Angina (Chest Pain) Treatment
Your doctor will decide on a treatment approach based on the type of angina you have, your symptoms, test results, and risk of complications. Unstable angina is a medical emergency that requires immediate treatment in a hospital. If your angina is stable and your symptoms are not getting worse, you may be able to control your angina with heart-healthy lifestyle changes and medicines. If lifestyle changes and medicines cannot control your angina, you may need a medical procedure to improve blood flow and relieve your angina.
If you are diagnosed with angina, your doctor will prescribe fast-acting medicines you can take to control angina events and relieve pain. Often other medicines are also prescribed to help control angina long-term. The choice of medicines may depend on what type of angina you have.
- Anticoagulant medicines, or blood thinners, such as heparin, help prevent dangerous blood clots and future complications, such as a heart attack or another angina event.
- Antiplatelet medicines help prevent blood clots from forming. If you have stable or unstable angina, your doctor may recommend aspirin to treat angina and reduce the risk of complications of heart disease. Other platelet inhibitors, such as clopidogrel, may also be prescribed.
- Beta blockers help your heart beat slower and with less force. These drugs are often prescribed to help relieve angina. If you cannot take beta-blockers for some reason, long-acting nitrates are the preferred alternative.
- Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax. Calcium channel blockers may be an alternative medicine if you are unable to take beta blockers or nitrates. For variant angina, your doctor is likely to order calcium channel blockers and avoid giving you beta blockers.
- Nitrates widen and relax blood vessels, which allows more blood to flow to the heart while reducing the heart’s workload. Nitrate pills or sprays, including nitroglycerin, act quickly and can relieve pain during an event. Long-acting nitrates are available as pills or skin patches. If you are hospitalized for chest pain, your doctor may order intravenous (IV) nitrates to relieve your angina pain.
- Statins prevent plaque from forming and to relieve blood vessel spasms or inflammation, reducing the risk of a heart attack or other complications after emergency treatment.
If you still have symptoms or experience side effects, your doctor may prescribe other medicines, including:
- Morphine relieves pain and help relax the blood vessels. Your doctor may suggest it if other medicines have not helped.
- Ranolazine helps you have angina symptoms less often. When given with other anti-angina medicines, ranolazine can also increase the length of time you can be physically active without pain. This medicine may work for coronary microvascular disease, which causes microvascular angina. Ranolazine may be a substitute for nitrates for men with stable angina who take drugs for erectile dysfunction.
If lifestyle changes and medicines do not control angina, you may need a medical procedure to treat the underlying heart disease.
- Coronary artery bypass grafting (CABG) to treat coronary heart disease and relieve angina. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.
- Percutaneous coronary intervention (PCI), also known as coronary angioplasty, to open narrowed or blocked blood vessels that supply blood to the heart. This procedure requires cardiac catheterization. If PCI includes certain medicines to expand coronary arteries, the procedure may be helpful for some people who have variant angina.