Therapy of angina pectoris


Angina pectoris is a symptom that occurs when the heart muscles are undersupplied with blood. Therapy depends on the form of angina pectoris. If there is pain in the chest area, a medical examination should be carried out in any case. The treating physician can then initiate the further necessary therapeutic measures.

Treatment of angina pectoris in general

Since angina pectoris can be life-threatening, one should go directly to the doctor or call the emergency services. First the possible cause should be eliminated. It is best to lie down with a slightly raised upper body (this position relieves the heart).

Acute therapy for angina pectoris includes the administration of oxygen to improve the oxygen supply to the heart. Also the so-called vital parameters are measured directly (blood pressure, pulse and oxygen saturation in the blood, these values have significance for the severity and further development of a patient, therefore they are always recorded). Furthermore, an intravenous access is placed in the arm to be able to apply medication in an emergency and an electrocardiogram (ECG) is taken.

This provides information on whether the patient has suffered a heart attack, angina pectoris or perhaps no heart disease at all. However, this is still confirmed by a blood test in hospital. There are cases in which no changes in the ECG can be seen, but the heart enzymes examined in the laboratory still confirm a heart attack.

The patient must now be monitored continuously. This means that the vital parameters are regularly checked closely and a monitoring ECG remains connected. In order to dilate the vessels around the heart, a spray (nitrolingual spray) is also placed under the tongue, which contains nitric oxide, which has a vasodilating effect.

So-called ß- (=beta) blockers can also be given. These act via the ß-receptors on the heart and thus lower the heart rate and the speed with which the heart muscle cells contract. This reduces the stress for the heart (i.e. it needs less oxygen) and thus also the symptoms.

However, ß-blockers are not administered in a Prinzmetalangina. Calcium antagonists (i.e. antagonists) also reduce the oxygen demand of the heart and are therefore also used in treatment. Further intensive medical observation and the causal therapy is carried out in hospital.

For example, a stent or a bypass operation could be considered in case of stenosis. In addition, the therapy attempts to treat the possible causes of angina pectoris. Thus, one tries to treat all blood vessel-damaging diseases (such as high blood pressure or diabetes mellitus).

We also try to identify stress triggers so that the patient can avoid them in the future. If it is suspected that the angina pectoris attack has triggered a heart attack, a different treatment is used. In this case, the drugs given are the blood thinners heparin and ASS.