Treatments for Coronary heart disease
Treatments for Coronary heart disease
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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Heart Disease And Medications: NHLBI (Excerpt)
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.)
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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.
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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."
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Blood cholesterol-lowering agents
decrease LDL cholesterol levels in the
blood.
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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)
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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)
NHLBI, coronary heart disease: NHLBI (Excerpt)
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)
NHLBI, coronary heart disease: NHLBI (Excerpt)
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)
NHLBI, coronary heart disease: NHLBI (Excerpt)
What medications are used to treat coronary heart disease? (Source: excerpt from NHLBI, coronary heart disease: NHLBI)
NHLBI, coronary heart disease: NHLBI (Excerpt)
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)
Coronary Artery Disease (Easy to Read): NWHIC (Excerpt)
There are three main treatments for heart disease:
- Medicine;
- "Balloon" angioplasty and other methods to open up the blockage in
your arteries; and
- Coronary artery bypass surgery.
These treatments work to make the blood flow to the heart muscle better
and to lower your chances of having a heart attack. None of these
treatments can cure heart disease. In addition to these treatments, you
also need to eat healthy, low-fat, low-salt foods and get lots of
exercise.
1. Medicine. Taking heart medicine can help more blood flow to the
heart muscle by relaxing the arteries that carry blood to your heart,
lowering your heart rate, and lowering your blood pressure. Medicine is
often the first step in treating heart disease. Some of the medicines used
to treat heart disease are nitroglycerin, beta-blockers, and calcium
antagonists. If medicine does not work, doctors will try other ways to
help get more blood to your heart.
2. "Balloon" Angioplasty and other methods for opening blocked
arteries. Balloon angioplasty and other methods are done to open up your
blocked arteries. All of these methods are done by putting a small tube
into one of the arteries in your leg, moving the tube up to your heart and
into the coronary artery which takes blood to the heart. Balloon
angioplasty stretches or breaks open the blockage and pushes it to the
side of the artery wall. Other methods scrape away the blockage or use a
small laser tip to burn or break down the blockage inside the artery. The
tube is then removed from your body. Sometimes a stent (a small metal
tube) is placed at the blockage site to keep the artery open. The stent
stays in your body. With all of these methods, there is a chance that the
blockage will return.
3. Coronary Artery Bypass Surgery. This is an operation in which a
blood vessel is taken from your leg or chest and is put onto the blocked
artery. The blood vessel bypasses or goes around the blocked area to bring
blood to the heart. A bypass can be done for each blocked artery. Bypass
surgery can make your chest pain better and lower the risk of heart
attack, but it does not cure heart disease. (Source: excerpt from Coronary Artery Disease (Easy to Read): NWHIC)
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Book Excerpts: Treatment of Coronary heart disease
Treatments of Coronary heart disease: Online Medical Books
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Coronary artery disease:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The goal of treatment in patients with angina is to either reduce myocardial oxygen demand or increase oxygen supply. Therapy consists primarily of nitrates such as nitroglycerin (given sublingually, orally, transdermally, or topically in ointment form) to dilate coronary arteries and improve blood supply to the heart. Glycoprotein IIb-IIIa inhibitors and antithrombin drugs may be used to reduce the risk of blood clots. Beta-adrenergic blockers may be used to decrease heart rate and lower the heart’s oxygen use. Calcium channel blockers may be used to relax the coronary arteries and all systemic arteries, reducing the heart’s workload. Angiotensin-converting enzyme inhibitors, diuretics, or other medications may be used to lower blood pressure.
Percutaneous transluminal coronary angioplasty (PTCA) may be performed during cardiac catheterization to compress fatty deposits and relieve occlusion in patients with no calcification and partial occlusion. PTCA carries a certain risk but its morbidity is lower than that for surgery. (See Relieving occlusions with angioplasty, pages 1098 and 1099.)Laser angioplasty corrects occlusion by vaporizing fatty deposits. In addition, a stent may be placed in the artery to act as a scaffold to hold the artery open. Another procedure is rotational atherectomy, which removes arterial plaque with a high-speed burr. Obstructive lesions may necessitate coronary artery bypass graft (CABG) surgery and the use of vein grafts.
