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Angina IV: Management

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...

Coronary Artery Disease V: Interprofessional Care

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...

Angina V: Nursing Management

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Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...

Angina II: Classification

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...

Antianginal Drugs: Nitrates and β-Blockers

Antianginal Drugs: Nitrates and β-Blockers

In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...

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Updated: Jul 7, 2026

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

Published on: April 4, 2022

Emerging therapies for refractory angina.

Daniel Satran¹, Jay H Traverse, Gregory W Barsness

¹Division of Cardiovascular Disease, Minneapolis Heart Institute Foundation/Abbott Northwestern Hospital, University of Minnesota, USA.

Minnesota Medicine

|February 14, 2008

Summary

Patients with refractory angina, often termed "no-option" patients, face challenges with traditional treatments. Emerging therapies offer new hope for managing severe coronary artery disease symptoms.

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Published on: February 3, 2021

Area of Science:

Cardiology
Vascular Medicine
Regenerative Medicine

Background:

Advances in pharmacologic and revascularization therapies have improved survival for coronary artery disease (CAD) patients.
Increased longevity leads to a growing population of CAD patients with extensive disease.

Observation:

Many long-living CAD patients develop myocardial ischemia and angina unresponsive to standard revascularization.
These patients are classified as having refractory angina or are considered "no-option" cases.

Findings:

The article reviews current clinical management strategies for refractory angina.
Emerging therapeutic options are discussed, including enhanced external counterpulsation, therapeutic angiogenesis, neurostimulation, and transmyocardial revascularization.

Implications:

Provides a comprehensive overview of management for a challenging patient group.
Highlights novel treatment avenues for severe, symptomatic chronic coronary artery disease.
Offers insights into improving quality of life for "no-option" angina patients.