Tests
You may also need to have some hospital tests before you can be sure your symptoms are caused by angina. These can include:- an ECG (electrocardiogram), where your heart's electrical activity is measured, when you are lying down or when you are exercising on a treadmill,
- an echocardiogram, where an ultrasound probe is run over your chest so the heart's chambers and valves can be seen working,
- an angiogram, where dye is injected into the coronary arteries to look for any blockages.
Treatment
The conditions that make angina more likely to occur, such as high blood pressure, will also be treated as well as the angina symptoms. Medicines are usually the first step in this. A small daily dose of aspirin is often prescribed as it cuts the risk of having a heart attack. Glyceryl trinitrate (GTN) is prescribed for relief during attacks. This comes as a spray (used in the mouth) or tablets placed under the tongue. Other treatments to prevent an angina attack are:- long-acting" nitrates such as isosorbide mononitrate, which widen the coronary arteries to improve blood flow to the heart,
- beta-blockers such as atenolol, which slow the heart rate and the pumping power of the heart,
- calcium channel blockers such as nifedipine, which relax the coronary arteries and other blood vessels and reduce the force of the contraction of the heart,
- the potassium-channel activator, nicorandil.
Surgery
For people with severe angina, surgery may be needed. There are several possible procedures, including:" Angioplasty - with this procedure, a collapsed balloon is threaded through the blood vessels until it reaches the arteries of the heart. The balloon is inflated to widen the blocked coronary artery. A stent (flexible mesh tube) may be inserted to help keep the artery open afterwards. A laser may be used to open up a fatty deposit for the balloon to pass through. " Coronary artery bypass graft (CABG) - this is where vessels from the legs or the chest are used to bypass the blockage. This is open-heart surgery and requires a longer stay in hospital.
Prevention
There are several practical steps you can take to prevent angina:- if you smoke, give up,
- maintain a healthy blood pressure -have it checked at least every five years,
- eat a low-fat, high-fibre diet, rich in fruit and vegetables,
- try to eat oily fish such as sardines or salmon, once a week,
- have your cholesterol level checked - if it's high, ask your doctor about the options for reducing it,
- if you have diabetes, you should aim to closely control your blood sugar levels, as advised by your nurse or doctor,
- take regular exercise. Walking briskly for half an hour every day is a good example.
(published with permission in writing from:http://www.mabels.org.uk/)
