The options for treating angina include lifestyle changes, medications, and invasive procedures such as coronary angioplasty or stent placement and coronary artery bypass surgery.

You and your doctor should agree on a plan for treating your angina on a daily basis. This should include:

• What medicines you should be taking to prevent angina
• What activities are okay for you to do, and which ones are not
• What medicines you should take when you have angina
• What are the signs that your angina is getting worse
• When you should call the doctor or 911

MEDICATIONS

You may be asked to take one or more medicines to treat blood pressure, diabetes, or high cholesterol levels. Follow your doctor's directions closely to help prevent your angina from getting worse.

Nitroglycerin pills or spray may be used to stop chest pain.

Taking aspirin and clopidogrel (Plavix) helps prevent blood clots from forming in your arteries, and reduces your risk of having a heart attack. Ask your doctor whether you should be taking these medications.

Your doctor may give you one or more medicines to help prevent you from having angina.

• ACE inhibitors to lower blood pressure and protect your heart
• Beta-blockers to lower heart rate, blood pressure, and oxygen use by the heart
• Calcium channel blockers to relax arteries, lower blood pressure, and reduce strain on the heart
• Nitrates to help prevent angina
• Ranolazine (Ranexa) to treat chronic angina

NEVER ABRUPTLY STOP TAKING ANY OF THESE DRUGS. Always talk to your doctor first. Stopping these drugs suddenly can make your angina worse or cause a heart attack.

Your doctor may recommend a cardiac rehabilitation program to help improve your heart's fitness.

INVASIVE AND SURGICAL TREATMENT

Some patients may need surgery to help improve the flow of blood through the coronary arteries.

Angioplasty and stent placement (also called percutaneous coronary intervention) is a procedure in which a physician inserts a catheter through an artery in either the arm or leg and advances the catheter into the heart. It is done to both open up and keep open a coronary artery that has become too narrow.

Angioplasty with stenting probably does not help you live longer than treatment with medicine alone. However, it can reduce angina or other symptoms of coronary artery disease. Angioplasty with stenting can be a life-saving procedure if you are having a heart attack or unstable angina.

Heart bypass surgery may be done for some people, depending on which of the coronary arteries are narrowed and the severity of the narrowing.

Stable angina usually improves with medication.

• Heart attack
• Sudden death caused by abnormal heart rhythms (arrhythmias)
• Unstable angina

Seek medical attention if you have new, unexplained chest pain or pressure. If you have had angina before, call your doctor.

Call 911 or your local emergency number if you experience chest pain or heaviness. The pain may be a sign of unstable angina or a heart attack.

Call your health care provider if:

• Angina episodes happen more often, last longer than usual, or feel different than before
• You have shortness of breath
• You need to take more and more nitroglycerin to make your angina go away

Seek immediate medical help if a person with angina loses consciousness.