What are the types of angina pectoris? What are the Western medical treatment methods for angina pectoris? Below is a detailed introduction.Angina primarily results from coronary artery atherosclerotic narrowing causing insufficient coronary blood supply, leading to transient myocardial ischemia and hypoxia. Patients may experience episodic chest pain, particularly after exertion, occurring once every few days or weeks, or multiple times within a single day. Sublingual nitroglycerin can relieve symptoms within minutes.
Based on exertion-related angina episodes, severity is categorized into four levels. Take this self-assessment to determine your angina stage:
Grade I Angina: You typically experience no significant symptoms during daily activities. However, angina symptoms may occur when engaging in physical exertion exceeding routine activity levels, such as jogging on flat ground, climbing three flights of stairs quickly or carrying heavy objects, or ascending steep slopes.
Grade II Angina: Your daily activities are already somewhat restricted. Angina may occur with ordinary physical exertion, such as walking 1.5–2 kilometers at a normal pace, climbing three flights of stairs, or ascending a slope.
Types of Angina Western Medical Treatment for Angina
Grade III Angina:You can no longer tolerate physical activities lighter than daily routines, such as walking 0.5–1 kilometer at a normal pace, climbing two flights of stairs, or ascending a small slope. Daily physical activities are significantly restricted.
Grade IV Angina Pectoris: Your angina has become frequent, triggered by even minimal daily physical exertion. You may experience angina even while walking slowly indoors or at rest.
Avoid all known triggers that can provoke attacks. Adjust your diet, especially avoiding overeating in a single sitting; abstain from smoking and alcohol. Modify daily routines and workload; reduce mental stress; maintain appropriate physical activity, but only to the extent that it does not cause pain symptoms; bed rest is generally not required.Patients experiencing initial episodes (primary onset), increased or worsening episodes (progressive type), or variants such as orthostatic, variant, intermediate syndrome, or post-infarction angina—particularly those suspected of being precursors to myocardial infarction—should rest for a period. Employ long-acting antianginal medications to prevent angina attacks. The following sustained-release agents may be used alone, alternated, or combined:
1. Nitrate Preparations
(1) Isosorbide dinitrate: Oral administration of 5–10 mg three times daily; onset within 30 minutes, duration 3–5 hours. Isosorbide mononitrate 20 mg twice daily.
(2) Pentaerythritol tetranitrate: 10–30 mg orally 3–4 times daily. Onset within 1–1.5 hours, duration 4–5 hours.
⑶ Long-acting nitroglycerin preparations: Take sustained-release tablets for continuous, gradual nitroglycerin release. Takes effect within 30 minutes after oral administration, lasting up to 8–12 hours. May be taken every 8 hours at 2.5mg per dose.Apply 2% nitroglycerin ointment or patch formulations (containing 5–10 mg) to the chest or upper wall skin; effects may persist for 12–24 hours.
2. Beta-blockers (beta-adrenergic antagonists) block the stimulation of heart rate and myocardial contractility receptors by sympathomimetic amines. They slow heart rate, lower blood pressure, reduce myocardial contractility and oxygen consumption, thereby alleviating angina attacks.Additionally, they reduce hemodynamic responses during exercise, decreasing myocardial oxygen consumption at equivalent exertion levels. They constrict small arteries (resistance vessels) in non-ischemic myocardial areas, thereby directing more blood through highly dilated collateral circulation (supplying vessels) to ischemic regions.High doses are required. Adverse effects include prolonged ventricular ejection time and increased cardiac volume, which may exacerbate myocardial ischemia or induce heart failure. However, its ability to reduce myocardial oxygen consumption far outweighs these adverse effects.