While you shouldn’t ignore chest pain (angina), some people experience the condition even when they aren’t having a heart attack. A doctor or healthcare professional may prescribe antianginal medications to lower your chest pain whether you’ve had a heart attack in the past or not.
Keep reading to find out more about antianginal medications and the roles they play in pain reduction and heart health.
Angina is a symptom of ischemia to your heart. Ischemia is when proper blood flow is affected. When your heart doesn’t get enough blood or oxygen, chest pain can occur.
- Stable angina is chest pain or discomfort that most often occurs with activity or emotional stress.
- Unstable angina is when you have chest pain even when you may be resting. It’s an emergency condition that requires immediate medical attention.
These types of angina are what you might get specific medications to address.
Doctors primarily prescribe antianginal medications to help lower your chest pain from stable angina.
Some of these antianginal medications do help lower your risk of a heart attack, but others don’t.
Three major classes of antianginal medications exist.
Beta-blockers prevent the stimulation of beta receptors in your heart. When stimulated, beta receptors can cause your heart to beat faster. In some people, a rapid heart rate causes chest pain because your heart is beating so fast that it can’t pump blood well.
By slowing down your heart rate, beta-blockers also lower how much oxygen and blood your heart needs to work. This can help lower your chest pain.
Examples of beta-blockers include:
Their names usually end in -ol.
Calcium channel blockers
Calcium channel blockers slow how quickly calcium moves into the cells in your heart and blood vessels. As a result, your blood vessels widen, and your heart needs less oxygen to work well. These effects help lower your chest pain.
Some calcium channel blockers lower your heart rate, too. These include verapamil and diltiazem. If you take these medications with beta-blockers, your heart rate could get too low.
Other calcium channel blockers include nifedipine and amlodipine. These don’t usually lower your heart rate, but they’re very effective vasoconstrictors. This effect can help lower your risk of ischemia and lower your chest pain.
Nitrates are medications that cause your blood vessels to widen or dilate. This allows more oxygen-carrying blood to flow through your heart, which lowers your chest pain.
Doctors can prescribe short- or long-acting nitrates. Short-acting nitrates include medications such as sublingual (goes under your tongue) and spray nitroglycerin.
Those who experience an episode of chest pain are to use a spray or sublingual tablet once every five minutes until your chest pain goes away. If it doesn’t go away after three doses, call 911 or local emergency services.
If you’re having a heart attack, a doctor may give you nitroglycerin to help reduce your symptoms until you receive treatment. The nitroglycerin isn’t necessarily treating your heart attack, but it could help your symptoms.
Long-acting nitrate medications include nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. True to their description, these medications work longer than short-acting nitrates to relieve your chest pain. Nitroglycerin is available in pill form or can be applied via a special patch that slowly releases the medication.
These medications are second-line therapies. This means doctors won’t usually prescribe them first but may prescribe them if you can’t take beta-blockers or calcium channel blockers or if these medications aren’t working well enough to lower your chest pain.
Each class of antianginal drugs has side effects. It’s important to discuss these with a doctor so you can know what’s expected and what you need to get medical attention for. Some of the most common side effects of each medication include:
- Beta-blockers: too-low heart rate, fatigue, depression, heart block, dizziness when standing, impotence, and can mask the effects of low blood sugar
- Calcium channel blockers: low heart rate, constipation, swollen gums, and heart block
- Nitrates: low blood pressure, flushing, and headache
These side effects may keep you from being able to take certain antianginal drugs. This is especially true if you typically have a low heart rate.
Still, other studies say beta-blockers help to lower your risk of a heart attack if you’ve had a heart attack before. Nitrates and calcium channel blockers don’t lower your risk of a heart attack.
There’s a lot of research to be done to figure out the benefits of antianginal drugs besides lowering chest pain.
When you should contact a doctor
You should call 911 or local emergency services if your chest pain doesn’t resolve with short-acting nitrate treatment. This symptom suggests you could be having a heart attack and need to be immediately treated.
You should call a doctor if you notice you’re getting chest pain more often or you’re able to exert yourself less (even if using short-acting nitrates still works). These symptoms can mean your
Antianginal drugs can help to take away the painful, squeezing sensations that can occur with ischemia. Studies haven’t conclusively indicated these medications lower the risk of a heart attack, although some suggest that beta-blockers might lower your risk of a heart attack. If you suspect you’re having a heart attack, call 911 or local emergency services and take nitroglycerin if a doctor prescribes it to you.