Chest Pain, Heart Attack, and Angina

Not every cardiac emergency begins with collapse. A patient may report central crushing pain, tightness, pain into the jaw or arm, breathlessness, nausea, clamminess, dizziness, or a strong feeling that something is wrong. Dental nurses often hear these reports at reception, during medical-history checks, or while assisting after treatment.

Practical first actions

• Stop treatment and alert the clinician immediately.
• Sit the patient upright or in a comfortable position.
• Keep the patient calm and do not let them walk around.
• Bring the emergency drug kit, oxygen, and AED.
• Call 999 if myocardial infarction is suspected or symptoms do not settle as expected.
• Record times, symptoms, observations, medication, and response.

Angina typically improves with rest and with GTN if the patient has it prescribed or its use is authorised under the dental emergency protocol. Persistent, severe, or worsening pain should be treated as possible myocardial infarction. SDCEP guidance includes oxygen, GTN and aspirin 300 mg for adults within the dental emergency pathway; hospital transfer is the priority if symptoms do not respond.

Oxygen, aspirin and GTN

Chest-pain emergencies require calm speed. If symptoms suggest myocardial infarction or do not settle, bring help to the patient, prepare for deterioration, and call 999.