Blocked heart arteries are causing your chest pain (angina), keeping an area of your heart from getting enough oxygen. Your doctor says you need to treat the blockages to avoid a heart attack and other complications.
There are several options for treating angina, which might depend on the type of angina you have. How do you choose? Here's information to help.
Angina is pain, discomfort or pressure in the chest. The most common types are chronic stable angina and unstable angina.
Unstable angina. This is either new chest pain or a change in your usual pattern of chest pain, whether it's worsening, lasting longer, or not being relieved by rest or medication.
Unstable angina is dangerous and a warning sign of a heart attack. If your angina is unstable, seek urgent medical care.
Other types of angina include variant or Prinzmetal's angina — a rare type caused by a spasm in the coronary arteries — and microvascular angina, which can be a symptom of disease in the small coronary artery blood vessels.
The best treatment for your angina depends on the type of angina you have and other factors. If your angina is stable, you might be able to control it with lifestyle changes and medicines. Unstable angina requires immediate treatment in a hospital, which could involve medicines and surgical procedures.
Several medications can improve angina symptoms, including:
Angioplasty and stent placement
Angioplasty, also known as percutaneous coronary intervention, increases blood flow through a blocked artery and decreases angina.
During an angioplasty (AN-jee-o-plas-tee), your doctor threads a tiny, deflated balloon attached to special tubing up through an artery, generally in your groin, to your narrowed coronary artery. Your doctor inflates the balloon to widen the artery. He or she might then insert a small metal tube (stent) to keep the artery open.
This procedure can take 30 minutes to several hours, and you'll probably remain in the hospital at least overnight. You can generally return to work or your normal routine soon after the angioplasty and stent procedure.
Angioplasty and stenting involve some risks, including a risk of the blockage re-forming. A stent coated with medication can help prevent this.
Enhanced external counterpulsation (EECP) therapy
EECP therapy might be recommended for some people whose angina doesn't improve with other treatments. For this therapy, large cuffs are wrapped around your legs. Air pressure causes the cuffs to inflate and deflate in time to your heartbeat. This typically requires getting five one-hour treatments a week for seven weeks.
Regardless of which angina treatment you choose, your doctor will recommend that you make heart-healthy lifestyle changes.
You can reduce or prevent angina by reducing your heart disease risks factors, including:
When placing a coronary artery stent, your doctor will find a blockage in your heart's arteries (A) using cardiac catheterization techniques. A balloon on the tip of the catheter is inflated to widen the blocked artery, and a metal mesh stent is placed (B). After the stent is placed, the artery is held open by the stent, which allows blood to flow through the previously blocked artery (C).
You and your doctor will discuss the pros and cons of each treatment to determine what might work best for you. For most people, first steps include medications and lifestyle changes. If those don't work for you, angioplasty and stenting can be another option.
Talk to your doctor if you think your treatment isn't controlling your angina well enough.