TREATMENTS AND
INVESTIGATIONS
How can the doctor help me?
There are medicines and various surgical procedures which can help. The
medicines used to treat angina fall into two groups:
Medicines which widen the blood vessels
Nitrates can be used when you have an attack of angina. They are usually
taken as a tablet or spray under the tongue. They work immediately to relieve
pain. Long acting nitrates are also available and these are usually taken as
tablets or put on as a skin patch. If these are used regularly each day they
can help reduce the number of angina attacks you get. The nitrates work by
forcing the arteries to open up a bit wider. They work on lots of blood vessels
throughout the body, so many people find they get a headache when they use them
because the blood vessels in the brain widen too. However, if the headaches are
particularly troublesome, or if you have any side effects which worry you, let
your doctor know.
Other heart medicines which you take every day
On the whole, the regular heart medicines you may have to take every day
reduce the amount of work the heart has to do. There are various types, the
most common being beta blockers. They calm the heart down and lower the blood
pressure so the heart does not have to work so hard. Calcium antagonists work
by opening up the arteries and some also slow the heart down which takes some
of the pressure off the heart. You may be given Aspirin to take which helps
thin the blood and can help prevent or reduce the risk of clots forming on
vessel walls. Remember, all medicines can have side effects, but your doctor
will be able to advise which medicines are the most suitable for you.
What if the medicines don't control the angina?
The medicines your doctor gives you for angina are designed to give you
relief from your symptoms. They will not stop heart disease from continuing to
progress.
Therefore, if you are still having troublesome angina, your doctor may send
you to see a heart specialist. The specialist will examine you and perform some
tests (including special x-rays) to see if you could be helped in another
The heart's supply of oxygen and nutrition comes via the coronary arteries.
There are 2 coronary arteries and either of them or their branches may become
partly or totally blocked by a clot. This means that not enough oxygen or
nutrition gets to the heart muscle. In this case, the specialist may suggest
that you have an angioplasty.
Angioplasty is a special procedure which is used when one or more of your
arteries are badly blocked. A fine tube or catheter with a deflated balloon
attached to the tip is put into an artery in the leg or the arm until it
reaches the arteries of the heart. As the tip of this tube or catheter is
passed through the narrowed part of the artery, the balloon is blown up gently
to widen the narrowing. You would normally be awake for this procedure and can
usually go home in 24 - 48 hours. When angioplasty is not suitable the
possibility of surgery may be discussed.
Coronary artery bypass is an operation on the heart which is used for
patients with very badly blocked arteries when angioplasty is no longer
suitable. The surgeon bypasses these blockages, rather like a ring road, by
using a blood vessel from the patient's own body, usually a vein from the leg
or one from inside the chest. Most people are able to return home in a week or
so.
There are other treatments available; only a few have been discussed here.
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