Medicines for Angina

What it is

Angina is the discomfort that happens when the heart muscle does not get enough oxygen-rich blood, most often because the coronary arteries have become narrowed by fatty deposits (atherosclerosis). It is typically felt as a tightness, heaviness or pressure in the chest that may spread to the arm, neck, jaw or back, and in stable angina it is brought on by exertion or stress and eases with rest. Angina itself is a warning sign rather than a heart attack, but it shares the same underlying disease, so it is treated both to relieve symptoms and to reduce the longer-term risk of a heart attack. A new, worsening or rest-onset pattern (unstable angina) is treated as an emergency. Diagnosis and ongoing care usually involve a doctor assessing symptoms, risk factors and tests of the heart’s blood supply.

How it is treated

Treatment has two distinct aims that run side by side: relieving and preventing the pain, and protecting the heart for the future. For symptoms, a fast-acting nitrate (GTN) is used to relieve or head off an attack, while a regular preventer — typically a beta-blocker or a calcium-channel blocker — reduces how often angina occurs by easing the heart’s workload. Just as important is secondary prevention, which tackles the underlying artery disease: an antiplatelet to make clots less likely and a statin to lower cholesterol are standard, alongside firm control of blood pressure, diabetes and smoking. When medicines do not control symptoms, or the disease is significant, procedures to open or bypass narrowed arteries may be considered. The overall plan is individualised and reviewed over time.