How Is Angina Evaluated?

First, your doctor will ask you a series of questions to determine what your symptoms are and what brings them on. After examining you, your doctor will order one or more of a series of tests to determine the underlying cause of the angina and the extent of coronary artery disease, if present. These tests include:

◆Exercise stress test
◆Electrocardiogram (ECG or EKG)
◆Nuclear imaging tests. These are specialized imaging tests that can accurately localize the part of the heart that has decreased blood flow. They are often performed in association with a stress test or echocardiography.
◆Echocardiogram
◆Cardiac catheterization
◆Electron beam CT (ultrafast CT)
How Is Angina Treated?

The treatment you receive depends on the severity of the underlying problem, namely the amount of damage to the heart. For most people with mild angina, a combination of medications and lifestyle changes can control the symptoms. Lifestyle changes include: eating a heart-healthy diet, lowering cholesterol, getting regular exercise, quitting smoking and controlling diabetes and high blood pressure.

Some medications used to treat angina work by either increasing the amount of oxygen delivered to the heart muscle or reducing the heart's need for oxygen. These medicines include:

◆Beta-blockers
◆Nitrates
◆Calcium channel blockers
◆ Angiotensin-converting enzyme inhibitors (ACE inhibitors)
Others work to prevent the formation of blood clots, which can further block blood flow to the heart muscle. These medicines include:

◆Antiplatelet medications
◆Blood thinners
◆Anticoagulants
For people with more serious or worsening angina, your doctor may recommend treatment to open blocked arteries. These include:

◆Angioplasty
◆Stenting
◆Coronary artery bypass grafting (CABG) surgery
◆Transmyocardial revascularization (TMR)
◆External counterpulsation (EECP)
What Should I Do if I Have Angina?

With any type of angina, stop what you are doing and rest.

If you have been prescribed a medication called nitroglycerin to treat your angina, take one tablet and let it dissolve under your tongue. If using the spray form, spray it under your tongue. Wait five minutes.

If you still have angina after five minutes, take another dose of nitroglycerin. Wait another five minutes and if angina is still present, take a third dose.

If you still have angina after resting and taking three doses of nitroglycerin or 15 minutes, call for emergency help (dial 911 in most areas) or have someone take you to the local emergency room.

If you think you are having a heart attack, do not delay. Call for emergency help right away. Do not drive yourself to the hospital. Consider taking an aspirin. Quick treatment of a heart attack is very important to lessen the amount of damage to your heart.

Why Shouldn't I Drive Myself to the Hospital?

When the ambulance arrives, the emergency personnel can begin to give you heart-saving care right away. They can start an IV to give you important drugs and give you oxygen to help improve the flow of oxygen-rich blood to your heart. Should problems occur, they are there to provide life-saving help as well.

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