Stephen J. Schueler, M.D.

Chest Pain due to Blocked Arteries Treatment

The treatment for angina requires medications that reduce stress on the heart and prevent blood clots from forming in the bloodstream. Treatment may also include coronary artery stents or coronary artery bypass surgery, in order to restore the blood flow to the heart muscle. New or worsening angina, called unstable angina, requires immediate treatment in the emergency room. If angina is caused by a heart attack, treatment involves thrombolytic therapy, emergency coronary angioplasty, or emergency bypass surgery.

Initial treatment of angina in the emergency department includes:


Key steps in the treatment of angina include:

The long-term treatment of coronary artery disease and angina may include:

Angina SeverityTreatment Options
Stable / mild or moderateControl of cardiac risk factors; drug therapy
Unstable / mild to moderateHospitalization; control of cardiac risk factors; drug therapy
Unstable / severe symptomsDrug treatment; angioplasty; coronary artery bypass grafting

For more information:

Chest Pain due to Blocked Arteries Angioplasty

Angioplasty is an effective treatment for angina that fails to respond to medications. Angioplasty is a procedure that must be performed during cardiac catheterization.

During a cardiac catheterization, a catheter (thin plastic tube) is inserted into an artery in the groin, and then threaded up through the aorta to the heart. During angioplasty, the catheter is advanced into the narrowed part of the coronary artery. A balloon at the end of the catheter is inflated, in order to force open the narrowed artery. Alternative techniques include cutting or burning away the blockage with a tiny blade or laser.

Examples:


After angioplasty, a stent may be used to help hold the artery open. Stents are tiny struts that expand against the inside wall of the artery. They prop open the blood vessel after it has been opened.

Examples:
  • Coronary artery stent
  • Coronary artery stenting

Rare complications of angioplasty include:
  • Allergic reaction to the dye
  • Heart attack
  • Coronary artery rupture
  • A small number of opened arteries become narrowed again. However, stents are used to protect against this complication.

Chest Pain due to Blocked Arteries Cardiac Rehabilitation

Those who suffer a heart attack or undergo bypass surgery lose physical strength because the heart is weakened and their activity has been limited. Cardiac rehabilitation helps the heart to recover. It provides a supervised exercise program that can restore exercise capacity and endurance.

Cardiac rehabilitation programs:

Chest Pain due to Blocked Arteries Drugs

Medications that improve blood flow through the coronary arteries include:

  • Aspirin:
    • Thins the blood, in to order lower the risk of blood clots in the coronary arteries
  • Heparin:
    • Thins the blood, in to order lower the risk of blood clots in the coronary arteries
  • Nitrates:
    • Open coronary arteries and let the heart work more efficiently
  • Platelet inhibitors:
    • Thins the blood, in order to lower the risk of blood clots in the coronary arteries
  • Thrombolytic medications:
    • Clot busting medication
  • Morphine:
    • Reduces anxiety and increased blood flow through coronary arteries

Additional medications that benefit the heart:

Chest Pain due to Blocked Arteries Aspirin

If a clot forms in a diseased coronary artery, oxygen no longer flows to the part of the heart muscle that is supplied by the artery. The lack of oxygen causes angina and leads to a heart attack. Aspirin plays an important role in the treatment of angina and heart attack. It reduces the risk for the formation of a clot in the narrowed coronary artery by interrupting the clotting process.

Those who have angina can reduce the risk of a heart attack by 50% by taking aspirin. Aspirin also reduces the risk of death by 25% in those who have severe coronary artery disease.

Chest Pain due to Blocked Arteries Beta-Blockers

Beta-blockers, such as metoprolol and atenolol, slow the heart rate, reduce the work done by the heart and reduce the blood pressure. These effects reduce the heart's demand for oxygen. Beta-blockers can reduce the symptoms of angina. In those who have suffered a heart attack, beta-blockers reduce the risk for death and reduce the risk for another heart attack.

Beta-blockers for the treatment of angina:

Chest Pain due to Blocked Arteries Blood Thinners

If a clot forms in a diseased coronary artery, oxygen no longer flows to the part of the heart muscle that is supplied by the artery. The lack of oxygen causes angina and leads to a heart attack. Blood thinners play an important role in the treatment of angina and heart attack. They reduce the risk for the formation of a clot in the narrowed coronary artery by interrupting the clotting process.

