Medical Treatment of Stable Angina

  • James T. Willerson
  • James J. FergusonIII
  • Dipsu D. Patel
Chapter
Part of the Cardiovascular Medicine book series (CVM)

Abstract

The medical treatment for patients with stable angina rests in correcting risk factors predisposing to the progression of coronary heart disease and unstable coronary artery plaques. High importance should be given to lowering low-density lipoprotein values as far below 100 mg/dl as possible with diet and medication, usually a statin. Control of blood pressure, blood sugar, and heart rate are very important. Medications that reduce myocardial oxygen demand (beta blockers) and those that increase myocardial blood flow (nitrates and selected calcium antagonists in appropriate patients) are sometimes also important. Aspirin therapy to reduce risk of intracoronary thrombus formation and possibly attenuate inflammation is also important in all patients who are able to take it. The patient on ideal medical therapy with angina or objective evidence of myocardial ischemia at rest or low levels of effort should undergo coronary arteriography with a plan to proceed to percutaneous coronary intervention or coronary artery surgery when the coronary anatomy allows. Patients with heart failure and stable angina need to be evaluated similarly with imaging procedures that characterize their left ventricular function, cardiac valves, and pulmonary artery pressure.

Keywords

Stable coronary heart disease Statins Aspirin Percutaneous coronary intervention Coronary artery bypass graft Nitrates Beta blockers Calcium antagonists Platelet antagonists 

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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  • James T. Willerson
    • 1
  • James J. FergusonIII
    • 2
    • 3
  • Dipsu D. Patel
    • 4
    • 5
  1. 1.Cardiology DivisionTexas Heart InstituteHoustonUSA
  2. 2.Cardiology ResearchTexas Heart Institute, Texas Medical CenterHoustonUSA
  3. 3.Vice President of AstraZenica PharmaceuticalsWilmingtonUSA
  4. 4.Stem Cell Center, Texas Medical CenterHoustonUSA
  5. 5.Private practice CityTexasUSA

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