Treatment options
Coronary artery stent
Coronary artery stent
Coronary artery stent
When placing a coronary artery stent, a doctor looks for a blockage in the heart's arteries (A) using cardiac catheterization techniques. A balloon on the tip of the catheter is inflated to widen the blocked artery. A metal mesh stent is used to hold the artery open (B). The stent allows blood to flow through the previously blocked artery (C).
If your angina is stable, you might be able to control it with lifestyle changes and medicines. Unstable angina requires treatment right away in a hospital. This may involve medicines or a procedure.
Medicines
Several medicines can improve angina symptoms, including:
- Aspirin. Aspirin and other anti-platelet medicines prevent blood clotting. This makes it easier for blood to flow through narrowed heart arteries.
- Nitroglycerin. This medicine widens the heart arteries. It can help control or relieve chest pain. Nitroglycerin is available as a pill, spray or patch.
- Beta blockers. These medicines help the heart beat more slowly and with less force. This eases angina pain.
- Statins. Statins are often prescribed to treat high cholesterol. They also might help prevent fatty deposits called plaque from clogging heart arteries.
- Calcium channel blockers. These medicines relax and widen blood vessels, increasing blood flow to the heart.
- Ranolazine. This medicine might be given with or instead of beta blockers for angina. It's typically used if angina symptoms don't improve with other medicines.
Angioplasty and stent placement
Angioplasty, also called percutaneous coronary intervention, increases blood flow through a blocked artery and decreases angina.
During an angioplasty, a doctor inserts a thin, flexible tube called a catheter into a blood vessel, usually in the groin or wrist. A tiny balloon is on the end of the tube. The doctor inflates the balloon to widen the artery. A small metal mesh tube called a stent may be placed to keep the artery open.
This process can take 30 minutes to several hours. You usually stay in the hospital at least overnight. Your health care team tells you when you can return to your daily activities.
Sometimes the blockage returns after an angioplasty. Using a stent coated with medicine can help prevent this.
If unstable angina or stable angina affects some of the main heart arteries and does not improve with stenting and other treatments, heart bypass surgery may be needed. Heart bypass surgery is open-heart surgery. It's also called coronary artery bypass grafting or CABG — pronounced "cabbage."
Enhanced external counterpulsation (EECP) therapy
EECP therapy might be recommended for some people whose angina doesn't improve with other treatments. For this therapy, large cuffs are wrapped around your legs. Air pressure causes the cuffs to inflate and deflate in time to your heartbeat. You typically need five one-hour treatments a week for seven weeks.
Lifestyle changes
Making lifestyle changes to keep the heart healthy is an important part of angina treatment. Try these tips:
- Quit smoking. If you smoke, stop. If you need help quitting, talk to your health care team about therapies that can help.
- Eat a healthy diet. Eat a healthy diet with limited amounts of saturated fat, trans fat, salt and sugar. Include a variety of fruits and vegetables, whole grains, lean meats, and low-fat dairy products in your diet.
- Stay active. Regular exercise and activity help control diabetes, high cholesterol and high blood pressure &mdash all risk factors for heart disease. Talk to your health care team about starting a safe exercise plan. If your angina occurs with activity, pace yourself and take rest breaks.
- Manage weight. Ask your doctor what a healthy weight is for you and how to achieve it.
- Treat medical conditions. Get treatment for health conditions that can increase your risk of angina, such as diabetes, high blood pressure and high blood cholesterol.
- Reduce stress. Find ways to help reduce emotional stress. Getting more exercise, practicing mindfulness and connecting with others in support groups are some ways to reduce and manage stress.