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Surgery and angioplasty

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These treatments are an option if drugs fail to control the pains, or if the condition becomes severe with one or more coronary arteries becoming very narrow.

Angioplasty. In this procedure a tiny wire with a balloon at the end is put into a large artery in the groin or arm. It is then passed up to the heart and into the narrowed section of a coronary artery using special x-ray guidance. The balloon is then blown up inside the narrowed part of the artery to open it wide again. This procedure is only suitable in some cases as only arteries with short narrowed sections can be treated this way.

Surgery. This involves an operation to bypass the narrowed sections of arteries with healthy blood vessel segments (grafts) which are taken from other parts of the body. The operation is called coronary artery bypass graft surgery (CABG). More blood can then get past into the heart muscle. Not all people with angina are suitable for this operation as it depends on where the narrowed arteries are.

Some common worries about angina

'Straining the heart' by exertion is a common worry. On the contrary, more physical activity is usually advised. You will normally be encouraged to exercise regularly. Physical activity helps to get the heart 'fitter' and improves the blood supply to the heart muscle.
Sex. Some people with angina worry that the physical effort of having sex will damage the heart. This is wrong, and you do not need to stop having sex. If sex does bring on an angina pain, it may be helpful to take some GTN beforehand.
Driving and flying. If you are a car driver, there is usually no restriction for driving your own car unless pains occur at rest, or while driving. However, you must inform your insurance company if you have angina. People with PSV or HGV licenses who have angina must stop driving and contact the DVLA. As regards flying, in general, if you can climb 12 stairs and walk 100 metres on the level without pain or getting very breathless, you are fit to fly as a passenger. People with frequent angina pains or unstable angina should avoid flying.