Treatment

Staying active, not smoking, and adopting healthy eating habits are important ways to control your symptoms. Medications prescribed by your health care team may also help. Some of the medications help lessen the risk of factors that lead to angina and heart disease, while others help ease symptoms 

Your health care professional will help you find the best combination of medications and treatments to manage your condition. 

Medications

Several medications are used to control the symptoms of angina.

Beta blockers help ease the work the heart has to do by slowing down your heart rate and lowering your blood pressure. If you have had a heart attack, these medications will help prevent another one and help you live longer. 

Nitroglycerin and nitrates increase blood flow to the heart by opening up, or dilating, the blood vessels in the body. This allows blood to flow to the heart muscle more easily when coronary arteries are narrowed. It also decreases the workload on the heart to supply blood to the body. There are commonly long-acting versions, but there are also fast-acting versions that go under the tongue. 

Calcium channel blockers, like beta blockers, help ease the work the heart has to do by slowing down your heart rate and lowering your blood pressure. Not all medications of this type will slow down heart rate as well as others, but they are all useful to lower high blood pressure. They are not used if your heart is weak. 

Ranolazine may be prescribed in some cases. This medicine helps the heart relax and not have to work as hard. Unlike other medications used for angina, it is able to do this without changing your blood pressure or your heart rate.

Procedures/Surgery

Opening up narrowed coronary arteries to restore blood flow to the area of the heart muscle that is not getting enough can relieve the symptoms of angina. There are two main ways to restore blood flow to the heart:

• Stent placement, also called balloon angioplasty or percutaneous coronary intervention (PCI)
• Coronary artery bypass graft (CABG) surgery, or open-heart surgery 

These treatments can improve quality of life for patients with advanced coronary artery disease.

Your treatment will depend on your symptoms and preferences, how many narrowed or blocked arteries you have and where they are, your age, overall health, and other risk factors. You will need to take antiplatelet medications after PCI. Talk about these options with your heart doctor.

Cardiac Rehabilitation
Cardiac rehabilitation (rehab) is typically a 12-week, medically supervised program. It includes counseling on how to exercise safely, eat heart healthy, manage stress and quit smoking. It also teaches you how to take better care of your health.  

Intensive cardiac rehab might be available in your area and consists of nine weeks of four-hour sessions, two times per week. In these sessions you will have supervised exercise, as well as an hour of nutrition counseling and a meal, an hour of stress relief, and an hour of group support. The outcomes from this intensive program are usually even better than traditional cardiac rehab.

Cardiac rehab can reduce heart symptoms, help control heart risk factors and improve quality of life.

Enhanced External Counterpulsation Therapy 
Enhanced external counterpulsation (EECP) therapy may be recommended in some patients if you have angina that limits you from your daily activities and that has not improved with standard treatments.  

During EECP, inflatable cuffs (similar to blood pressure cuffs) are placed on the calves, thighs and buttocks.  The cuffs inflate and deflate in rhythm with your heart, improving blood flow to the heart. EECP may generate the formation of small blood vessels in the heart to create a natural bypass around blocked or narrowed arteries. EECP may increase exercise duration and decrease angina.