Angina: Introduction FeedbackA general introduction to Angina.Source: Clinical Knowledge Summaries, 01 May 2012
Angina is chest pain (or constricting discomfort) caused by an insufficient blood supply to heart muscle.
Angina is usually caused by coronary artery disease.
Less commonly, angina is caused by valve disease (for example aortic stenosis), hypertrophic obstructive cardiomyopathy, or hypertensive heart disease.
Stable angina usually occurs predictably with physical exertion or emotional stress, and is relieved within minutes of rest.
Unstable angina is new (usually within 24 hours) onset angina or abrupt deterioration in previously stable angina, often occurring at rest. Unstable angina usually requires immediate admission or referral to hospital.
Management of stable angina includes lifestyle advice:
All people who smoke should be offered advice and assisted to stop.
A cardioprotective diet should be encouraged.
Advice and support should be offered to help achieve and maintain a healthy weight if people are overweight or obese.
An increase in physical activity levels should be encouraged within the limits set by their symptoms.
Limitation of alcohol consumption should be encouraged.
Drugs used to treat angina include:
Sublingual glyceryl trinitrate (GTN) for the rapid relief of symptoms of angina and for use before performing activities known to cause symptoms of angina.
A beta-blocker or a calcium-channel blocker as first-line regular treatment to reduce the symptoms of stable angina.
Second-line treatment such as a long-acting nitrate (such as isosorbide mononitrate), nicorandil, or ivabradine.
If symptom control is poor on the maximum licensed or highest tolerated dose of one drug, another drug from a different class should be switched to or added in.
If symptom control is poor on the maximum licensed or tolerated doses of two drugs, referral to a cardiologist (for assessment for revascularization) should be arranged.
Starting a third anti-anginal drug should be considered whilst waiting for specialist assessment.
Drugs are also used for secondary prevention of cardiovascular events:
Antiplatelet treatment should be considered in all people with stable angina. For most people this will be low-dose aspirin (75 mg daily).
An angiotensin-converting enzyme (ACE) inhibitor should be prescribed for people with coexisting hypertension, heart failure, asymptomatic left ventricular dysfunction, chronic kidney disease, or previous myocardial infarction in line with current guidance, unless this is contraindicated or not tolerated. Treatment with an ACE inhibitor should be considered for people with stable angina and diabetes mellitus.
A statin should be offered in line with NICE guidance on lipid modification.
Treatment for high blood pressure should be offered in line with NICE guidance on hypertension.
Hospital admission is recommended for people presenting 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.
Angina: Guidance FeedbackThe most relevant search results for Angina from producers of guidance information.
- Scottish Intercollegiate Guidelines Network, 29 January 2013
- Clinical Knowledge Summaries, 01 May 2012
- Stable angina - NICE Pathways
- National Institute for Health and Care Excellence, 01 July 2011
Unstable angina and NSTEMI: The early management of unstable angina and non-ST-segment-elevation myocardial infarction - guidance (CG94)National Institute for Health and Care Excellence, 01 March 2010
Chest pain of recent onset: Assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin - guidance (CG95)National Institute for Health and Care Excellence, 01 March 2010
- National Institute for Health and Care Excellence, 01 August 2011
- Finnish Medical Society Duodecim, 09 December 2013
- National Institute for Health and Care Excellence, 20 September 2012
Angina: Commissioning FeedbackThe most relevant search results for Angina from producers of commissioning advice.
- National Institute for Health and Care Excellence, 01 August 2012
- QIPP, 27 November 2009
- National Institute for Health and Care Excellence, 01 November 2013
- National Institute for Health and Care Excellence, 01 May 2012
- National Institute for Health and Care Excellence, 12 August 2012
- National Institute for Health and Care Excellence, 05 September 2014
- National Institute for Health and Care Excellence, 09 September 2014
Information for the public
Angina: Information for the public FeedbackThe most relevant search results for Angina, from Department of Health accredited producers of patient information.
Angina: Ongoing Research FeedbackThe most relevant search results for Angina, from research trials.
- UK Clinical Trials Gateway, 13 September 2010
- UK Clinical Trials Gateway, 15 August 2005
- UK Clinical Trials Gateway, 21 June 2010
MR INFORM - MR Perfusion Imaging to Guide Management of Patients With Stable Coronary Artery DiseaseUK Clinical Trials Gateway, 08 November 2010
- UK Clinical Trials Gateway, 22 September 2011
BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME).UK Clinical Trials Gateway, 26 May 2010
Angina: Medicines FeedbackAppropriate medicines information for Angina supplied by Datapharm, a leading source of trusted, credible information about medicines.
