Stable angina

  • Alternative Names

    Angina - stable; Angina - chronic; Angina pectoris


    Treatment

    The options for treating angina include lifestyle changes, medications, and invasive procedures such as coronary angioplasty or stent placement and coronary artery bypass surgery.

    You and your doctor should agree on a plan for treating your angina on a daily basis. This should include:

    • What medicines you should be taking to prevent angina
    • What activities are okay for you to do, and which ones are not
    • What medicines you should take when you have angina
    • What are the signs that your angina is getting worse
    • When you should call the doctor or 911

    MEDICATIONS

    You may be asked to take one or more medicines to treat blood pressure, diabetes, or high cholesterol levels. Follow your doctor's directions closely to help prevent your angina from getting worse.

    Nitroglycerin pills or spray may be used to stop chest pain.

    Taking aspirin and clopidogrel (Plavix) or prasugrel (Effient) helps prevent blood clots from forming in your arteries, and reduces your risk of having a heart attack. Ask your doctor whether you should be taking these medications.

    Your doctor may give you one or more medicines to help prevent you from having angina.

    • ACE inhibitors to lower blood pressure and protect your heart
    • Beta-blockers to lower heart rate, blood pressure, and oxygen use by the heart
    • Calcium channel blockers to relax arteries, lower blood pressure, and reduce strain on the heart
    • Nitrates to help prevent angina
    • Ranolazine (Ranexa) to treat chronic angina

    NEVER ABRUPTLY STOP TAKING ANY OF THESE DRUGS. Always talk to your doctor first. Stopping these drugs suddenly can make your angina worse or cause a heart attack. This is especially true of anti-clotting drugs (aspirin, clopidogrel, and prasugrel).

    Your doctor may recommend a cardiac rehabilitation program to help improve your heart's fitness.

    INVASIVE AND SURGICAL TREATMENT

    Some patients may need surgery to help improve the flow of blood through the coronary arteries.

    Angioplasty and stent placement (also called percutaneous coronary intervention) is a procedure in which a physician inserts a catheter through an artery in either the arm or leg and advances the catheter into the heart. It is done to both open up and keep open a coronary artery that has become too narrow.

    Angioplasty with stenting probably does not help people with stable angina live longer than treatment with medicine alone. However, it can reduce angina or other symptoms of coronary artery disease. Angioplasty with stenting can be a life-saving procedure if you are having a heart attack or unstable angina.

    Not every blockage can be treated with angioplasty. Some people need coronary bypass (heart surgery). Whether this procedure can be done depends on which of the coronary arteries are narrowed and how severely they are narrowed.


    Support Groups


    Expectations (prognosis)

    Stable angina usually improves with medication.


    Complications
    • Heart attack
    • Sudden death caused by abnormal heart rhythms (arrhythmias)
    • Unstable angina

    Calling your health care provider

    Seek medical attention if you have new, unexplained chest pain or pressure. If you have had angina before, call your doctor.

    Call 911 if your angina pain:

    • Does not go away after 15 minutes
    • Does not go away after three doses of nitroglycerin
    • Is getting worse
    • Returns after the nitroglycerin helped at first

    Call your doctor if:

    • You are having angina symptoms more often.
    • You are having angina when you are sitting. This is called rest angina.
    • You are feeling tired more often.
    • You are feeling faint or light-headed.
    • Your heart is beating very slowly (less than 60 beats a minute) or very fast (more than 120 beats a minute), or it is not steady.
    • You are having trouble taking your heart medicines.
    • You have any other unusual symptoms.

    Seek immediate medical help if a person with angina loses consciousness.