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Angina - stable - Management
Overview of management
- Consider hospital admission for people with the following symptoms, as they may have unstable angina:
- Pain at rest (which may occur at night).
- Pain on minimal exertion.
- Angina that seems to be progressing rapidly despite increasing medical treatment.
- Refer all people with suspected angina to a chest pain evaluation service for confirmation of the diagnosis and assessment of the severity of coronary heart disease.
- For people with a confirmed diagnosis of angina:
- Treat the symptoms.
- Give a short-acting nitrate for rapid symptom relief, and a beta-blocker (unless contraindicated).
- If additional treatment is required to control symptoms, consider adding a second anti-anginal drug.
- If symptoms are not controlled with optimum use of two drugs, refer for consideration of revascularization.
- Ensure that all people with angina are taking aspirin and a statin (unless contraindicated or not tolerated), and consider an angiotensin-converting enzyme inhibitor.
- Give advice on managing cardiovascular risk, driving, work, and sexual activity.
- Give education about myocardial infarction (heart attack) and the need to seek help rapidly by phoning for an ambulance if symptoms develop.
- Review the person every 6 months to 1 year depending on the stability of their angina and their comorbidities.
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