Because cardiac ischemia is due to the heart not getting enough oxygen, one treatment option involves reducing the heart’s need for oxygen or improving its utilization of available oxygen. This may include taking medications that slow the heart rate, reduce blood pressure and relax the blood vessels. Drugs used to accomplish these goals include ACE inhibitors, beta blockers, calcium channel blockers and nitrates. Aspirin and other antiplatelets may be prescribed to decrease the chance of a blood clot forming in the narrowed artery (which could trigger a heart attack). Exercise and/or stress management techniques may be helpful as well.

In some cases, physicians may choose to treat underlying factors that can lead to cardiac ischemia, such as hypertension, anemia and hyperthyroidism.

If noninvasive techniques are not successful, more invasive techniques such as a balloon angioplasty or bypass surgery may be recommended to clear the blockage in the coronary arteries, thus increasing blood flow to the heart. The development of drug-coated (drug eluting) stents has helped to reduce the rates of re-narrowing (restenosis) following angioplasty. Advances in treatment have also resulted in the increased use of off-pump bypass surgery. About 20 percent of coronary artery bypass surgeries are currently performed without use of the heart-lung bypass machine.