It is most useful when coronary bypass surgery is being considered, as noted below. Treatment Treatment of symptoms is divided into medical and surgical types. The choices are complicated, and depend largely on individual factors, as well as regional resources and preferences. General comments on the major options are included in this section, although exceptions are common. Each of these drugs is discussed in greater detail in the drug section of HealthNet, and the reader is referred to the appropriate section for more detail.
Medications are increasingly effective for symptom control, as well as prevention of complications.
The oldest and most common agents are the nitrates, derivatives of nitroglycerine. They include nitroglycerine, isosorbide, and similar agents. Newer forms include long acting oral agents, plus skin patches which release a small amount through the skin into the bloodstream over a full day. They act by reducing the burden of blood returning to the heart from the veins and also by dilating the coronary arteries themselves. Nitrates are highly effective for relief and prevention of angina, and sometimes for limiting the size of a heart attack.