How Is Angina Treated?
Treatments for angina include lifestyle changes,
medicines, medical procedures, and cardiac rehabilitation (rehab). The main
goals of treatment are to:
- Reduce pain and discomfort and how often it
occurs
- Prevent or lower the risk of
heart
attack and death by treating the underlying heart condition
Lifestyle changes and medicines may be the only
treatments needed if your symptoms are mild and aren't getting worse. When
lifestyle changes and medicines don't control angina, you may need medical
procedures or cardiac rehab.
Unstable angina is an emergency condition that
requires treatment in the hospital.
Lifestyle Changes
Making lifestyle changes can help prevent episodes
of angina. You can:
- Slow down or take rest breaks if angina comes on
with exertion.
- Avoid large meals and rich foods that leave you
feeling stuffed if angina comes on after a heavy meal.
- Try to avoid situations that make you upset or
stressed if angina comes on with stress. Learn ways to
handle stress that can't be avoided.
You also can make lifestyle changes that help lower
your risk of heart disease. An important lifestyle change is adopting a healthy
diet. This will help prevent or reduce
high
blood pressure,
high
blood cholesterol, and
obesity.
Follow a heart healthy eating plan that focuses on
fruits, vegetables, whole grains, low-fat or no-fat diary products, and lean
meat and fish. The plan also should be low in salt, fat, saturated fat,
trans fat, and cholesterol.
Examples of healthy eating plans are the National
Heart, Lung, and Blood Institute's
Therapeutic
Lifestyle Changes (TLC) diet and the
Dietary
Approaches to Stop Hypertension (DASH) eating plan.
Your doctor may recommend TLC if you have high
cholesterol or the DASH eating plan if you have high blood pressure. Even if
you don't have these conditions, you can still benefit from these heart healthy
plans.
Other important lifestyle changes include:
- Quitting smoking, if you smoke. Avoid secondhand
smoke.
- Being physically active. Check with your doctor
to find out how much and what kinds of activity are safe for you.
- Losing weight, if you're overweight or obese.
- Taking all medicines as your doctor prescribes,
especially if you have
diabetes.
Medicines
Nitrates are the most commonly used medicines to
treat angina. They relax and widen blood vessels. This allows more blood to
flow to the heart while reducing its workload.
Nitroglycerin is the most commonly used nitrate for
angina. Nitroglycerin that dissolves under your tongue or between your cheeks
and gum is used to relieve an angina episode. Nitroglycerin in the form of
pills and skin patches is used to prevent attacks of angina. These forms of
nitroglycerin act too slowly to relieve pain during an angina attack.
You also may need other medicines to treat angina.
These medicines may include beta blockers, calcium channel blockers, ACE
inhibitors, oral antiplatelet (an-ty-PLAYT-lit) medicines, and anticoagulants
(AN-te-ko-AG-u-lants). These medicines can help:
- Lower blood pressure and cholesterol levels
- Slow the heart rate
- Relax blood vessels
- Reduce strain on the heart
- Prevent blood clots from forming
Medical Procedures
When medicines and other treatments don't control
angina, you may need a medical procedure to treat the underlying heart disease.
Angioplasty
(AN-jee-oh-plas-tee) and
coronary
artery bypass grafting (CABG) are both commonly used to treat angina.
Angioplasty opens blocked or narrowed coronary
arteries. During angioplasty, a thin tube with a balloon or other device on the
end is threaded through a blood vessel to the narrowed or blocked coronary
artery. Once in place, the balloon is inflated to push the plaque outward
against the wall of the artery. This widens the artery and restores blood flow.
Angioplasty can improve blood flow to your heart,
relieve chest pain, and possibly prevent a heart attack. Sometimes a small mesh
tube called a
stent
is placed in the artery to keep it open after the procedure.
During CABG, healthy arteries or veins taken from
other areas in your body are used to bypass (that is, go around) your narrowed
coronary arteries. Bypass surgery can improve blood flow to your heart, relieve
chest pain, and possibly prevent a heart attack.
Your doctor will help decide which treatment is
right for you.
Cardiac Rehabilitation
Your doctor may prescribe cardiac rehab for angina
or after angioplasty, CABG, or a heart attack.
The cardiac rehab team may include doctors, nurses,
exercise specialists, physical and occupational therapists, dietitians, and
psychologists or other behavioral therapists.
Rehab has two parts:
- Exercise training. This part helps you learn how
to exercise safely, strengthen your muscles, and improve your stamina. Your
exercise plan will be based on your individual abilities, needs, and interests.
- Education, counseling, and training. This part of
rehab helps you understand your heart condition and find ways to reduce your
risk of future heart problems. The cardiac rehab team will help you learn how
to cope with the stress of adjusting to a new lifestyle and to deal with your
fears about the future.
For more information on cardiac rehab, see the
Diseases and Conditions Index
Cardiac
Rehabilitation article. |