Reviewed By: Pramod Kerkar, MD, FFARCSI

Angina is a type of chest pain that occurs when the arteries carrying blood to their heart muscle turn narrow. This can restrict the blood supply and so result in pain called an angina attack. Angina attacks are caused by physical exertion, excitement or stress. But if someone has unstable angina, then their attacks can be unpredictable, with no obvious cause. Angina is not life-threatening on its own. However, someone who suffers from it is at far greater risk of having life-threatening problems, like heart attack or heart stroke.

Now, what exactly you need to do for angina attack? Read below and discover the same.

What To Do For Angina Attack?

First of all, it is important to determine what type of angina you have. It must be noted that different types of angina may require different types of treatments. Chronic stable angina is a common type of angina that is a type of angina occurring when your heart is working hard. Even unstable angina, is also a common type of angina which is new chest pain that is getting worse. Variant angina and mircovascular angina are other types of angina.

Mild stable angina is controlled by medications and one may not need any further treatments. However, if you are experiencing symptoms of chronic stable angina even after taking medications and making lifestyle changes, you are at higher risk of serious heart disease and your doctor may recommend angioplasty or coronary bypass surgery. Similarly, treatment for unstable angina involves hospitalization with medications to stabilize your condition. Some people may also require angioplasty along with stenting; and in some cases heart surgery or coronary bypass surgery may be required.

Below are some of the options to manage an angina attack:

Treat With Nitroglycerin:

If you get angina attack and are prescribed nitroglycerin; what you need to do is dissolve 1 nitroglycerin tablet under your tongue or use nitroglycerin spray under the tongue, wait for 5 minutes to see the improvement in condition.

In case of chronic stable angina, dissolve 1 nitroglycerin tablet under the tongue or use the nitroglycerin spray under the tongue and repeat this every 5 minutes until you have taken 3 tablets in 15 minutes.

Even after trying Nitroglycerin, if you still have angina then call 911 or consult your doctor immediately.

Medications For Angina Attack:

If you have stable angina then you may be able to treat the condition with medications and lifestyle changes alone, and you may not require angioplasty and stenting. Below are some of the medications that can be used to improve symptoms of angina.

Aspirin: Aspirin is the medicine that reduces the ability of your blood to clot, and thus making it easier for blood to flow through narrowed heart arteries. Preventing blood clotting may reduce the risk of a heart attack.

Nitrates: Nitrates are usually used to treat angina. Nitrates relax and widen the blood vessels, allowing more of blood to flow to the heart muscle.

You might take a nitrate when you have chest discomfort due to angina, before doing something that usually triggers angina attack(such as physical exertion), or on a long-term preventive basis. The most common form of nitrate used to treat angina is sublingual nitroglycerin tablets, which you have to put under your tongue.

Statins: There are drugs, known as statins which are used to lower blood cholesterol and they work by blocking a substance your body requires to make cholesterol. They may also help your body reabsorb cholesterol that has accumulated in the fats buildup or plaques in your artery walls, thus helping prevent further blockage in the blood vessels.

Beta Blockers: Beta blockers are medications that work by blocking the effects of hormone epinephrine, also known as adrenaline. As a result of this, your heart beats more slowly and with less force; thus reducing the blood pressure and reducing the workload on your heart. They also help blood vessels relax and open up to improve the flow of blood, which reduces or prevents angina attack.

Calcium Channel Blockers: Calcium channel blockers, which are also known as calcium antagonists, relax and widen blood vessels by affecting the muscle cells in the arterial walls. This in turn increases blood flow in the heart and thus reducing or preventing angina. Calcium channel blockers or calcium antagonists, also slow your pulse and reduces the workload on your heart.

Ranolazine or Ranexa: Ranolazine or Ranexa, is an anti-angina medication that may be prescribed by your doctor with other angina medications, such as beta blockers. It can also be used as a substitute if you cannot take beta blockers.

Angiotensin-Converting Enzyme or ACE Inhibitors: Angiotension-converting enzyme or ACE inhibitors are the drugs that help relax blood vessels. ACE inhibitors prevent an enzyme in your body from producing angiotensin II, or a substance in your body that affects your cardiovascular system in several ways, including narrowing your blood vessels. This narrowing of blood vessel can result in high blood pressure and force your heart to work harder. These medications might help people having other conditions such as high blood pressure and diabetes.

NOTE: If you have tried the medicines and also went through the crucial lifestyle changes, and still have symptoms of angina that are limiting you, an angioplasty with stenting may be essential, depending on your condition and the cause of angina.

Angioplasty and Stenting for Angina Attack:

In angioplasty, the doctor inserts a tiny balloon in your narrowed artery via a catheter that is placed in an artery, generally in your groin. In order to widen the narrowed artery, your doctor inflates the balloon, and then the doctor may insert a small metal tube known as the Stent so as to keep the artery open. Some stents are bare metal, some are covered with a synthetic fabric, and others are coated with medications so as to help keep your artery open.

We must let you know that angioplasty and stenting involve some risks such as, risk of blockages re-forming after a stent is implanted, risk of a blood clot forming in the stent, and also small risks of having a heart attack, heart stroke, or life-threatening bleeding during or after the angioplasty and stenting procedure. You should consider that even if you have a stent placed, you will likely require taking aspirin for the rest of your life and also to prevent blood clots, you may need to take additional medications.

You must be made aware that you will probably remain hospitalized for at least a day while your heart is monitored and your vital signs are checked frequently. Generally patients can return back to work or their normal routine soon after angioplasty.

Enhanced External Counterpulsation Therapy or EECP Therapy:

Enhanced external counterpulsation therapy or EECP may be recommended for some individuals with angina. During this therapy, your doctor places cuffs on your legs and applies air pressure to the legs in rhythm with your heartbeats. This treatment may help improve blood flow to yoru heart and thus may improve the condition in angina.

Stem Cell Therapy For Angina:

Stem cell therapy could be a new treatment for angina. This new treatment came from the discovery some years ago that CD3+ stem cells stimulate the formation of new blood vessels. Coronary artery disease involves not only the blockage of major arteries, but also the death of small vessels, or capillaries of the heart muscles. This stem cell treatment targets these small vessels that have been damaged. The stem cells have shown their ability to repair and replace the damaged small vessels in animal model.

From the findings on stem cell therapy for angina, it can be said in human terms, that patients who might have been able to sit and watch television with no symptoms could now walk at a normal pace without chest pain, and someone who could walk at a slow pace, might be able to ride a bike.

Lifestyle Changes:

You have to make some healthy lifestyle changes. You can reduce or prevent angina by working on reducing your heart disease risk factors and thus making healthy lifestyle. For this, you need to avoid smoking, eat healthy diet with limited amount of saturated fat, trans fat and salt and include a lot of fruits and vegetables, lean meats, whole grains, and low-fat dairy products in your diet, start a safe exercise plan by asking to your doctor, try out all weight-loss option and avoid being overweight.

Apart from all these, avoid stress by trying out all possible stress-reduction techniques and also get treatment for diseases or conditions that can increase the risk of angina, such as high blood pressure, high blood cholesterol, and diabetes.

Conclusion:

Now we talked about some of the treatment methods that could be used if you have an angina attack. So, if you try medication and lifestyle changes and yet do not relieve your angina, angioplasty and stenting may be other option. In some cases coronary bypass surgery may be required. There are also other options that can be used to treat the angina attack. So, it is essential for you to talk to your doctor if you are suffering from angina. Your doctor will let you know about what therapy would be appropriate for you. Remember that with any treatment plan, lifestyle changes are also important.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: November 8, 2018

This article does not provide medical advice. See disclaimer

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