Treatment for angina includes lifestyle changes, medicine, special procedures, and cardiac rehabilitation. The main goals of treatment are to:

• Reduce the frequency and severity of symptoms
• Prevent or lower the risk of heart attack and death

Lifestyle changes and medicine may be the only treatments needed if your symptoms are mild and are not getting worse. Unstable angina is an emergency condition that requires treatment in the hospital.

Lifestyle Changes

The first thing that you need to do is change your living habits to avoid bringing on an episode of angina.

• Slow down or take rest breaks, if angina comes on with exertion.
• Avoid large meals and rich foods that leave you feeling stuffed, if angina comes on after a heavy meal.
• Try to avoid situations that make you upset or stressed, if angina comes on with stress. Learn techniques to handle stress that can't be avoided.

You can also make other lifestyle changes, for example:

• Eat a healthy diet to prevent or reduce high blood pressure, high blood cholesterol, and obesity
• Quit smoking, If you smoke
• Be physically active, as directed by your doctor
• Lose weight, if you are overweight or obese.
• Follow your doctor's orders and take all medicines as directed, especially if you have diabetes

Medications

Nitrates are the most commonly used medicines to treat angina. They relax and widen blood vessels. This allows more blood to flow to the heart while reducing its workload.

Nitroglycerin is the most commonly used nitrate for angina. Nitroglycerin that dissolves under your tongue or between your cheeks and gum is used to relieve an angina episode. Nitroglycerin in the form of pills and skin patches is used to prevent attacks of angina. These forms of nitroglycerin act too slowly to relieve pain during an angina attack.

You also may need other medicines to treat angina. These medicines may include beta blockers, calcium channel blockers, ACE inhibitors, oral antiplatelet medicines, and anticoagulants. These medicines can help:

• Lower blood pressure and cholesterol levels
• Slow the heart rate
• Relax blood vessels
• Reduce strain on the heart
• Prevent blood clots from forming

Medical Procedures

When medicines and other treatments don't control angina, you may need a medical procedure to treat the underlying heart disease. Angioplasty and coronary artery bypass grafting (CABG) are both commonly used to treat angina.

Angioplasty opens blocked or narrowed coronary arteries. During angioplasty, a thin tube with a balloon or other device on the end is threaded through a blood vessel to the narrowed or blocked coronary artery. Once in place, the balloon is inflated to push the plaque outward against the wall of the artery. This widens the artery and restores blood flow.

Angioplasty can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure.

During CABG, healthy arteries or veins taken from other areas in your body are used to bypass (that is, go around) your narrowed coronary arteries. Bypass surgery can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.

Your doctor will help decide which treatment is right for you.

Cardiac Rehabilitation

Your doctor may prescribe cardiac rehab for angina or after angioplasty, CABG, or a heart attack.

The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians, and psychologists or other behavioral therapists.

Rehab has two parts:

• Exercise training. This part helps you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your individual abilities, needs, and interests.
• Education, counseling, and training. This part of rehab helps you understand your heart condition and find ways to reduce your risk of future heart problems. The cardiac rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and to deal with your fears about the future.