What Are the Treatment Options for Angina?

Angina is a medical term used to describe chest pain or discomfort due to coronary artery disease (CAD). It is classified as either stable angina or unstable angina.

Stable angina comes and goes with stress and activity and can be treated with medication, lifestyle changes, and, in some cases, surgery. Unstable angina is a medical emergency that must be treated immediately.

This article will discuss angina treatment options and the differences between angina types.

Angina Treatment Options

Angina treatment aims at reducing the frequency of episodes and reducing symptom severity. By managing angina, there is also a decreased risk of heart attack and death. Angina treatments can include:

• Lifestyle changes
• Medications
• Angioplasty
• Open-heart bypass surgery

Lifestyle Changes

Angina is one of the symptoms of coronary artery disease (CAD). Lifestyle changes can be made to manage angina. These lifestyle changes are:

• Quit smoking: Smoking can damage blood vessels and worsen angina.
• Limit alcohol: Limit drinking to no more than one drink per day for women and two drinks per day for men. (The terms for sex or gender are those used in the cited source.)
• Manage stress: Implement stress management techniques, as stress can trigger angina.
• Eat a healthy diet: Large, heavy meals can trigger angina. Eat heart-healthy food to reduce cholesterol and blood pressure.
• Maintain a healthy weight: If you have overweight or obesity, discuss a weight loss plan with a healthcare provider.
• Be physically active: Check with a healthcare provider before beginning exercise. If permitted, engage in aerobic exercise like walking or biking.
  

Medications

People who have angina will likely need to take medication to help manage their symptoms. These include:

• Nitrates, such as nitroglycerin, are the most common medications for angina. These drugs relax the blood vessels, including the coronary arteries. This decreases the heart's workload and increases blood flow to the coronary arteries.
• Beta-blockers are another class of medication used to treat angina. Examples include Tenormin (atenolol) and Lopressor (metoprolol tartrate). They reduce heart rate and force.
• Calcium channel blockers such as Calan (verapamil) may be used if someone cannot take nitroglycerin or beta-blockers. It relaxes heart muscle cells and blood vessels.

Other medications someone might take if they have angina are statins, blood thinners, and antiplatelet medications. Statins lower cholesterol, Blood thinners and antiplatelet medications reduce the risk of blood clots that can cause stroke or heart attack.

Therapies

Cardiac rehabilitation (rehab) is a medically supervised program designed to teach people how to live heart-healthy lives. It is a nine- to 12-week program run by healthcare providers from several different backgrounds and specialties. These providers deliver a program that is comprised of exercise education, nutrition counseling, and teaching stress reduction.

People with angina can reduce their symptoms and improve their quality of life with cardiac rehab. Research has found that cardiac rehab can reduce CAD death by almost 30%.

Procedures and Surgery

When a coronary artery is narrowed or occluded, it cannot provide adequate blood flow to the heart. Some procedures or surgeries can be done to restore blood flow in these cases.

Angioplasty, or percutaneous coronary intervention (PCI), is a procedure that uses cardiac catheterization to open the narrowed arteries. A healthcare provider may use a stent during the procedure to keep the coronary artery open. While it is an invasive procedure, it is less invasive than surgery.

Coronary artery bypass graft (CABG) surgery is an open-heart procedure in which a surgeon places blood vessels above and below a blocked coronary artery. This creates a new route, or bypass, for the blood to flow. This is the most invasive surgery for angina.

Enhanced external counterpulsation (EECP) is a noninvasive treatment that can reduce the number of episodes and severity of angina. Several inflatable cuffs are wrapped around the lower legs, upper legs, and around the hips and buttocks. The cuffs inflate and deflate in sequence with each heartbeat to increase blood return to the heart.

EECP treatment is done over the course of seven weeks with one treatment for five days per week.

Stable vs. Unstable Angina Treatment: What’s the Difference?

Stable and unstable angina are similar yet different conditions requiring different treatments.

Stable angina is caused when the blood vessels that feed the heart muscle (coronary arteries) are narrowed and the heart is not getting enough blood flow. When the heart needs more blood flow than it is receiving, angina symptoms can result.

Stable angina symptoms are relieved when the activity causing the symptoms (like exercising) is stopped. Angina episodes tend to be similar and usually don't last more than five minutes. Stable angina treatment involves medications, lifestyle changes, and sometimes surgery to prevent complications like a heart attack.

Unstable angina is unexpected chest pain that usually happens when resting. It occurs when the coronary arteries become narrowed or blocked. It is a medical emergency that needs immediate attention. Treatment is aimed at restoring blood flow through the blocked artery or providing a bypass.

How to Decide the Right Angina Treatment for You

Angina treatment will depend on several different factors. First, a healthcare provider will need to determine if the angina is unstable or stable. This will guide the healthcare provider toward certain treatment options.

Treatment is not only based on the type of angina but also on the person's symptoms and preferences. A healthcare provider will look at the person's age, risk factors, and overall health. It's important to communicate your wishes with your healthcare provider to ensure you receive the care you want.

Summary

Angina is chest pain caused by narrowed coronary arteries. It is brought on by one of many triggers like exercise or stress. Angina can be treated with medications, lifestyle changes, and medical procedures. If you have angina that comes on during rest and does not go away, seek immediate medical attention.