Angina is the outcome of too little oxygen reaching the heart muscle. Oxygen starvation is usually caused by the narrowing of blood vessels (coronary arteries) that carry both blood and oxygen to the heart muscle

In classic angina pain usually occurs during exertion or emotional stress, with variant angina the pain may also be felt when the body is at rest. The narrowing of the coronary artery walls is caused by deposits of fat called atheroma (build up of fat). However in the variant type angina is caused by contraction of the muscle fibres in the artery walls.

Those individual most at risk of atheroma (build up of fat) are those people that eat high-fat diets and those who smoke. That is why as a basic starter your doctor is likely to recommend you stop smoking and a change of diet would be the order of the day. I am aware of the public bashing overweight people suffer at the hands of the media, but there is no two ways around it, doctors would advise you to lose weight as it is proven that being overweight puts a great strain on the heart. A change of life style may well bring a marked improvement in the symptoms of angina. However, drug treatment would be frequently necessary.

Why They Are Used

Having frequent episodes of angina can be most disabling and if left untreated can lead to an increased risk of having a heart attack. The use of drugs can be used to either relieve angina attacks, or reduce how often an attack is suffered. Individuals who suffer the attacks only occasionally would usually be prescribed quick acting medication to take at the first signs of an attack, or before an activity that is known to bring on an attack. Glyceryl trinitrate a fast acting nitrate would usually be prescribed for this purpose. regular attacks or more severe attacks would require regular preventive measures. Drugs such as beta blockers, long acting nitrates and calcium channel blockers would be used. Adhesive patches that deliver nitrates through the patients skin have extended the the lasting action of glyceryl nitrate, making treatment a lot easier.

How They Work

Calcium channel blockers and nitrates work by relaxing the muscle layer in the blood vessel walls. This allows for easier blood flow through the dilated vessels, which in turn reduces strain on the heart. By interrupting signal transmission in the heart beta blockers decrease heart muscle stimulation, which means the heart muscle requires less oxygen, which in turn reduces the risk of angina attacks.

How They Affect You

Drugs that work by preventing attacks would allow the sufferer to undertake more strenuous activities without provoking pain. Nitrates would usually provide effective relief should an attack occur. By the dilation of blood vessels throughout the body nitrates and calcium channel blockers can present a variety of minor side effects such as dizziness, while standing and may cause fainting. Other possible adverse effects could be headache, usually at the start of treatment, ankle swelling and a flushing of the skin more pronounced on the face. The taken of beta blockers is often found to produce cold hands and feet as well as a heaviness in the legs.

Beta Blockers

Below is listed a number of the most common medications used to treat angina. Highlighted medication will open in a new window.

Calcium Channel BlockersNitratesPotassium channel Opener
AmlodipineGlyceryl TrinitrateNicorandil
DiltiazemIsosorbide Dinitrate/Mononitrate
Other Medication