How should I manage a new or worsening symptom?

Management of New or Worsening Symptoms

When experiencing a new or worsening symptom, you should seek immediate medical attention if symptoms are severe, persistent, or concerning, as this could indicate a serious condition requiring prompt evaluation and treatment. 1, 2

General Approach to New or Worsening Symptoms

• For any new or worsening symptom, the first step is to assess the severity and potential urgency of the situation 2
• If symptoms are severe (significant pain, difficulty breathing, changes in consciousness), call emergency services (9-1-1) immediately 2
• For symptoms that are mild but worsening, contact your healthcare provider promptly for guidance 2

Specific Guidance Based on Symptom Type

Chest Pain or Discomfort

• If you experience chest pain or discomfort and have previously been prescribed nitroglycerin:
  • Take 1 dose of nitroglycerin immediately 2
  • If symptoms are unimproved or worsen after 5 minutes, call 9-1-1 immediately 2
  • If symptoms improve significantly after one dose but don't completely resolve, you may repeat nitroglycerin every 5 minutes for a maximum of 3 doses, but call 9-1-1 if symptoms persist 2
• If you experience chest pain or discomfort and have NOT been prescribed nitroglycerin:
  • Call 9-1-1 immediately if symptoms are unimproved or worsen after 5 minutes 2
  • If symptoms completely subside within 5 minutes, notify your physician about the episode 2

Respiratory Symptoms (Asthma)

• For worsening asthma symptoms:
  • Use your rescue inhaler (SABA) as prescribed 2
  • If symptoms don't improve after using your rescue inhaler, seek immediate medical attention 2
  • For patients with a written asthma action plan, follow the instructions for worsening symptoms 2
• High-risk patients (previous severe exacerbation, frequent ED visits, high SABA use) should seek medical care early during an exacerbation 2

Pain or Fever

• For pain that worsens or lasts more than 10 days, stop over-the-counter medications and consult your doctor 1
• For fever that worsens or lasts more than 3 days, seek medical evaluation 1
• If redness or swelling develops with pain, this could indicate a serious condition requiring prompt medical attention 1

Sinus Symptoms

• For persistent sinus symptoms after initial treatment:
  • Contact your healthcare provider as this may indicate bacterial sinusitis requiring antibiotic therapy 3
  • Monitor for warning signs like high fever, severe headache, or visual changes that could indicate complications 3

Rheumatic and Musculoskeletal Disease Symptoms

• Patients with rheumatic and musculoskeletal diseases who experience worsening of COVID-19 symptoms should immediately seek healthcare advice from an expert in treating COVID-19 2
• For new or worsening symptoms in patients with rheumatic conditions, contact your rheumatologist for guidance on medication adjustments 2

Neurological or Motor Symptoms

• For regression of motor skills, loss of strength, or concerns with respiration or swallowing, seek urgent reevaluation 2
• Progressive disorders must be brought to medical attention immediately 2

When to Seek Emergency Care

• Call 9-1-1 or seek immediate emergency care if you experience:
  • Severe chest pain or pressure, especially if accompanied by shortness of breath, sweating, or nausea 2
  • Sudden severe headache or changes in vision 3
  • Difficulty breathing or shortness of breath 2
  • Sudden weakness, numbness, or inability to speak 2
  • High fever with severe symptoms 1

When to Contact Your Healthcare Provider

• Contact your healthcare provider for:
  • Symptoms that persist or worsen despite initial treatment 3
  • New symptoms that develop during treatment 1
  • Pain that lasts more than 10 days or fever that lasts more than 3 days 1
  • Worsening of chronic condition symptoms 2
  • Changes in medication effectiveness 2

Follow-up Care

• For chronic conditions, regular follow-up visits (e.g., annual) with your healthcare provider are recommended to evaluate disease status and assess changes that may require intervention 2
• After experiencing new or worsening symptoms, follow up with your provider if symptoms don't improve within the expected timeframe 3
• Consider further evaluation of underlying risk factors if symptoms recur frequently 3

Remember that early recognition and response to worsening symptoms can significantly reduce morbidity and mortality from serious conditions 2.