Angina - Medicines Information
- Adalat (a brand of Nifedipine)
- Adipine (a brand of Nifedipine)
- Adizem (a brand of Diltiazem Hydrochloride)
- Angitil (a brand of Diltiazem Hydrochloride)
- Bedranol (a brand of Propranolol Hydrochloride)
- Beta-Adalat (a brand of Atenolol , a brand of Nifedipine)
- Beta-Prograne (a brand of Propranolol Hydrochloride)
- Betim (a brand of Timolol Maleate)
- Bi-Carzem (a brand of Diltiazem Hydrochloride)
- Cabren (a brand of Felodipine)
- Calchan (a brand of Nifedipine)
- Calcicard (a brand of Diltiazem Hydrochloride)
- Cardene (a brand of Nicardipine Hydrochloride)
- Cardicor (a brand of Bisoprolol Fumarate)
- Cardioplen (a brand of Felodipine)
- Chemydur (a brand of Isosorbide Mononitrate)
- Cibral (a brand of Isosorbide Mononitrate)
- Coracten (a brand of Nifedipine)
- Cordilox (a brand of Verapamil Hydrochloride)
- Corgard (a brand of Nadolol)
- Dilcardia (a brand of Diltiazem Hydrochloride)
- Dilzem (a brand of Diltiazem Hydrochloride)
- Emcor (a brand of Bisoprolol Fumarate)
- Felendil (a brand of Felodipine)
- Felogen (a brand of Felodipine)
- Felotens (a brand of Felodipine)
- Fortipine (a brand of Nifedipine)
- Glyceryl Trinitrate
- Horizem (a brand of Diltiazem Hydrochloride)
- Hypolar (a brand of Nifedipine)
- Ikorel (a brand of Nicorandil)
- Isoket (a brand of Isosorbide Dinitrate)
- Isosorbide Dinitrate
- Isosorbide Mononitrate
- Istin (a brand of Amlodipine)
- Ivabradine (a generic version of Procoralan)
- Kentipine (a brand of Nifedipine)
- Kenzem (a brand of Diltiazem Hydrochloride)
- Monomil (a brand of Isosorbide Mononitrate)
- Monosorb (a brand of Isosorbide Mononitrate)
- Neofel (a brand of Felodipine)
- Nifopress (a brand of Nifedipine)
- Parmid (a brand of Felodipine)
- Pinefeld (a brand of Felodipine)
- Ranexa (a brand of Ranolazine)
- Retalzem (a brand of Diltiazem Hydrochloride)
- Sectral (a brand of Acebutolol Hydrochloride)
- Securon (a brand of Verapamil Hydrochloride)
- Slozem (a brand of Diltiazem Hydrochloride)
- Syprol (a brand of Propranolol Hydrochloride)
- Tensipine (a brand of Nifedipine)
- Tildiem (a brand of Diltiazem Hydrochloride)
- Transiderm-Nitro (a brand of Glyceryl Trinitrate)
- Trasicor (a brand of Oxprenolol Hydrochloride)
- Triapin (a brand of Felodipine , a brand of Ramipril)
- Univer (a brand of Verapamil Hydrochloride)
- Vascalpha (a brand of Felodipine)
- Vera-Til (a brand of Verapamil Hydrochloride)
- Vertab (a brand of Verapamil Hydrochloride)
- Viazem (a brand of Diltiazem Hydrochloride)
- Visken (a brand of Pindolol)
- Xismox (a brand of Isosorbide Mononitrate)
- Zemtard (a brand of Diltiazem Hydrochloride)
- Zolvera (a brand of Verapamil Hydrochloride)
- Results are currently sorted by relevance (Sort results by: date)
- Results 1 - 10 (of 12176)
National Institute for Health and Care Excellence, 09 July 2013 - Publication type: Pathway, Guidance
...In Twitter Facebook Email More... Angina Angina D000787Angina Pectoris D060050Angina, Stable...Cardiovascular 2012-05-01Last revised in September 2014 Angina - Summary Angina is chest pain (or constricting...
Clinical Knowledge Summaries, 01 May 2012
Ivabradine (Procoralan) in the symptomatic treatment of angina: risk of cardiac side effects—new advice to minimise risk
...Procoralan) in the symptomatic treatment of angina: risk of cardiac side effects—new advice...heart failure and the symptoms of chronic angina in adults unsuited to or unable to take...049 participants who had symptomatic angina. In this subgroup, there was a small...
Medicines and Healthcare products Regulatory Agency, 18 December 2014
...for the diagnosis and management of angina and myocardial infarction (NICE technology appraisal guidance 73). Angina is pain or constricting discomfort...discomfort, breathlessness or nausea. Angina is the main symptom of myocardial ischaemia...
National Institute for Health and Care Excellence, 01 July 2011
...recommendations for the early management of unstable angina and NSTEMI from NICE technology appraisal...encompasses a range of conditions from unstable angina to ST-segment-elevation myocardial...addresses the early management of unstable angina and non-ST-segment-elevation myocardial...
National Institute for Health and Care Excellence, 01 March 2010
...revascularisation (TMLR) for refractory angina pectoris shows no efficacy, based on...Indications and current treatments 2.1.1 Angina pectoris is chest discomfort, often described...of coronary artery disease. Refractory angina is a severe angina form that cannot be...
National Institute for Health and Care Excellence, 01 May 2009
...revascularisation (PLR) for refractory angina pectoris shows no efficacy and suggests...Indications and current treatments 2.1.1 Angina pectoris is chest discomfort, often described...of coronary artery disease. Refractory angina is a severe angina form that cannot be...
National Institute for Health and Care Excellence, 01 May 2009
Management of stable angina A national clinical guideline 1...cardiology and cardiac surgery 12 5 Stable angina and non-cardiac surgery 19 6 Psychological...Guidelines Network Management of stable angina A national clinical guideline February...
Scottish Intercollegiate Guidelines Network, 01 February 2007
...Email Close Show sections Unstable angina and NSTEMI: The early management of unstable angina and non-ST-segment-elevation myocardial...care and treatment of adults with unstable angina or NSTEMI from the time of diagnosis to leaving...
24 March 2010 - Publisher: NICE - Publication type: Guideline
...Traditional Chinese herbal products for stable angina Qi Zhuo 1 , Zhengyong Yuan 2...Traditional Chinese herbal products for stable angina. Cochrane Database of Systematic Reviews...of support Notes Index terms Angina pectoris is the most common clinical manifestation...
Cochrane Database of Systematic Reviews, 12 May 2010 - Publisher: John Wiley & Sons, Ltd
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