In this Article

• Introduction to angina
• What is angina and what are the symptoms of angina?
• What causes angina?
• What are other causes of chest pain?
• Why is it important to establish the diagnosis of angina?
• How is angina diagnosed?
• What are the treatment options for angina patients?
• Medication
• Nitroglycerin
• Beta Blockers
• Calcium Channel Blockers
• Angioplasty and coronary artery bypass surgery
• What's new in the evaluation of angina?
• What's new in the treatment of angina and heart attacks?
• Angina At A Glance
• Patient Discussions: Angina - How Was Diagnosis Established
• Angina Glossary
• Angina Index

What are the treatment options for angina patients?

Treatment options include:

• rest,
  
  
• medications (nitroglycerin, beta blockers, calcium channel blockers),
  
  
• percutaneous transluminal coronary angioplasty (PTCA), or
  
  
• coronary artery bypass graft surgery (CABG).

Medications

Nitroglycerin

Resting, nitroglycerin tablets (placed under the tongue), and nitroglycerin sprays all relieve angina by reducing the heart muscle's demand for oxygen. Nitroglycerin also relieves spasm of the coronary arteries and can redistribute coronary artery blood flow to areas that need it most. Short-acting nitroglycerin can be repeated at five minute intervals. When 3 doses of nitroglycerin fail to relieve the angina, further medical attention is recommended. Short-acting nitroglycerin can also be used prior to exertion to prevent angina.

Longer-acting nitroglycerin preparations, such as Isordil tablets, Nitro-Dur transdermal systems (patch form), and Nitrol ointment are useful in preventing and reducing the frequency and intensity of episodes in patients with chronic angina. The use of nitroglycerin preparations may cause headaches and lightheadedness due to an excess lowering of blood pressure.

Beta Blockers

Beta blockers relieve angina by inhibiting the effect of adrenaline on the heart. Inhibiting adrenaline decreases the heart rate, lowers the blood pressure, and reduces the pumping force of the heart muscle, all of which reduce the heart muscle's demand for oxygen. Beta blockers include:

• acebutolol (Sectral)
  
  
• atenolol (Tenormin)
  
  
• bisoprolol (Zebeta)
  
  
• metoprolol (Lopressor, Lopressor LA, Toprol XL)
  
  
• nadolol (Corgard)
  
  
• propranolol (Inderal)
  
  
• timolol (Blocadren)

Side effects include:

• worsening of asthma,
  
  
• excess lowering of the heart rate and blood pressure,
  
  
• depression,
  
  
• fatigue,
  
  
• impotence,
  
  
• increased cholesterol levels, and
  
  
• shortness of breath due to diminished heart muscle function (congestive heart failure).

Angina - How Was Diagnosis Established

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How was the diagnosis of your angina established?

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Suggested Reading by Our Doctors

• Beta Blockers - Learn more about Beta Blockers, a drug that treats angina and other heart rhythm disorders, migraines, high blood pressure, panic attacks, and tremors. Generic and brand names are included in the article.
• Coronary Artery Bypass Graft - Read about heart bypass surgery (coronary artery bypass graft surgery, CABG) including how coronary artery disease is diagnosed, treated, recovery time, risks and complications, and the long term results after CABG.
• Low Blood Pressure - Learn about low blood pressure (hypotension). Low blood pressure is blood pressure below normal and symptoms may include: lightheadedness, dizziness, fainting upon standing (orthostatic hypotension). There are many causes of low blood pressure, and treatment is dependant upon the cause.

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