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You are here : 3-RX.com > Medical Encyclopedia > Diseases and Conditions > Unstable Angina: Treatment & Monitoring
      Category : Health Centers > Heart Diseases

Unstable Angina

Alternate Names : Unstable Angina Pectoris

Unstable Angina | Symptoms & Signs | Diagnosis & Tests | Prevention & Expectations | Treatment & Monitoring

What are the treatments for the condition?

A person who has unstable angina is usually hospitalized. This allows the healthcare provider to determine if the person is having a heart attack, which can cause the same symptoms as unstable angina. The provider will attempt to optimize the person's medication regimen. The types of medications include the following:

  • nitroglycerin, to expand the small arteries and veins
  • beta-blockers, to reduce the work of the heart
  • blood thinners, to reduce the chance of clotting in the already narrowed arteries
  • Calcium channel blockers, such as diltiazem, nifedipine, or verapamil, have been used for over 20 years to open the coronary arteries and lower high blood pressure. However, the findings of 2 recent studies have shown that people who take a calcium channel blocker have a much higher incidence of complications than people taking other medications for coronary artery disease and high blood pressure. One study, for example, found that the risk of heart attack was 27% greater and the risk of congestive heart failure was 26% higher for those taking a calcium channel blocker. The American Heart Association recommends discussing risks and benefits of the medication with the healthcare provider.

    Sometimes the even the best combination of medications fails to control angina. In this case, surgery may be used to restore blood flow to the affected areas of the heart. Common procedures include:

  • percutaneous transluminal coronary angioplasty, or PTCA. In this procedure, a tube containing a balloon is inserted into the blocked artery and inflated. This reopens the artery and allows blood to flow.
  • heart bypass surgery, also known as coronary artery bypass graft or CABG. In this procedure, veins taken from the legs or arteries taken from the chest are used to bypass the narrowed or blocked portion of the arteries in the heart.
  • a stent, or narrow tube, which is placed into the artery at the reopened area to keep it from narrowing again
  • laser surgery, which uses light waves to dissolve plaque
  • atherectomy, a surgical procedure in which plaque that causes narrowing of a blood vessel is removed
  • What are the side effects of the treatments?

    Beta-blockers can cause:

  • a slow heartbeat
  • low blood pressure
  • depression
  • erectile dysfunction
  • unpleasant dreams
  • Calcium channel blockers can cause:

  • flushing
  • nausea
  • headache
  • swelling of the ankles
  • low blood pressure
  • weakness
  • a higher risk of heart attack and congestive heart failure
  • Nitrates can cause headaches and low blood pressure. Aspirin and warfarin increase the risk of bleeding. Surgery can result in infection, bleeding, and allergic reaction to anesthesia.

    What happens after treatment for the condition?

    A person whose unstable angina has been relieved will be monitored in the hospital to be sure the treatment continues to work. If the person has had surgery, the healthcare provider will also check to be sure that the blood flow does not suddenly become blocked again. A cardiac rehabilitation program will be started and will continue after the person leaves the hospital.

    A person with unstable angina should make every effort to reduce coronary risk factors. This may include the following: smoking cessation, control of other diseases such as diabetes and high blood pressure, and following a healthy diet to minimize heart disease. Medications may need to be adjusted to achieve the best response.

    How is the condition monitored?

    A person who has been treated for unstable angina will periodically have an ECG done during exercise. This will show how the heart is working with the remaining blood supply. Cardiac catheterization may need to be repeated in the future, especially if chest discomfort returns. Any new or worsening symptoms should be reported to the healthcare provider.


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    Unstable Angina: Prevention & Expectations

     

    Author: William M. Boggs, MD
    Reviewer: Eileen McLaughlin, RN, BSN
    Date Reviewed: 07/05/01



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