Angina pectoris is a specific type of the chest pain or discomfort. Unlike other chest pain cases (e.g. pain in muscular pathology or osteochondrosis), angina pectoris arises against the background of the coronary artery disease. The coronary arteries are the only origin of the heart blood supply. Once they are blocked or narrowed, the myocardium starts suffering from the oxygen and nutrients deficit. This is when pain arises.
Restoring sufficient blood flow reduces symptoms and improves quality of life. To reach this aim, a cardiologist needs to make the well-grounded choice between the available treatment options.
Tolerating the unpleasant symptom or disregarding a life-threatening condition?
Stable angina pectoris may frighten a patient, but rarely poses serious life threat. Patients usually know that physical exertion, emotional stress, heavy meals or hot/cold weather may trigger the pain episode. It typically lasts for 5 minutes or less and is relieved by rest or nitrates intake. Stable angina pectoris has three main negative aspects:
- It limits significantly the physical activity.
- It causes emotional disturbances and affects quality of life.
- Over time it may progress to the unstable angina, or an acute coronary syndrome, which is a life-threatening condition.
People with angina pectoris should go through a number of diagnostic tests (including ECG and EchoCG with stress tests, blood tests, angiography) and visit a general practitioner or cardiologist for further guidance.
Treatment options: from smoking cessation to cardiac surgery
Management of the angina pectoris includes the wide spectrum of options – from lifestyle modifications and secondary prevention to cardiac surgery. Choosing the most beneficial treatment tactics for reaching the optimal long-term result is the delicate and responsible task.
According to the American Heart Association guidelines, lifestyle modifications are the first step of treatment. Normalization of the body mass, smoking cessation, blood pressure control, maintaining the normal level of blood sugar and cholesterol are the basis of the coronary arteries normal function.
Drug therapy gives one more chance to avoid surgical intervention. Your doctor may administer medications for lowering high blood pressure (e.g. beta blockers, calcium channel blockers, ACE inhibitors), statins for lowering the cholesterol level, aspirin for improving blood rheology and nitrates for the pain syndrome management.
Cardiac surgery directly restores the coronary vessels patency (stenting or angioplasty) or forms the new way for blood circulation (coronary artery bypass). Interventions can be made during the open-heart surgery or in the minimally invasive mode. After the surgery, some patients will need to take aspirin lifelong, as a secondary preventive measure.
How to choose the most efficient medical approach
Your doctor will elaborate the treatment scheme based on the severity and frequency of angina pectoris episodes. Right after the diagnosis confirmation, you will start from modification of the above mentioned risk factors. In case angina episodes persist regardless your efforts, more active therapy starts.
If you want to cope with symptoms fast, angioplasty or stenting may be performed first. Such therapy eliminates the root cause of the disease, although it is connected with the certain surgical risks. Drug therapy is more sparing and cost-effective. You will need more time to see the result and take medications daily. It is better to discuss all possible options with an experienced cardiologist and cardiac surgeon, who are skilled enough in all therapeutic modes. Typically, such specialists work in the large European hospitals (e.g. University Hospital RWTH Aachen, University Hospital of Ludwig Maximilian University of Munich).
If you are going to receive the treatment of angina pectoris abroad, it will be more convenient and safer to contact Booking Health. Booking Health is the certified provider of medical tourism services (certificate ISO 9001:2015) that works with patients from 75 countries worldwide. Specialists of Booking Health stay with you 24/7 from the stage of hospital selection and preparation for the trip to independent monitoring of the treatment course and work with medical reports after your returning in the native country.