رجل عمره ٦٤ سنة معروف بذبحة صدرية مستقرة، جاءه ألم صدر وهو يصعد الدرج في بيته. جلس وأخذ قرص نيتروجليسرين تحت اللسان، وبعد ٥ دقائق ما زال الألم كما هو مع تعرق خفيف. اتصلت زوجته بخط الاستشارة. ما التعليمات الصحيحة؟

A 64-year-old man with known stable angina develops chest pain climbing stairs at home. He sits down and takes a sublingual nitroglycerin tablet; after 5 minutes the pain is unchanged and he is mildly sweaty. His wife calls the advice line. What are the correct instructions?

1. Call emergency services now, then he may take the second tablet
2. Drive himself to the nearest hospital without waiting
3. Take two tablets together now, because the first was not enough
4. Wait another 15 minutes before deciding whether to call anyone

Answer: A) Call emergency services now, then he may take the second tablet. If pain is not better 5 minutes after the first dose it may be an MI, so call emergency services at once; he may continue up to three doses 5 minutes apart. Two tablets together cause hypotension, waiting wastes critical time, and driving himself is dangerous.