Understanding Angina Pectoris and its Management

Angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease. It occurs when the heart muscle doesn't get as much blood as it needs, typically because of a blockage in a coronary artery.

There are three primary classes of anti-anginal drugs: nitrates, beta-blockers, and calcium channel blockers. Each works differently to relieve angina by improving blood flow or reducing the heart's workload.

Nitroglycerin, a fast-acting nitrate, can alleviate acute angina attacks within minutes. It's taken sublingually, allowing direct absorption into the bloodstream, which causes rapid vasodilation and relief of chest pain.

Beta-blockers not only reduce the heart rate and contractility to lower oxygen demand but also have an anti-arrhythmic effect. They're especially beneficial post-myocardial infarction due to their protective properties.

Calcium channel blockers relax coronary arteries by limiting calcium entry into heart and vessel walls. They are particularly effective for variant angina caused by coronary artery spasms, a less common type of angina.

Ranolazine is a newer anti-anginal medication that works by inhibiting the late phase of the sodium current in the cardiac cells, thus reducing the calcium overload and making it easier for the heart to pump blood.

In addition to medications, lifestyle changes, such as exercise, smoking cessation, and diet modifications, play a crucial role in managing angina. In severe cases, surgical procedures like angioplasty or bypass surgery may be necessary.