A surgical technique available as an alternative to traditional CABG surgery is minimally invasive coronary artery bypass surgery, also known as “keyhole” surgery. This procedure requires a shorter recovery period and has fewer postoperative complications. Instead of sawing open the patient’s sternum and spreading the ribs apart, several small cuts are made in the torso through which small surgical instruments and fiber-optic cameras are inserted. This procedure was initially designed to correct blockages in just one or two easily reached arteries; it may not be suitable for more complicated cases.
Coronary brachytherapy, which involves delivering beta or gamma radiation into the coronary arteries, may be used in patients who’ve undergone stent implantation in a coronary artery but then developed such problems as diffuse in-stent restenosis. Brachytherapy is a promising technique, but its use is restricted to the treatment of stent-related problems because of complications and the unknown long-term effects of the radiation. However, in some facilities, brachytherapy is being studied as a first-line treatment of coronary disease.
Because CAD is so widespread, prevention is of incalculable importance. Dietary restrictions aimed at reducing intake of calories (in obesity) and salt, saturated fats, and cholesterol serve to minimize the risk, especially when supplemented with regular exercise. Abstention from smoking and stress reduction are also beneficial. Other preventive actions include control of hypertension, control of elevated serum cholesterol or triglyceride levels (with antilipemics), and measures to minimize platelet aggregation and the danger of blood clots (with aspirin or other antiplatelet agents).
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Valvular heart disease:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment depends on the nature and severity of associated symptoms. For example, heart failure requires digoxin, diuretics, a sodium-restricted diet and, in acute cases, oxygen. Other measures may include anticoagulant therapy or antiplatelet medications to prevent thrombus formation around diseased or replaced valves, prophylactic antibiotics before and after surgery or dental care, and valvuloplasty. An intra-aortic balloon pump may be used temporarily to reduce backflow by enhancing forward blood flow into the aorta.
If the patient has severe signs and symptoms that can’t be managed medically, open heart surgery using cardiopulmonary bypass for valve replacement is indicated.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Coronary artery disease:
Treatment
(Handbook of Diseases)
The goal of treatment in patients with angina is to either reduce myocardial oxygen demand or increase oxygen supply. Therapy consists primarily of nitrates, such as nitroglycerin (given sublingually, orally, transdermally, or topically in ointment form), isosorbide dinitrate (given sublingually or orally), beta-adrenergic blockers (given orally), or calcium channel blockers (given orally). Obstructive lesions may necessitate coronary artery bypass surgery and the use of vein grafts.
Angioplasty may be performed during cardiac catheterization to compress fatty deposits and relieve occlusion in patients with no calcification and partial occlusion. (See Relieving occlusions with angioplasty.) A certain risk is associated with this procedure, but its morbidity is lower than that for surgery. Percutaneous transluminal coronary angioplasty may be done in combination with coronary stenting. Stents provide a framework to hold an artery open by securing flaps of tunica media and intima against the artery wall.
UNDER STUDY: Therapeutic angiogenesis is a promising treatment for ischemic heart disease, especially in patients who aren’t candidates for revascularisation. Protein-based therapy with fibroblastic growth factor and vascular endothelial growth factor has produced significant angiogenesis in animal models. The increased perfusion to the ischemic myocardium relieved symptoms and improved cardiac function.
Prevention
Because CAD is so widespread, prevention is of incalculable importance. Dietary restrictions aimed at reducing intake of calories (in obesity) and of dietary fats and cholesterol serve to minimize the risk, especially when supplemented with regular exercise. Abstention from smoking and reduction of stress are also beneficial.
Other preventive actions include control of hypertension (with sympathetic blocking agents, such as methyldopa and propranolol, or diuretics, such as hydrochlorothiazide), control of elevated serum cholesterol or triglyceride levels (with antilipemics, such as HMG-reductase inhibitors, pravastatin sodium, or simvastatin), and measures to minimize platelet aggregation and the danger of blood clots (with aspirin).
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Valvular heart disease:
Treatment
(Handbook of Diseases)
Therapy depends on the nature and severity of associated symptoms. For example, heart failure requires digoxin, diuretics, a sodium-restricted diet and, in acute cases, oxygen.
Other measures may include anticoagulant therapy to prevent thrombus formation around diseased or replaced valves, prophylactic antibiotics before and after surgery or dental care, and valvuloplasty. If the patient has severe signs and symptoms that can’t be managed medically, open-heart surgery using cardiopulmonary bypass for valve replacement is indicated.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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