Blood thinners:

Chest Pain due to Blocked Arteries CCBS

Calcium channel blockers or CCB's are used to treat angina in those who cannot tolerate a beta-blocker medication or who fail to respond to a beta-blocker and nitrate combination. CCB's are also used to treat someone with Prinzmetal angina.

Calcium channel blockers used in the treatment of angina:

Chest Pain due to Blocked Arteries Nitrates

If a clot forms in a diseased coronary artery, oxygen no longer flows to the part of the heart muscle that is supplied by the artery. The lack of oxygen causes angina and leads to a heart attack. Nitroglycerin plays an important role in the treatment of angina and heart attack. Nitroglycerin improves blood flow through the coronary arteries and decreases angina by dilating the coronary arteries.

Nitrates used in the treatment of angina:

Chest Pain due to Blocked Arteries Statins

Patients with angina may benefit from treatment with statin drugs. They are designed to lower cholesterol. However, statin medications also reduce the risk of death and the risk of heart attack in those who have coronary artery disease.

The statins are very effective at reducing cholesterol. Statins interrupt the production of cholesterol in the liver. Side effects include muscle aches and pains, joint pain, and nausea. Statins should not be used during pregnancy or in those who have liver disease. Rarely, statins cause damage to the liver.

Statins:

Chest Pain due to Blocked Arteries Thrombolytics

Coronary arteries become narrowed when cholesterol builds up on the inside wall of the artery. If a clot forms where the artery is narrowed, then the artery becomes completely blocked, causing angina or a heart attack. Thrombolytic medications are powerful blood thinners that can break down new blood clots in the coronary arteries.

Examples:


Thrombolytic medications include:

Severe bleeding is the major complication of the thrombolytic medications. Overall, they reduce the risk of death from a heart attack.

Conditions in which thrombolytics are not used include:

Chest Pain due to Blocked Arteries Long-Term Care

The long-term treatment of angina depends on the severity of the coronary artery disease, the condition of the heart and the presence of other diseases.

Angina SeverityTreatment Options
Stable / mild or moderateControl of cardiac risk factors; drug therapy
Unstable / mild to moderateHospitalization; control of cardiac risk factors; drug therapy
Unstable / severe symptomsDrug treatment; angioplasty; coronary artery bypass grafting

The long-term treatment of coronary artery disease and angina may include:
  • Correcting lifestyle factors
  • Treatment of additional medical problems
  • Medications
  • Angioplasty
  • Surgery

Chest Pain due to Blocked Arteries Diet

Heart healthy diet for angina includes:

  • Limit fat intake to no more than 30% of your total calories
  • Eat quality fats: use virgin olive oil and other unsaturated, low-cholesterol fats.
    • 10% to 15% of your total calories should be in the form of monounsaturated fats, such as olive oil, canola oil, and peanut oil.
  • Eat less than 300 milligrams of dietary cholesterol a day.
  • Reduce salt in your diet to no more than 6 grams per day.
  • Eat plenty of fresh fruit and vegetables
  • Limit your intake of simple carbohydrates, such as sugar. Instead, eat more complex carbohydrates, such as starch and fiber. Good sources of fiber include:
  • Whole grains
  • Brown rice
    • Fruits
    • Vegetables
    • Bran
    • Barley
    • Oats
    • Beans
    • Nuts
  • Limit iron intake: too much iron can increase atherosclerosis
  • Avoid fad diets
  • Check with your doctor about B vitamins. You may benefit from vitamin B supplements.

Chest Pain due to Blocked Arteries Questions For Doctor

The following are some important questions to ask before and after the treatment of angina.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • What else can I do to reduce my risk for complications?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Chest Pain due to Blocked Arteries Specialist

Physicians from the following specialties evaluate and treat angina:

Chest Pain due to Blocked Arteries Surgery

Blocked coronary arteries require bypass surgery. The aim is to provide blood flow to the artery beyond the blockage, bypassing the obstruction. Small arteries in the chest wall, or veins from the legs, are removed for this purpose. A small segment of the bypass vessel is attached to the wall of the diseased vessel, where blood flow is strong. And then, the other end of the bypass vessel is attached to the blocked vessel, beyond the blockage. This allows blood to flow around the blockage, restoring the delivery of oxygen and nutrients to the part of the heart that was supplied by the vessel before it became blocked.

Example:

  • Heart bypass surgery

The risks for bypass surgery:

Continue to Chest Pain due to Blocked Arteries Home Care

Last Updated: Jun 7, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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