Stable angina

Alternative Names

Treatment

Treatment involves rest and medicine.

Medicines used to treat angina include:

• Nitroglycerin
• Blood thinners, including aspirin and clopidogrel (Plavix)
• Cholesterol-lowering drugs
• Blood pressure medicines, including calcium channel blockers, beta blockers, and angiotensin-converting enzyme (ACE) inhibitors

Ranolazine (Ranexa) is a relatively new medicine approved for the treatment of chronic angina. The drug is for patients who do not respond to traditional angina treatment. It should be used in combination with other medication. Your doctor will tell you which ones.

Your doctor may recommend a cardiac rehabilitation program to help improve your heart's fitness.

Some patients may need surgery such as:

• Angioplasty
• Coronary artery bypass grafting (CABG)

Recent studies show that angioplasty with stenting does not help you live longer than medicine alone, but it can reduce angina or other symptoms of coronary artery disease.

Angioplasty with stenting, however, can be a life-saving procedure if you are having a heart attack.

Outlook (Prognosis)

Stable angina usually improves with medication.

Possible Complications

• Unstable angina
• Heart attack
• Sudden death caused by lethal arrhythmias

When to Contact a Medical Professional

You should seek medical attention if you have new, unexplained chest pain or pressure. If you have had angina before, call your doctor.

Immediately go to the hospital if chest pain or heaviness lasts longer than 15 minutes or is not relieved with medication prescribed by your doctor. The pain may represent unstable angina or a heart attack.

Call your health care provider if:

• You have chest pain and have never seen a doctor for it
• Your need to take more and more nitroglycerin to make your angina go away
• Angina episodes happen more often, last longer than usual, or feel different than before
• You have shortness of breath

Seek immediate medical help if a person with angina loses alertness (consciousness).

References

Boden WE, O'rourke RA, Teo KK, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease. N Engl J Med. 2007 Mar 26; [Epub ahead of print].

Gibbons RJ, Abrams J, Chatterjee K, et al.: ACC/AHA 2002 guideline update for the management of patients with chronic stable angina--summary article: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on the Management of Patients With Chronic Stable Angina). J Am Coll Cardiol. 2003; 41(1): 159-68.

U.S. Food and Drug Administration. FDA Approves New Treatment for Chest Pain. Rockville, MD: National Press Office; January 31, 2006. Press Release P06-15.

Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed. St. Louis, Mo; WB Saunders; 2005: 1281-1308.

Mehta SB. Management of coronary heart disease: stable angina, acute coronary syndrome, myocardial infarction. Prim Care. 2005; 32(4): 1057-81.