Is stable angina curable?

Stable angina is also known as chronic ischemic cardiomyopathy. This is the most common form of chest pain in coronary artery disease.
Actually called stable angina because of the similar nature and severity in each occurrence and especially the pain usually occurs only when performing strenuous activities or when the patient Psychological stress, sudden environmental temperature changes. Usually this pain subsides with rest or medication.
MORE: What to do when you have chronic ischemic heart disease?
For stable angina, the patient often feels pain or discomfort in the chest, the heart as if someone is squeezing or being pressed by a heavy object. The pain may spread to nearby areas of the body such as the neck, shoulders, arms, back and be accompanied by symptoms of shortness of breath, fatigue, sweating,...
So stable angina can can it be cured? In fact, the treatment of stable angina only aims to improve pain, improve quality of life, reduce the rate of heart failure as well as reduce the mortality rate for patients, but it cannot be completely cured.
MORE: Treatment measures, treatment to reduce angina

If stable angina is not treated promptly and properly, the patient can have a heart attack, heart failure or stroke. These are some of the dangerous complications that affect the health and life of the patient.
There are 3 methods of treating stable angina pectoris: using drugs, percutaneous coronary intervention, and coronary artery bypass graft surgery. However, when treating, it is necessary to adjust the risk factors for the patient.

Use of antiplatelet drugs:
Use of Aspirin: With a dose of 75 - 325 mg/day. In case of allergy or poor tolerance to Aspirin, it is possible to replace Ticlopidine (Ticlid) 250mg tablet, taking 2 tablets / day or Clopidogrel (Plavix) 75mg tablet, 75mg / day. Correction of dyslipidemia:
Treatment of stable angina using HMG-CoA inhibitors such as: Fluvastatin (Lescol), Simvastatin (Zocor), Atorvastatin (Lipitor)... Treatment of angina stabilize the chest using fibrin derivatives such as Benzafibrate (Banzalip), Gemfibrozil (Lopid), or using fenofibrate (Lipanthyl). Nicotinic acid (Niacin) or bile acid-binding Resins such as Colestipol, Cholestyramine. Using Nitrates derivatives:
Nitroglycerin (Glycerin trinitrate Nitrobid, Nitrostat, Nitrodur, Natispray, Nitromit...) Isosorbide dinitrate (Isosorbid, Lenitral, Sorbitrate) or Isosorbid - 5- mononitrate (Imdur, Ismo) Erythrityl tetranitrate (Cardilatel tetranitrate) ) Sympathomimetic B blockers:
Selective B1 drugs: Metoprolol at a dose of 50 - 200 mg/day; Atenolol (Tenormin) at a dose of 25 - 200 mg/day; Acebutolol (Sectral) at a dose of 200 - 600 mg or Betaxolol at a dose of 20 - 40 mg/day Non-selective drugs (blocks both B1 and B2): Use Propranolol (Inderal) at a dose of 40 - 320 mg/day or use Nadolol, Timolol, Pindolol. Blockers of both B and A such as: Labetalol, Carvedilol. Calcium channel blockers:
Calcium channel blockers such as Dihydropyridines have little effect on coronary arteries. Benzothiazepines: Diltiazem (Tildiem) at a dose of 30-90 mg x 3 times / day. However, this drug should not be used in patients with reduced left ventricular contractility, bradycardia. Phenylalkylamine: Verapamil (Isoptine) at a dose of 120 - 240 mg x 2 times / day. However, this drug should not be used in patients with heart failure. ACE inhibitors:
Should only be used in patients with stable angina after myocardial infarction with left ventricular dysfunction or in patients with concomitant hypertension. Hormone replacement therapy:
Currently, the commonly used drug is Estrogen at a dose of 0.625 mg/day. Should be taken for 25 consecutive days, 5 days off. Free radical scavengers: Drugs include: Vitamin E 400 - 800 units/day.

