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What are the various treatment options for angina?

Your treatment plays a vital role to reduce or control your risk of heart attack or stroke. There is a lot you can do to prevent your angina or CAD from getting worse. Treatment also depends on how severe your angina is, your current health condition, the results of your tests & whether your angina is stable or unstable. Stable angina could be treated best with prescribed medication & lifestyle modifications rather than having complicated treatments such as coronary angioplasty or bypass surgery.


Lifestyle changes

In the history of cardiovascular disease, lifestyle changes had always won the war against any heart disease. Therefore most of the patients have helped their heart through the lifestyle changes like:

  • Quitting smoking & chewing tobacco – Nicotine in tobacco is harmful. It can cause heart attacks, strokes, cancers (oral, lung and stomach) and many systemic illnesses. Stop smoking and tobacco is the most important thing you can do for your heart.

  • Quit alcohol – Alcohol has deleterious effects on your stomach, liver, brain and many other systems of your body.

  • Start a Nutritional Diet :

To have good heart health, being vegan & eating more plants is one of the healthiest options to do. Prefer food low in sodium. And give weightage to eating fruits, vegetables, sprouts & salads. Increase your intake of fiber, as it also helps to reduce belly fats. Whole grains, lentils, beans etc. are excellent sources of fiber. Avoid food with saturated fats & preferably use groundnut oil to cook. If you are diabetic, avoid a meal with sweet dishes & additional sugar. Eat more fruit rather than fruit juice. Also avoid street food, energy drinks & stop alcohol.


  • Try to maintain healthier body weight:

Maintaining an ideal body weight helps to reduce strain on your body muscles, & heart is a muscle which pumps blood throughout a body. Being overweight refers to high levels of cholesterol & fats, which are responsible for plaque in coronary arteries. Always remember, obesity gives an invitation to various problems including both physical & emotional. Thus, to protect your heart, you should exercise & follow a healthy diet.

  • Be regular in exercise:

Exercise at least 30-40 minutes/day. If you have angina don't run out for a marathon or jump into heavy exercises like the gym. Instead preferably do morning yoga which will improve your breathing difficulties & also help you to normalize the heart rate. In old age, light exercise, walking in fresh air, & little stretching can improve your heart health. A mixture aerobic + weight training + yoga exercises is best for your heart health. Your cardiologist, in association with a cardiac rehabilitation specialist or physiotherapist would help you plan your exercise schedule.


  • Stress management:

Stress can turn into panic attacks & constricts the blood vessels. Thus, the risk of getting a heart attack rises with increasing stress. Try to relax. Do the activities, whatever you love to do, follow your hobbies & keep your mind busy. Try new things, get holidays, visit peaceful places & spend some time with your loved ones. Meditation is a key to free stress. Start meditating. Your life is like a heartbeat where ups & downs are the sign that you are alive. So, stop focusing on problems, & focus on effective solutions to get over them.


  • Medicines:

Medicines are given to control your blood pressure, heart beat, cholesterol and sugar levels. These risk factors are controllable. We have fantastic medicines that not only control these risk factors but also increase your heart strength, help your heart to function longer and better, increase your lifespan and reduce your morbidity. Your Cardiologist is the best judge to decide how many medicines are needed.


Your doctor / cardiologist will prescribe you medicines as per the need of your heart & body requirements. He / she will prescribe you aspirin (blood thinner), beta blockers (to control your heart beat), ACE inhibitors / ARB (to control BP), nitrates (symptom reliever), calcium channel antagonist, statins (cholesterol lowering and plaque stabilization), anti-diabetic agents and other medicines as per your requirement.


  • Coronary Angioplasty:

Whenever, there is a block in the coronary arteries, the blood flow to the heart muscle is compromised. The blood flow to the living heart muscle can be easily restored by a simple procedure called a coronary angioplasty. Your cardiologist, will use a wire to cross the block in the heart. Then, he inserts a balloon over the block and inflates it at a high pressure to squeeze open the block. To keep the artery segment open, your cardiologist will insert a metal stent (usually medicated) at the location of the block. This ensures the blood supply to your heart muscle is restored.


It is done in the catheterization laboratory. It is done under local anesthesia, and the patient is conscious throughout the procedure. It requires 2-3 days of hospital stay. After an angioplasty, most people can return to work the week after discharge. Medicines and regular follow up with the cardiologist must be continued lifelong.


Risks and complications of coronary angioplasty – This is a relatively safe procedure with a success rate of >98%. Like all other procedures, it is associated with a few risks and complications. It may be associated with a risk of sudden cardiac arrest, death, arrhythmias (electrical disturbances of the heart), bleeding (major and minor), kidney failure, stroke, need of ventilation and other issues associated with heart problems or other systemic illnesses.


Coronary Artery Bypass Graft Surgery (CABG) (Open heart surgery)

It is a surgical procedure to restore normal blood flow to an obstructed coronary artery. The arteries of the chest, forearm or veins of the legs are used as conduits to bypass the blocked arteries.


It is done in an operation theatre. A cardiothoracic surgeon, cardiac anesthetist and perfusionist team up to operate the patient in general anesthesia. The patient is connected to a ventilator during the surgery, which is removed once the patient is stable. Post-surgery, hospital stay of 5-10 days may be required for the patient to recover. Usually most patients are able to resume their normal activities 2-3 months after surgery. Medicines and regular follow up with the cardiologist must be continued lifelong.


Risks and complications of CABG – The success rate of CABG is >95%. Like most surgical procedures, it is associated with a risk of stroke, bleeding (major and minor), infection, arrhythmias (electrical disturbances of the heart), kidney failure, sudden cardiac arrest and death.


When your doctor advises you angioplasty or bypass surgery, he weighs the pros and cons, risks and complications of a particular procedure/ surgery and chooses the best available option for the patient. All decisions are individualized, based on patient’s clinical condition.


Wish you a healthy heart

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Do's: Continue your follow up with your cardiologist / doctor & get a full checkup as per the doctor's consultation. Do not miss the scheduled appointments. Even if you are doing fine, you should see