Private angina treatment - what's available?

Angina is a crushing pain in the chest that happens when the heart is not getting enough blood and oxygen to carry on beating effectively. The underlying cause is the build up of fatty plaques in the coronary arteries, which narrow the lumen of the blood vessels. Angina attacks usually occur during exercise or exertion, when the heart needs to work harder. Having an angina attack when at rest is usually a sign that the coronary arteries are almost completely blocked, and may mean that a heart attack is imminent. This is a medical emergency that requires a 999 call and an ambulance; once you are stable you can then opt to have private angina treatment, or treatment within the National Health Service.

Stable angina needs constant and careful control; private angina treatment offers the same types of drug therapies and surgical interventions as the NHS but you have the advantage of being able to arrange appointments to suit your own schedule, you can choose your cardiologist and you have more continuity of care, seeing the same specialist each time. Many people with private medical insurance through work opt for private angina treatment.

This article on private angina treatment is written by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

Diagnosis and private angina treatment

If you have suspected angina and have private medical insurance, or decide to pay for your own private angina treatment, the first step will be to go through a series of tests to confirm your diagnosis. Angina symptoms must be checked out as quickly as possible; private angina treatment can be arranged very promptly and an appointment with a cardiologist can usually be arranged within days. The cardiologist in charge of your private angina treatment will offer some or all of the following tests:

• A resting electrocardiogram (ECG) – to check out how well your heart is beating.
• An exercise test with an ECG, usually on a treadmill – to see how your heart responds to exercise.
• A stress echocardiogram – usually done in people who cannot do a treadmill test. Dobutamine, a drug to raise the heart rate, is injected just before the test and then the echocardiogram is done to see if any of the coronary arteries are narrowed.
• Perfusion scanning – a radioactive tracer is injected into the blood and then a detector is used to provide accurate images of the coronary arteries

If any of the tests reveal unstable angina, or serious narrowing of the coronary arteries, your cardiologist will arrange for you to have a coronary angiogram. This provides even more accurate images of the coronary arteries using a special dye and a series of X-rays. Private angina treatment in this case will then involve an urgent angioplasty or coronary artery bypass surgery.

Private angina treatment for an acute angina attack

If your tests show that you have angina that is stable, private angina treatment will focus on helping you cope with angina attacks and on lowering the frequency of those attacks. First of all you will be prescribed a mouth spray, or small tablets containing glyceryl nitrate. As soon as you start to feel the pain of angina, simply spray this into your mouth, or put one of the tablets under your tongue, and it should disappear within 5 minutes. The dose can be repeated up to twice more, at 5 minute intervals. If you still have pain then, or it is getting worse and you are feeling ill, it is time to call 999.

Private angina treatment to prevent angina attacks

NHS cardiologists and specialists that offer private angina treatment regard beta blockers as the drug of choice for patients with stable angina. Beta blockers are used to slow down the heart rate, so that it beats more slowly and also less forcefully. This means that, even during exercise, the muscle doesn’t work as hard, so is less likely to become short of oxygen. If you have asthma or lung problems such as chronic obstructive pulmonary disease, your private angina treatment regime will include calcium channel blockers or long acting nitrates instead, as these reduce the risk of angina attacks but do not adversely affect your lungs.

Private angina treatment to prevent heart attacks

As well as reducing the frequency of attacks, your private cardiologist will also suggest some lifestyle changes to decrease your overall risk of having a heart attack. You will need to take more exercise, eat a healthy diet, stop smoking and lose weight if necessary. Your blood cholesterol and blood pressure will also be checked and your private angina treatment plan will include statins and blood pressure medication if they are required.

You may also be given anti-platelet drugs such as low dose aspirin to prevent blood clots forming in arteries elsewhere in the body where you may have fatty plaques. If you are at high risk of blood clots developing in your veins because of poor blood circulation in the legs, your private angina treatment will also include blood thinning drugs such as warfarin or heparin.

Surgical private angina treatment

Your condition will be carefully monitored and if your angina does not improve with drug therapy, the cardiologist in charge of your private angina treatment may recommend a balloon angioplasty, perhaps with a stent to keep your coronary arteries open and clear. This is a relatively non-invasive procedure done with tiny instruments introduced into the heart through a blood vessel in the leg and is available in private hospitals throughout the UK.

If you have several coronary arteries that are partially blocked with plaques and your angina is worsening, you may then need a coronary artery bypass. This is a more significant operation in which blood vessels from the legs are used to bypass and take over the function of the coronary arteries. Again, it can be done as part of private angina treatment in many private centres all over the country.

Profile of the author

Dr Kathryn Senior is an acclaimed medical journalist who has written over 500 feature articles for leading international journals within The Lancet group. As Senior Writer at Freelance Copy she produces high quality scientific and medical content for websites and printed publications for companies and organisations in the health, medical and pharmaceutical sectors.