Treatment can help stop angina attacks. It can also reduce the risk of further problems such as heart attacks.
Treatment usually involves medicine. Your doctor may recommend surgery if medicines do not help.
You may also need to make healthy lifestyle changes to live well with angina.
Medicines for angina
Most people with angina need to take a few medicines.
Medicines to treat attacks
If you have stable angina, you'll be prescribed medicine to take when you have an angina attack.
This medicine is called glyceryl trinitrate (GTN). It comes as a mouth spray or tablets that dissolve under your tongue.
If you have an angina attack:
- Stop what you're doing and rest.
- Use your GTN medicine.
- Take a second dose after 5 minutes if the first does not help.
- Call 112 or 999 for an ambulance if you still have symptoms 5 minutes after taking the second dose.
You can also use GTN to avoid an attack, for example before doing exercise. You may have a headache, flushing or dizziness soon after using it.
GTN tablets usually expire about 8 weeks after the packet is opened. You'll need to replace them after this. GTN spray lasts much longer, so may be more convenient.
Medicines to prevent angina attacks
To help avoid more attacks, you also need to take at least 1 other medicine every day for the rest of your life. Some people need to take 2 or more medicines.
The main medicines used to prevent angina are:
- beta blockers - to make the heart beat slower and with less force
- calcium channel blockers - to relax the arteries, increasing blood supply to the heart muscle
If you cannot have these medicines or they do not work, you may be given other medicines such as ivabradine, nicorandil or ranolazine.
Medicines to prevent hearts attacks and strokes
Angina is a warning sign that you're at a higher risk of problems such as heart attacks or strokes.
You may also need to take extra medicines to reduce this risk.
These include:
- low-dose aspirin - to prevent blood clots
- statins - to reduce your cholesterol (blood fats) level
- ACE inhibitors - to reduce your blood pressure
Other treatments for angina
Your GP or cardiologist may recommend other treatments if medicines are not helping to control your angina.
Other ways to treat angina include:
- percutaneous coronary intervention (PCI)
- coronary artery bypass graft (CABG)
Talk to your doctor or surgeon about the best option for you.
You'll need to continue taking some medicines after the procedure.
Percutaneous coronary intervention (PCI)
Percutaneous coronary intervention (PCI) is where a narrowed section of artery is widened using a tiny tube called a stent. This also called stenting.
Coronary artery bypass graft (CABG)
Coronary artery bypass graft (CABG) is where a section of blood vessel is taken from another part of the body.
Your surgeon uses the blood vessel to channel blood around a blocked or narrow section of artery.
Unstable angina
If you have unstable angina, you need medicines to prevent blood clots. Medicines also reduce your risk of having a heart attack or stroke.
You may be given:
- low-dose aspirin
- clopidogrel
- an injection of a blood-thinning medicine soon after you're diagnosed
Surgery may be recommended if you:
- have a high risk of having another angina attack
- you're at a high risk of having a heart attack or stroke
