The most effective coronary heart disease treatment plan includes a multifaceted approach that includes regular medical monitoring and testing, lifestyle and dietary changes, and may include medications and surgery. Prognosis and outcomes of coronary heart disease vary greatly depending on how quickly it was diagnosed and treated, coexisting diseases, lifestyle and other factors.
The first step in treatment of coronary heart disease includes the same measures that are recommended for the prevention of the disease. These include regular exercise, not smoking or drinking excessively, achieving and maintaining a healthy weight, and eating a heart-healthy well-balanced diet. Risk factors, such as high cholesterol, diabetes, and hypertension can be prevented or controlled through these lifestyle changes, regular medical care and/or medication.
Medications to lower blood pressure include beta blockers, diuretics, and angiotensin-converting enzyme (ACE) inhibitors. Cholesterol- lowering medications that may be prescribed include statins or fibrates. In some people daily aspirin therapy may be recommended to prevent the formation of blood clots in the coronary arteries.
Treatment of severe coronary heart disease and the complication of a heart attack often includes a surgical procedure called a coronary angioplasty. In this procedure, the narrowed coronary artery or arteries are widened using a balloon device and a stent is placed in the artery to keep it open. If a clot is present, it is removed.
Less commonly, a more invasive and riskier procedure called a coronary artery bypass is performed. In this surgery new graft arteries are placed to bypass the blocked coronary artery or arteries. Blood flow is then redirected through healthy new graft arteries to the affected heart muscle.
Treatment of coronary heart disease that has resulted in complications, such as heart attack, cardiac arrhythmia, and heart Failure, requires hospitalization. Treatment includes the administration of supplemental oxygen aimed at increasing the amount of oxygen that is delivered to the heart tissue. Treatment also involves intensive monitoring and stabilization of vital signs, which may require CPR, advanced life support measures and/or intravenous medications. Breathing may need to be supported by mechanical ventilation. Heart rhythm and cardiac enzymes are also monitored. Abnormal heart rhythms may need treatment with medications and possibly electrical defibrillation.
In a heart attack, medications, such as nitroglycerin, may be used to improved blood flow to the heart. Pain medications, such as morphine, may be used to reduce pain and anxiety and lower the amount of oxygen the heart needs. Drugs that stop the formation of clots, such as aspirin or heparin, may be used. Other drugs may include clot-dissolving drugs that can break up the clot in the coronary artery that is causing a heart attack.
The list of treatments mentioned in various sources for Coronary heart disease includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
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Drugs used to treat CHD include:
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Aspirin Aspirin helps to lower the risk of a heart attack for those who have already had one. It also helps to keep arteries open in those who have had a previous heart bypass or other artery-opening procedure such as coronary angioplasty. (More on aspirin and heart attack) Because of its risks, aspirin is not approved by the Food
and Drug Administration for preventing heart attacks in
healthy individuals. It may be harmful for some persons,
especially those with no risk of heart disease. Patients must
be assessed carefully to make sure the benefits of taking
aspirin outweigh the risks. Talk to your doctor about whether
taking aspirin is right for you. (For
details on the use of aspirin to prevent heart attacks, please
visit the FDA Web site.) | |
|
Digitalis makes the heart contract
harder and is used when the heart's pumping function has been
weakened; it also slows some fast heart
rhythms. | |
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ACE (angiotensin converting enzyme)
inhibitor stops the production of a chemical that
makes blood vessels narrow and is used to help control high
blood pressure and for damaged heart muscle. It may be
prescribed after a heart attack to help the heart pump blood
better. It is also used for persons with heart failure, a
condition in which the heart is unable to pump enough blood to
supply the body's needs. | |
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Beta blocker slows the heart and makes
it beat with less contracting force, so blood pressure drops
and the heart works less hard. It is used for high blood
pressure, chest pain, and to prevent a repeat heart
attack. | |
|
Nitrates (including nitroglycerine)
relaxes blood vessels and stops chest pain.
| |
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Calcium channel blocker relaxes blood
vessels and is used for high blood pressure and chest
pain. | |
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Diuretic decreases fluid in the body and
is used for high blood pressure. Diuretics are sometimes
referred to as "water pills." | |
|
Blood cholesterol-lowering agents
decrease LDL cholesterol levels in the
blood. | |
|
Thrombolytic agentsalso called "clot
busting drugs," they are given during a heart attack to break
up a blood clot in a coronary artery in order to restore blood
flow. (More
on these and heart
attack) |
Drugs can cause side effects. If side effects occur, report them to your doctor. Often, a change in the dose or type of a medication, or the use of a combination of drugs can stop the side effect. (Source: excerpt from Heart Disease And Medications: NHLBI)
CHD is treated in a number of ways, depending on the seriousness of the disease. For many people, CHD is managed with lifestyle changes and medications. Others with severe CHD may need surgery. In any case, once CHD develops, it requires lifelong management. (Source: excerpt from NHLBI, coronary heart disease: NHLBI)
Although great advances have been made in treating CHD, changing one's habits remains the single most effective way to stop the disease from progressing.
If you know that you have CHD, changing your diet to one low in fat, especially saturated fat, and cholesterol will help reduce high blood cholesterol, a primary cause of atherosclerosis. In fact, it is even more important to keep your cholesterol low after a heart attack to help lower your risk of having another one. Eating less fat should also help you lose weight. If you are overweight, losing weight can help lower blood cholesterol and is the most effective lifestyle way to reduce high blood pressure, another risk factor for atherosclerosis and heart disease.
People with CHD can also benefit from exercise. Recent research has shown that even moderate amounts of physical activity are associated with lower death rates from CHD. However, people with severe CHD may have to restrict their exercise somewhat. If you have CHD, check with your doctor to find out what kinds of exercise are best for you.
Smoking is one of the three major risk factors for CHD. Quitting smoking dramatically lowers the risk of a heart attack and also reduces the risk of a second heart attack in people who have already had one. (Source: excerpt from NHLBI, coronary heart disease: NHLBI)
What medications are used to treat coronary heart disease? (Source: excerpt from NHLBI, coronary heart disease: NHLBI)
What types of surgery are used to treat CHD? Many patients can control CHD with lifestyle changes and medication. Surgery may be recommended for patients who continue to have frequent or disabling angina despite the use of medications, or people who are found to have severe blockages in their coronary arteries.
Coronary angioplasty or balloon angioplasty begins with a procedure similar to that described under angiography. However, the catheter positioned in the narrowed coronary artery has a tiny balloon at its tip. The balloon is inflated and deflated to stretch or break open the narrowing and improve the passage for blood flow. The balloon-tipped catheter is then removed.
Strictly speaking, angioplasty is not surgery. It is done while the patient is awake and may last 1 to 2 hours. If angioplasty does not widen the artery or if complications occur, bypass surgery may be needed.
In a coronary artery bypass operation, a blood vessel, usually taken from the leg or chest, is grafted onto the blocked artery, bypassing the blocked area. If more than one artery is blocked, a bypass can be done on each. The blood can then go around the obstruction to supply the heart with enough blood to relieve chest pain.
Bypass surgery relieves symptoms of heart disease but does not cure it. Usually you will need to make a number of changes in your lifestyle after the operation. If your normal lifestyle includes smoking, a high-fat diet, or no exercise, changes are advised (Source: excerpt from NHLBI, coronary heart disease: NHLBI)
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