services (9-1-1) immediately for angina symptoms that are unimproved or worsening after 5 minutes of onset. 1

Initial Steps When Experiencing Angina Without NTG

1. Stop all physical activity and rest immediately

   • Sit or lie down in a comfortable position
   • Remain calm to reduce cardiac workload

2. Call emergency services (9-1-1) without delay

   • Do not attempt to drive yourself to the hospital
   • Ambulance transport is associated with better outcomes 1
   • Emergency medical technicians can provide life-saving interventions if cardiac arrest occurs

3. Take aspirin if available

   • Chew 160-325 mg of non-enteric coated aspirin 2
   • This helps prevent clot formation in coronary arteries

4. Breathing and positioning

   • Take slow, deep breaths to improve oxygenation
   • Sit upright to reduce cardiac workload unless feeling faint

What NOT to Do

• Do not borrow nitroglycerin from someone else 1
• Do not wait to see if symptoms resolve on their own if they persist beyond 5 minutes
• Do not take sildenafil (Viagra) or similar medications if you anticipate needing nitroglycerin soon 1
• Do not consume alcohol or caffeine during an anginal episode

Special Considerations

For Patients with Known Coronary Artery Disease

• If you have previously been prescribed beta-blockers, you may take your regular dose if available 2
• If you have supplemental oxygen at home and your oxygen saturation is below 94%, you may use it while waiting for emergency services 2

For Recurrent Angina Episodes

• Work with your physician to develop a personalized emergency action plan
• Ensure regular refills of prescribed nitroglycerin to avoid running out
• Consider keeping a backup supply of nitroglycerin in multiple locations (home, work, car)

After the Episode

Once the immediate episode has passed and medical attention has been received:

• Discuss with your healthcare provider about obtaining a prescription for nitroglycerin
• Review your current medication regimen for optimal angina prevention
• Consider long-term preventive medications such as beta-blockers, calcium channel blockers, or long-acting nitrates 1

When to Expect at the Hospital

Emergency treatment at the hospital will likely include:

• Immediate ECG monitoring
• Intravenous nitroglycerin if symptoms persist
• Possible morphine administration for pain unrelieved by nitrates 1
• Evaluation for possible acute coronary syndrome

Remember that angina is a warning sign of potential heart attack. Without nitroglycerin available, the safest approach is to seek emergency medical attention promptly rather than attempting alternative home remedies.