Percutaneous coronary intervention for the treatment of stable angina including percutaneous angioplasty with or without stenting. This method is performed through the femoral, radial, or brachial arteries.
With this method, a catheter will be used to guide through the peripheral artery, then thread it to the aortic root for the purpose of accessing the coronary artery hole.
A catheter with a balloon tip is passed through the catheter to guide the narrow site under ultrasound or radiographic guidance. Inflate the balloon to flatten the atherosclerotic plaque, widen the lumen of the narrow vessel

This method will improve blood flow to the heart muscle, helping patients reduce chest pain symptoms as well as use less drugs and be physically active, live longer.
This surgery aims to create a bypass from the aorta to posterior coronary artery occlusion. Your doctor will take a piece of an artery or vein from other parts of your body and connect these blood vessels directly behind the narrowing of the damaged coronary artery. From there, blood can flow better through the narrow areas and to more of the heart muscle.

Dyslipidemia: Blood lipids should be corrected with statins. Target LDL less than 70 mg/dL or >50% LDL-C reduction when the goal is not difficult to achieve. At the same time, other drugs such as niacin, ezetimibe, fibrates, resins should be used to lower cholesterol. Diabetes: A target HbA1c level < 53 mmol/mol is recommended to reduce coronary risk. For patients with diabetes and coronary artery disease, SGLT-2 should be started early. Chronic kidney disease: People with chronic kidney disease at high risk need control of their risk factors, blood pressure goals, and blood lipids. Hypertension: Target blood pressure should be systolic <140 mmHg and diastolic <90mmHg. Obesity and overweight: People who are overweight or obese need to lose weight to prevent high blood pressure, reduce blood lipids as well as reduce the risk of type 2 diabetes and other cardiovascular risks. ACE inhibitors: ACEIs inhibit blood vessel constriction through inhibiting the action of the enzyme that converts angiotensin I to angiotensin II. However, the use of ACEIs is contraindicated during pregnancy, a history of edema or acute renal failure when using ACEIs, and patients with low blood pressure. Depression: Sertraline, citalopram, and mirtazapine are effective and safe to treat depression in patients with stable angina. Antiplatelet drugs: Platelet activation and adhesion are considered to be key factors in the thrombogenic response to plaque sloughing, so antiplatelet drugs will reduce the rate of complications in people. stable angina.

Use of drugs:
For drugs to correct dyslipidemia: Indicated in patients with dyslipidemia with a history of angina or myocardial infarction. The following patient underwent coronary artery bypass grafting. Calcium antagonists: Drugs are often used in combination with beta-blockers when beta-blockers alone are ineffective or in patients with intolerance or contraindications. Coronary intervention:
Coronary interventional treatment is applied in facilities with interventional cardiology. Cardiac-coronary bypass surgery:
Applied in establishments with heart surgery centers. Multiple stenosis coronary artery disease, eg damage to 3 coronary arteries. Injury to the common body, complex lesions are not suitable for intervention, but the distal segment is still good... Currently, methods of percutaneous coronary intervention or surgery to make coronary artery bypass and medical treatment with drugs are kept. a very important role in the treatment of stable angina. However, in parallel with the control of stable chest pain by the above methods, patients also need medical treatment of accompanying factors, control of blood pressure... to increase the effectiveness of treatment.
Cardiovascular disease is the leading cause of death, so it is very important to control and treat the disease at an early stage. With many years of experience in the examination and treatment of cardiovascular diseases, now Vinmec International General Hospital has become one of the major Cardiology centers, possessing a team of qualified doctors and nurses. are well-trained and have a system of modern medical facilities and equipment. As a result, the Cardiovascular Center at Vinmec International General Hospital is capable of examining, treating and managing chronic cardiovascular diseases. In particular, here has also implemented and applied the most advanced intensive cardiovascular techniques in the world in treatment such as: Painless open-heart surgery; Percutaneous aortic intervention without general anesthesia; Treatment of mitral regurgitation through the catheter has a success rate of 95%; Ventricular-assisted artificial heart transplantation for patients with end-stage heart failure prolongs quality of life beyond 7 years.
The whole process of examination, monitoring, recovery and treatment of cardiovascular disease is always integrated with many specialties to provide the opportunity for quick recovery, avoiding recurrence, affecting health as well as economy. for the patient.