Angina is a symptom of ischemic heart disease. Your doctor may recommend the following heart-healthy lifestyle changes to help you manage angina:

• Heart-healthy eating. Following a healthy eating plan, including limiting alcohol, can prevent or reduce high blood pressure and high blood cholesterol, helping you reduce angina symptoms and maintain a healthy weight. You should avoid large meals and rich foods if heavy meals trigger your angina. If you have variant angina, drinking alcohol can also be a trigger.

• Aiming for a healthy weight. If you are overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you manage the risk factors for angina.

• Being physically active. Before starting any exercise program, ask your doctor about what level of physical activity is right for you. Slow down or take rest breaks if physical exertion triggers angina.

• Managing stress. If emotional stress triggers your angina, try to avoid situations that make you upset or stressed.

• Quitting smoking. Smoking can damage and tighten blood vessels, make angina worse, and raise the risk of life-threatening complications.

 •          Prevent repeat angina events

Stable angina usually occurs in a pattern. After several events, you will learn what causes the pain to occur, what the pain feels like, and how long the pain typically lasts. To help learn your angina’s pattern and triggers, keep a log of when you feel pain. The log helps your doctor regulate your medicines and evaluate your need for future treatments. When you know what triggers your angina, you can take steps to prevent or lessen the severity of events.

• Know the limits of your physical activity. Most people who have stable angina can continue their normal activities. This includes work, hobbies, and sexual relations. Learn how much exertion triggers your angina, so you can try to stop and rest before the chest pain starts.

• Learn how to reduce and manage stress. Try to avoid or limit situations that cause anger, arguments, and worry. Exercise and relaxation can help relieve stress. Alcohol and drug use play a part in causing stress and do not relieve it. If stress is a problem for you, talk with your doctor about getting help.

• Avoid exposure to very hot or cold conditions, because temperature extremes strain the heart.

• Tell your doctor right away if your pattern changes. Pattern changes may include angina that occurs more often, lasts longer, is more severe, occurs without physical exertion, or does not go away with rest or medicines. These changes may be a sign that your symptoms are getting worse or becoming unstable.

 •          Seek help for angina that does not improve.

Not all angina improves with medicines or medical procedures. If your symptoms continue, your doctor may change your medicines or therapies to help relieve your chest pain. Additional treatments for hard-to-treat angina include:

• Enhanced external counterpulsation therapy (EECP) to improve the flow of oxygen-rich blood to your heart muscle, which may help relieve angina. EECP uses large cuffs, similar to blood pressure cuffs, on your legs. The cuffs inflate and deflate in sync with your heartbeat. You typically get five 1-hour treatments per week for 7 weeks. Side effects may include back or neck pain and skin abrasions.

• Spinal cord stimulators to block the sensation of pain. Emerging research suggests that this technology can help people be more physically active, feel angina less often, and have a better quality of life.

• Transmyocardial laser therapy to stimulate the growth of new blood vessels or improve blood flow in the heart muscle. It can relieve angina pain and increase your ability to exercise without discomfort. This laser-based treatment is done during open-heart surgery or through cardiac catheterization. Rarely, your doctor may recommend this treatment in combination with CABG.

 •          Know your medicines

You should know what medicines you are taking, the purpose of each, how and when to take them, and possible side effects. Learn exactly when and how to take nitroglycerin or other short-acting nitrates to relieve chest pain. Then talk to your doctor about the following:

• Any other medicines you are taking, including vitamins and nutritional supplements. Some medicines can cause serious or life-threatening problems if they are taken with nitrates or other angina medicines. For example, men who take nitrates, including nitroglycerin, for their angina should not take medicines for erectile dysfunction without checking with their doctor first.

• Any side effects you may experience. Do not stop taking your medicines without talking to your doctor first.

• How to store your medicines correctly and when to replace them.