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Angina Pectoris (cont.)

Can I care for my angina at home?

Stop doing whatever it is that causes the symptoms and call 911. Immediate help and intervention is the best chance for survival if someone is having a heart attack or other serious problem.

  • Lie down in a comfortable position with the head up.
  • Chew a regular adult aspirin or its equivalent (as long as the person is not allergic to aspirin). Chewing more than one will not do any good and may cause unwanted side effects.

If the person has had angina before and been evaluated by a doctor, follow his or her recommendations.

  • This may mean rest and the immediate use of sublingual nitroglycerin.
  • It may include a visit to the hospital emergency department.

What is the medical treatment for angina?

If the person has come to the hospital emergency department, they may be sent to another care area for further testing, treatment, or observation. On the basis of the provider's preliminary diagnosis, the patient may be sent to the following units:

  • An observation unit pending test results or further testing
  • A cardiac care unit
  • A cardiac catheterization unit

Regardless of where the patient is sent, several basic treatments may be started. Which ones are given depends on the severity of the symptoms and the underlying disease.

  • At least one IV line will be started. This line is used to give medication or fluids.
  • Aspirin will probably be administered (unless the patient has already taken one)
  • Oxygen will be administered through a face mask or a tube in the nose. This will help if the patient is having trouble breathing or feeling uncomfortably short of breath. The direct administration of oxygen raises the oxygen content of the blood.

Treatment will depend on the severity of the symptoms, severity of the underlying disease, and extent of damage to the heart muscle, if any.

  • Simple rest and observation, an aspirin, breathing oxygen, and sublingual nitroglycerin may be all that the patient needs, if it is only angina.
  • Medication may be administered to reduce anxiety.
  • Medication may be administered to lower blood pressure or heart rate.
  • Medication may be administered to reduce the risk of having a blood clot or to prevent further clotting.
  • If the health-care professional believes the chest pain actually represents a heart attack, the patient may be given a fibrinolytic (a powerful clot-buster medication).

After reviewing the patient's immediate test results, the hospital doctor will make a decision about where the patient should be for the next hours and days.

  • If the diagnosis of angina is made, and the patient is feeling better and their condition is stable they may be allowed to go home. The patient may be given medications to take. Follow-up with a health-care professional within the next day or two will be recommended.
  • The patient will be admitted to the hospital if they are unstable with continuing symptoms. Further testing will be ordered, and if the arteries are critically blocked, the patient may undergo coronary angiography, coronary artery angioplasty, or even coronary artery bypass surgery.

Angioplasty is a treatment used for people whose angina does not get better with medication and/or who are at high risk of having a heart attack.

  • Before angioplasty can be done, the area(s) of coronary artery narrowing is located with coronary arteriography.
  • A thin plastic tube called a catheter is inserted into an artery in the arm or groin with local sedation. The catheter has a tiny balloon attached to the end.
  • The catheter is threaded through the arteries and into the artery where the narrowing is.
  • The balloon on the catheter is inflated, opening up the narrowing.
  • Following balloon treatment, many patients require placement of a "stent," a small metal sleeve that is placed in the narrowed artery. The stent holds the artery open.

If the patient has had angina symptoms and is visiting a health-care professional for evaluation, he or she will make a decision about how to proceed with the evaluation. The choices include going ahead with the evaluation on an outpatient basis, referring the patient to a specialist in heart disorders (cardiologist), or admitting the patient to the hospital for further workup.

Medically Reviewed by a Doctor on 5/31/2016

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