Patient education: Treatment choices for angina (The Basics)

What is angina? — 

This is chest pain or discomfort caused by a condition called "coronary artery disease" (also called "coronary heart disease"). In this condition, the arteries that supply the heart with blood get clogged with fatty deposits. When the vessels get too narrow, the heart muscle does not get enough blood. This causes chest pain or discomfort, especially during physical activity.

How is angina treated? — 

There are 2 main treatments: medicines and procedures.

Medical treatment — 

This includes different types of medicines, such as "nitrates" and "beta blockers." These work by relaxing blood vessels going to the heart muscle or reducing the amount of work the heart muscle has to do (figure 1).

If you have heart disease, you will also need to take other medicines, including:

●Statins, which lower cholesterol

●Medicines to lower blood pressure

●Aspirin or other medicines that help prevent blood clots in the arteries

You should also make these lifestyle changes:

●Quit smoking, if you smoke.

●Eat lots of fruits and vegetables, but not a lot of meat or fatty foods.

●Walk or do some kind of physical activity on most days of the week.

●Lose weight, if you have excess body weight. Your doctor nurse can help you do this in a healthy way.

Procedures — 

These restore blood flow to the part of the heart that is not getting enough blood. They include:

●Stenting – The doctor puts a thin tube (called a "catheter") into a blood vessel in the leg or arm and moves it to the clogged artery in the heart. Then, they inflate a tiny balloon inside the clogged artery to open it. In most people, the doctor keeps the artery open using a tiny metal tube called a stent (figure 2).

●Bypass surgery – This is also known as "coronary artery bypass grafting." The doctor uses a healthy blood vessel from another part of the body where it is not needed. They attach this new blood vessel below the area that is clogged. This re-routes blood around the clogged artery, and lets it get to the part of the heart that was not getting blood (figure 3).

For relieving angina, either stenting or bypass surgery might be better than medicines alone. Some people get both procedures. But people who have a procedure still need to take medicines. In fact, skipping medicines after these procedures can be very dangerous.

Which treatment is best for me? — 

Your doctor will help you decide. Many different things affect the decision. These include your age, your symptoms, and the results of certain heart tests.

If your doctor recommends stenting or bypass surgery, ask these questions:

●How might this procedure help me?

●Will it help me live longer?

●Will it reduce my chance of having a heart attack?

●Will I feel better if I have this procedure than I would with medicines alone?

●What are the risks of the procedure?

●What happens if I don't have this procedure?

More on this topic

Patient education: Medicines for angina (The Basics)
Patient education: Angina (The Basics)
Patient education: Chest pain (The Basics)
Patient education: Medicines after a heart attack (The Basics)
Patient education: Cardiac catheterization (The Basics)
Patient education: Coronary artery bypass graft surgery (The Basics)
Patient education: Coronary artery disease (The Basics)
Patient education: Coronary artery disease in women (The Basics)
Patient education: Heart-healthy diet (The Basics)

Patient education: Angina treatment — medical versus interventional therapy (Beyond the Basics)
Patient education: Medications for angina (Beyond the Basics)
Patient education: Chest pain (Beyond the Basics)
Patient education: Heart attack recovery (Beyond the Basics)
Patient education: Coronary artery bypass graft surgery (Beyond the Basics)