| To relieve the immediate pain of angina, individuals are advised to sit down as soon as the discomfort begins and remain quiet until the pain stops. A short-acting nitrate (nitroglycerin) can be placed under the tongue (sublingually). This usually relieves the pain within several minutes by enlarging the diameter (vasodilating) of the coronary arteries and lowering the systemic blood pressure so the heart does not have to perform as much work. The individual suffering from angina should keep nitroglycerin on hand at all times. If pain is not relieved by a repeat dose, emergency medical attention is needed.
For ongoing treatment, long-acting nitrates are often given in combination with beta-blocking agents to decrease the number and severity of angina attacks. Long-acting nitrates can be taken orally or administered as a skin patch or paste (topically). Calcium channel blockers may also be prescribed to complement the antianginal action of vasodilators and beta-blockers. Other medical treatments that may be beneficial include enteric-coated aspirin to inhibit blood clotting, lipid lowering agents, and estrogen therapy in women to reduce low-density lipoprotein and increase high-density lipoprotein.
Lifestyle changes such as limiting dietary fat intake, getting adequate exercise, and ceasing to smoke can minimize progression of coronary artery disease and decrease the frequency and severity of angina. Individuals who are anxious and nervous may be advised to seek counseling, and a mild tranquilizer may be prescribed. Overweight individuals should be encouraged to reduce weight, avoid high-calorie and high-cholesterol diets, abstain from gas-forming foods, and rest for short periods following meals. A high-fiber diet may lower serum cholesterol and triglyceride levels, decrease hypertension, and decrease the number and severity of anginal attacks. Diabetics should optimize control of their blood sugar levels. A regular program of daily exercise and immediate abstinence from smoking should be encouraged. Individuals should avoid "passive smoking" (being with a smoker or in a smoke-filled room) in order to reduce the risk of angina.
Invasive procedures designed to increase coronary blood flow and ease the symptoms of angina include inflation of a balloon in the artery at the site of obstruction (percutaneous transluminal coronary angioplasty or PTCA), placement of a self-expanding device into the vessel at the site of obstruction (coronary stent), and a coronary artery bypass graft (CABG) where the obstructed part of the artery is surgically bypassed. |
Source: Medical Disability Advisor