Treatment of Angina Pectoris
Treatment of Angina Pectoris is generally tailored to the patient’s condition, ranging from lifestyle changes, drug consumption, to medical measures such as surgery and other supportive therapies.
- Lifestyle changes
- Patients are generally advised to stop smoking or avoid cigarette smoke, eat nutritious and low-fat foods in small portions, exercise as directed, and maintain glucose levels for people with diabetes.
- Lifestyle changes are advised not only during treatment, but for the long term for the angina pectoris attack to decrease or stop completely.
- As angina strikes, glyceryl trinitrate drugs can be taken to relieve symptoms in a short time. Glyceryl trinitrate included in the class of nitrate serves to calm and dilate blood vessels to facilitate blood flow to the heart. Side effects such as dizziness and redness of the skin may occur. Avoid consuming alcohol, operating heavy equipment, or driving while in this treatment.
- Glyceryl trinitrate may be taken in two doses, when the angina attack and when symptoms do not subside within a period of 5 minutes. If symptoms are still present, visit the nearest hospital for quick treatment.
- This drug can also be used as a deterrent just before exercise or other strenuous activities. Make sure you ask your doctor before taking this medication.
If angina is frequent, your doctor may prescribe the following medications:
- Aspirin, including the class of antiplatelet drugs (blood thinners) that work to relieve or avoid blood clots, and reduce the risk of heart attack. Side effects that may be experienced are irritation of the stomach, nausea and digestive problems. Avoid giving these drugs to children or adolescents aged 16 and under before consulting a doctor.
- Beta blockers (beta blockers), help lower blood pressure by inhibiting the effects of epinephrine or adrenaline hormones that can increase heart rate in excess. It also helps to dilate blood vessels and smooth blood flow. Side effects that may be experienced are easily tired, diarrhea, nausea, and cold sweat.
- Anti-clotting drugs, used to inhibit blood clots by preventing blood platelet cells from sticking. Side effects that may be experienced are severe dizziness, bleeding, hair loss, and bruises on the skin.
- Calcium channel blockers (calcium channer blockers). This drug serves to dilate blood vessels by relaxing muscle walls of the arteries. Side effects that may be experienced are facial redness, dizziness, and easily tired.
- Statins, used to inhibit cholesterol-producing enzymes in the liver and reduce the risk of heart attack or stroke. It also helps the body soak up cholesterol that accumulates as plaque attached to the artery walls, and provides other positive effects. Side effects that may be experienced are constipation, diarrhea, and abdominal pain.
- The angiotensin-converting enzyme (ACE inhibitors) drug, works by inhibiting angiotensin II hormone as a trigger for constriction of blood vessels and lowering blood pressure in the body. These drugs can reduce the blood supply to the kidneys, so it is advisable to check the condition of the kidney through blood and urine tests before and during taking this drug. Side effects that may be experienced are dizziness, fatigue, and a dry cough that is generally only temporary.
- Ivabradine. These drugs lower the rate of heart rate as a beta blocker, but have more security for people with lung infections, or other diseases that are not allowed to take beta-blocking drugs. Side effects that may be experienced are blurred vision or glare for some time. Patients are advised not to drive after taking this drug.
- Ranolazine, used to relax the heart muscle and improve blood flow. These drugs are commonly prescribed for patients with heart failure and artemia because they do not affect heart rate. Side effects that may be experienced are dizziness, easy fatigue, and constipation.
- Nicorandril. This drug contains a potassium channel activator that works dilate the arteries and blood circulation to the heart. Nicorandil is commonly used as a substitute for calcium channel inhibitors for patients with certain medical conditions. Side effects that may be experienced are nausea and dizziness.
If symptoms of angina pectoris do not improve with either treatment, it would be recommended to do combination therapy by combining some of these drugs.
- Coronary artery bypass graft (CABG). Surgical action is performed by creating a new flow at the point of narrowing or blockage of the arteries through the transplantation of blood vessels from other limbs. This action is usually recommended for people with angina with diabetes, aged over 65 years, and has more than 3 blockages in the arteries.
- Percutaneous coronary intervention (PCI). Surgical action also called coronary angioplasty is done by inserting a small balloon on the outside of the narrowed artery, and retained using an iron ring (sten) to smooth the blood flow again. This action is not recommended for patients with structural abnormalities of blood vessels.
In general, both of these surgical actions can be performed for stable and unstable angina patients, but patients should consider the side effects and complications that may occur at or after the action. Consult a physician before making a decision.
Therapy and other medical measures
If treatment and surgery can not be performed or do not help much, suggestions for cognitive behavioral therapy or cognitive behaviour therapy (CBT) may be an option. This therapy is done by changing the mindset of the patient with a positive response with the aim of reducing the symptoms associated with stress of the mind and facilitate the healing process. This therapy can also be done if the patient is depressed or anxiety due to symptoms of angina pectoris repeatedly attacked.
Sometimes, acupuncture therapy becomes an alternative choice of therapy. It is advisable to consult a doctor before doing so, in order to avoid harmful side effects.