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| 2007-08-20 general | | Angina Pectoris | | Treatment of Angina Pectoris | | | | Diagnosis of Angina Pectoris
Diagnosis of angina is based upon the classic history of chest pain on exertion and by means of tests, demonstrating the presence of coronary artery disease.
In most instances, drugs are recommended for the treatment of angina before surgery is considered. The major classes of drugs used to treat angina include the following:
**Nitrates. These come in several forms: nitroglycerine tablets to be slipped under the tongue during or in anticipation of an attack; ointment to be absorbed through the skin; long-acting medicated skin discs; or long-acting tablets. The latter three forms are used mostly to prevent rather than relieve attacks. The nitrates work by reducing the oxygen requirements of the heart muscle.
**Beta-blocking Drugs. These agents act by blocking the effect of the sympathetic nervous system on the heart, slowing heart rate, decreasing blood pressure, and thereby, reducing the oxygen demand of the heart. Recent studies have found that these drugs also can reduce the chances of dying or suffering a recurrent heart attack if they are started shortly after suffering a heart attack and continued for two years.
**Calcium-channel Blocking Drugs. These drugs are prescribed to treat angina that is thought to be caused by coronary artery spasm. They can also be effective for stable angina associated with exercise. All muscles need varying amounts of calcium in order to contract. By reducing the amount of calcium that enters the muscle cells in the coronary artery walls, the spasms can be prevented. Some calcium-channel blocking drugs also decrease the workload of the heart and some lower the heart rate as well.
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