Stable Angina Treatment in Noida, Delhi, India

Overview

Stable angina, also known as angina pectoris, is a common heart condition characterized by chest pain or discomfort that occurs during physical exertion or emotional stress. This type of angina is predictable and typically subsides with rest, with episodes lasting less than five minutes. It results from reduced blood flow to the heart, often triggered by activities or stress, and is less severe than unstable angina. Stable angina serves as an indicator of an underlying heart condition.

Symptoms of Stable Angina

Symptoms associated with stable angina may include:

• A sensation resembling gas or indigestion
• Fatigue and weakness
• Heart palpitations
• Shortness of breath
• Dizziness or light-headedness
• Nausea and vomiting
• Sweating
• Chest pain that:
  • Occurs during physical activity or stress
  • Lasts from 1 to 15 minutes
  • Is relieved by rest or nitroglycerin

Angina attacks can happen at any time throughout the day.

Causes of Stable Angina

Stable angina occurs when the heart muscles do not receive sufficient oxygen during periods of increased demand. Factors that may trigger an attack include:

• Cold weather
• Anemia
• Heart failure
• Physical exertion
• Hyperthyroidism
• Emotional stress
• Large meals
• Abnormal heart rhythms
• Heart valve disease
• Coronary artery spasm (Prinzmetal angina)

Diagnosis of Stable Angina

Diagnosis involves a comprehensive evaluation, including:

• A review of symptoms and medical history
• A physical examination, including blood pressure measurement
• Listening for irregular heart sounds, such as murmurs or abnormal rhythms.

Diagnostic tests may include:

• Blood Tests: To assess heart tissue damage and risk of heart attack.
• Electrocardiography (ECG): Records the heart’s electrical activity to identify abnormalities or irregularities.
• Echocardiography: An ultrasound to evaluate heart function, & structure.
• Event Monitoring: For long-term heart function tracking.
• Stress Tests: Assess heart performance during physical exertion.
• Holter Monitoring: Continuous heart rhythm tracking using a portable device.
• Coronary Angiography: The gold standard for identifying artery blockages.
• Additional Tests: Including CT coronary angiography, cardiac MRI, and chest radiography.

Treatment of Stable Angina

The goal of treatment is to relieve symptoms and lower the risk of a heart attack. Treatment approaches include:

Lifestyle Changes

Making heart-healthy choices is critical, including:

• Quitting Smoking: Tobacco cessation significantly reduces heart disease risk.
• Healthy Diet: Emphasizing fruits, vegetables, whole grains, lean proteins, and low-fat dairy while limiting saturated fats, trans fats, salt, and sugar.
• Regular Exercise: Participating in physical activities that are suited to one’s individual abilities.
• Weight Management: Maintaining a healthy weight to lower heart disease risk.
• Stress Management: Techniques such as meditation and yoga to handle stress effectively.

Medications

Common medications for treating stable angina include:

• Nitrates: Such as nitroglycerin, which relaxes blood vessels and improves blood flow.
• Aspirin: Reduces blood clotting to lower heart attack risk.
• Clot-preventing Drugs: Including clopidogrel and ticagrelor.
• Beta-Blockers: Reduce heart rate and lower blood pressure.
• Statins: Lower cholesterol levels to prevent blockages.
• Calcium Channel Blockers: Relax blood vessels & improve blood flow.
• Ranolazine: For chronic stable angina that doesn’t respond to other treatments.

Interventions

For more severe cases, procedures may include:

• Angioplasty, & Stenting: A minimally invasive procedure to open blocked arteries.
• Coronary Artery Bypass Grafting (CABG): Recommended for multiple blockages or when angioplasty is not viable.

Complications of Stable Angina

Ignoring stable angina can lead to serious complications, including:

• Heart attack
• Sudden death due to abnormal heart rhythms
• Progression to unstable angina

Risk Factors for Stable Angina

Several risk factors contribute to stable angina, including:

• Obesity and lack of physical activity
• Poor dietary habits and large meals
• History of heart disease
• Tobacco use
• High blood pressure and diabetes
• A familial history of coronary artery disease occurring at a young age.

Prognosis

The outlook for individuals with stable angina is typically favorable. With appropriate treatment and lifestyle modifications, many experience significant improvements in symptoms and quality of life.

Conclusion

Stable angina is a manageable condition with timely diagnosis, treatment, and lifestyle changes. Patients are encouraged to consult healthcare professionals if they experience symptoms and to follow prescribed treatment plans diligently.

Reviewed by Dr. Prashant Tarakant Upasani, Sr. Consultant – Interventional Cardiologist, Cardiology on 12-Dec-2023.