• Living with Stable Angina: Prepare Your Action Plan


    Angina can be painful and frightening but it doesn’t have to ruin your life. If you take action and work with your doctor to find a treatment plan that’s right for you, you can find relief from your symptoms.

    When Angina Strikes…

    For immediate relief from your angina:

    • Stop, relax and rest. Lie down if you can. Calm yourself by focusing on your breathing. Breathe in through the nose and breathe out slowly from the mouth.
    • If your doctor has prescribed nitroglycerin, take it.
    • If the pain or discomfort doesn’t stop a few minutes after taking nitroglycerin or if your symptoms become more severe, call 911 or let someone know that you need immediate medical assistance.
    • If your symptoms do stop when you rest or take nitroglycerin, that’s great news, but you may continue to feel anxious and afraid — especially the first time you have angina. It’s okay and very common to have these feelings, but if you keep them to yourself they can make you feel worse. Ask for help. Talk to your family and loved ones. Talk to your doctor about treatment options for improving the quality of your life. You’ll feel better and you’ll be that much closer to finding the right treatment plan for you.

    Take Action

    If your angina symptoms are so frequent and severe that they interfere with your quality of life, consider doing something about it:

    • Write down your symptoms and how they made you feel, both physically and emotionally, so you’ll have a record to share with your doctor.
    • Adjust your lifestyle by:
        • Maintaining a healthy weight and eating a healthy diet
        • Stopping smoking
        • Exercising for 30 minutes, 5 times a week
        • Managing your stress
        • Asking your doctor about cardiac rehab
    • See your doctor and describe the details of your angina, share how angina is affecting you, and explain how the episodes of angina are interfering with your work and other activities that are important to you.

    Work with Your Doctor to Set Treatment Goals

    Think of your doctor as a teammate. You each have information the other needs to make the best treatment decision for you. Telling your doctor everything — how you feel, your concerns about the future, and how angina has limited your activities — is a very important step toward finding the best treatment for you. In addition to supporting you in your lifestyle changes, your doctor may recommend one or more of the following treatments for your angina:

    • Medications - In addition to nitroglycerin for immediate symptom relief, your doctor may prescribe one or more of the medications listed below to reduce your symptoms and risk of heart attack and cardiovascular problems:
        • Aspirin or other antiplatelet medications
        • Beta blockers
        • Calcium channel blockers
        • Ranolazine
        • Short- or long-term nitrates
        • Statins
    • Angioplasty and Stenting - Angioplasty is a minimally invasive procedure to open arteries that are blocked or narrowed by plaque to increase the flow of oxygen-rich blood to the heart. It is performed by inserting a small tube called a sheath into an artery and then maneuvering long plastic tubes called catheters up to the arteries of the heart to take pictures that are used in identifying blockages that may be interfering with blood flow to the heart. Once the blockages are identified the catheter can also be used to insert a stent, which is a mesh tube that is permanently inserted into the artery to keep it open, facilitating healthy blood flow to the heart muscle.
    • Coronary Artery Bypass Graft Surgery (CABG) - Your doctor may recommend bypass surgery if a lengthy portion of an artery becomes narrowed, if an artery is severely blocked, or if the blockage is in a critical location. A surgeon makes a cut near the blocked artery, and then attaches a new blood vessel (from another part of the body) above and below the blockage. By providing a channel for the blood to bypass the blockage, the new vessel, called a graft, allows blood to continue to flow to the leg and foot. Once the vessel is attached, the surgeon closes the cut with sutures or staples.
    • Enhanced External Counterpulsation (EECP) — Generally EECP is used to treat angina in patients who continue to have chest pain or discomfort even after treatment with medication and angioplasty and stenting. It is also used to treat patients with blood flow problems in blood vessels too small to treat with other procedures. EECP is a non-invasive procedure that increases blood flow to the heart by using inflatable cuffs on the legs to push blood back to the heart in between beats. Treatment takes one or two hours per daily session for about 7 weeks.

    Give Your Doctor as Much Information as Possible and Ask Questions

    Remember, you are the expert on your own angina. You live with it every day and know how it feels. Your doctors have a wealth of medical knowledge, but they cannot know exactly what you feel or experience unless you tell them.

    What Questions Should I Ask My Healthcare Providers About My Stable Angina?

    1. I still have angina. How do I know that my medication is working?
    2. Am I a good candidate for angioplasty and stents? How do I know if I need a stent?
    3. How do I know if I need a stent?
    4. What can I do to prevent triggering my angina?
    5. How do I know when to call 911?
    6. How do I know when to see a doctor?
    7. How can I get the exercise I need if I have angina every time I exert myself?
    8. Can you recommend any programs (such as cardiac rehab) or support groups that could help me?
    9. How long before I expect some relief from my symptoms?
    10. What should I do if my angina doesn’t seem to be getting any better? Are there other treatments we can try?

    What Should I Do If I Have More Questions?

    Ask them. Any time you have a healthcare decision to make, the conversations you have with your doctor are the key to successful results. Be sure your doctor is aware of all of your symptoms as well as all of the medications, vitamins, and supplements you may be taking. And ask every question you have.

    To download the PDF of this information, click here.

    We hope you will also use this website to learn more about your cardiovascular health and treatment options. SecondsCount.org was developed by the Society for Cardiovascular Angiography and Interventions (SCAI), the medical society for interventional cardiologists.