NICE Angina Guideline

Link to NICE website

This is what the National Institute for Health and Clinical Excellence (NICE) has to say. It would be sensible to use it as a checklist to see if these things were done in your case. In our experience doctors might think they have followed these guidelines to the letter but many patients have no memory of it if they did:

5.2.4 Recommendations and link to evidence

  • Clearly explain stable angina to the person, including factors that can provoke angina (for example, exertion, emotional stress, exposure to cold, eating a heavy meal) and its long-term course and management. Where relevant, involve the person’s family or carers in the discussion.
  • Encourage the person with stable angina to ask questions about their angina and its treatment. Provide opportunities for them to voice their concerns and fears.
  • Discuss the person’s, and if appropriate, their family or carer’s ideas, concerns and expectations about their condition, prognosis and treatment. Explore and address any misconceptions about stable angina and its implications for daily activities, heart attack risk and life expectancy.
  • Advise the person with stable angina to seek professional help if there is a sudden worsening in the frequency or severity of their angina.
  • Discuss with the person the purpose and any risks and benefits of their treatment.
  • Explore and address issues according to the persons’ needs, which may include:
    • self-management skills such as pacing their activities and goal setting
    • concerns about the impact of stress, anxiety or depression on angina
    • advice about physical exertion including sexual activity.

Advise people that the aim of anti-anginal drug treatment is to prevent episodes of angina and the aim of secondary prevention treatment is to prevent cardiovascular events such as heart attack and stroke.

Full NICE SLIDE SET available to download

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Published by the National Clinical Guidelines Centre at The Royal College of Physicians, 11 St Andrews Place, Regent‘s Park, London, NW11 4LE   First published 2011   © National Clinical Guidelines Centre 2011

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