Spontaneous Angina Treatment: First-Line Medications and Emergency Response

When experiencing spontaneous angina, the first-line medication is sublingual nitroglycerin. This fast-acting drug effectively dilates the coronary arteries and helps prevent coronary spasms. Nitroglycerin is typically the go-to treatment during acute episodes due to its rapid onset of action, often within minutes of administration.

Immediate Steps During an Angina Episode

In addition to taking nitroglycerin under the tongue, it's crucial to provide the affected individual with high-flow oxygen to improve myocardial oxygenation. Ensuring a calm and quiet environment can also help reduce stress and lower the heart's workload. It's equally important to keep the room well-ventilated to support better breathing and stabilize the patient's condition.

Seeking Emergency Medical Help

One of the most critical steps during a spontaneous angina episode is calling emergency services immediately—such as dialing 120. Prompt medical attention is essential to evaluate the severity of the condition and rule out potentially life-threatening complications like myocardial infarction.

Diagnostic Procedures at the Hospital

Upon arrival at the hospital, healthcare professionals will likely perform a series of diagnostic tests. These may include an electrocardiogram (ECG), echocardiogram, coronary computed tomography angiography (CTA), or even coronary angiography. These tests help determine the duration of the angina episode and whether there are any signs of heart muscle damage or blockages in the coronary arteries.

Treatment Options Based on Diagnosis

Depending on the results of these diagnostic evaluations, doctors can decide on the most appropriate treatment plan. Options may include medical therapy using anti-anginal drugs like beta-blockers, calcium channel blockers, or long-acting nitrates. In more severe cases where blockages are identified, coronary stenting may be performed to open the affected artery and restore normal blood flow.

For patients with extensive coronary artery disease or multiple blockages, a coronary artery bypass graft (CABG) might be recommended. This surgical procedure creates new pathways for blood to flow around blocked arteries, significantly reducing angina symptoms and improving long-term heart function.