Refractory Angina Pectoris Pain Management



RAP has a variety of symptoms including chest pain or discomfort, nausea, fatigue, shortness of breath, sweating, and dizziness. Chest pain or discomfort might be accompanied by similar sensations in the arms, neck, jaw shoulder or back. The pain and discomfort might feel like pressure from a heavy weight, or squeezing of a vice. If chest pain lasts longer than a few minutes and is not cured by medication, it could be the sign of a heart attack and emergency medical attention is recommend.


RAP is caused by reduced blood flow and oxygen to the heart often caused by narrowing arteries or plaque build-up in the arteries.


There are many treatment options ranging from lifestyle modifications, medications, angioplasty and stenting, or coronary bypass surgery.

Lifestyle Modification

Quitting smoking, losing weight, eating a healthy diet, and limiting stress can help reduce the pain and discomfort of RAP.


Nitrates and calcium channel blockers help relax and widen blood vessels in the heart muscle and arterial walls to increase blood flow to the heart. Aspirin or blood clot-preventing drugs can reduce plaque buildup in the arteries and blood vessels, while statins can help block the creation of cholesterol buildup. Beta blockers affect adrenaline production and reduce the heartbeat’s intensity, speed, oxygen and blood consumption.

Angioplasty & Stents

A tiny balloon is inflated inside the artery (angioplasty) and a wire mesh (stent) is permanently implanted to keep the artery walls open for improved blood and oxygen flow.

Coronary Bypass Surgery

During surgery, an artery or vein from another body part is used to bypass the blocked or narrowed heart artery to increase blood flow.

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