Unstable and stable angina

Treatment of both stable and unstable angina depends on initially defining the pathophysiological mechanisms. The goal of treatment is to prevent the development of angina pectoris and possibly also to improve the prognosis. beta-blockade is effective in treating effort-related angina, as are calcium antagonists, which are also effective in treating coronary spasm. Combination therapy may be synergistic, but evidence to support this is controversial. In unstable angina the main goal of treatment is the prevention of myocardial infarction and death. While calcium antagonists have not been shown to improve the prognosis, there is more evidence to support the use of beta-blockers, particularly in combination with a calcium antagonist. Aspirin and possibly heparin should be considered as routine treatment.