Treatments for Ischemic heart disease
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Unlabeled Drugs and Medications to treat Ischemic heart disease:
Unlabelled alternative drug treatments for Ischemic heart disease include:
- Ticlopidine
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- Gen-Ticlopidine
- Novo-Ticlopidine
- Nu-Ticlopidine
- PMS-Ticlopidine
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Latest treatments for Ischemic heart disease:
The following are some of the latest treatments for Ischemic heart disease:
Hospital statistics for Ischemic heart disease:
These medical statistics relate to hospitals, hospitalization and Ischemic heart disease:
- 555 per 100,000 rate for hospitalizations for Ischemic Heart Disease in Canada 1995 Surveillance on-line, 1998 LCDC, Health Canada)
- 3.21% (409,412) of hospital episodes were for ischaemic heart disease in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 75% of hospital consultations for ischaemic heart disease required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 64% of hospital episodes for ischaemic heart disease were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 36% of hospital episodes for ischaemic heart disease were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
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Book Excerpts: Treatment of Ischemic heart disease
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Chest Pain:
Treatment
(In a Page: Signs and Symptoms)
-
Attention to airway, breathing, and circulation
-
All patients with suspected coronary artery disease should initially be treated with supplemental O2, aspirin, and nitroglycerin; morphine may be added if pain does not subside
-
- If an acute myocardial infarction is suspected, β-blockers, ACE inhibitors, heparin (usually low molecular weight heparin, enoxaparin), thrombolytic therapy or primary angioplasty (PTCA), and/or glycoprotein IIb/IIIa inhibitors (e.g., eptifibatide, abciximab, or tirofiban) may be indicated
Treat other etiologies as appropriate (e.g., antiarrhythmics and/or cardioversion for arrhythmias, pericardiocentesis for cardiac tamponade, H2 blockers or PPIs for GERD and peptic ulcer disease, antibiotics for pneumonia, bronchodilators and steroids for asthma)
Emergent surgery for aortic dissections that involve the aortic arch proximal to left subclavian artery (type A); strict blood pressure control for type B dissections that only involve the aorta distal to left subclavian artery
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Chest Pain:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Most patients/families with chest pain simply want reassurance that symptoms are not cardiac in origin
-
A careful history and physical exam are most important; however, a normal CXR and ECG provide therapeutic reassurance to the patient/family
-
Further cardiology consultation is rarely required but should be considered with patients experiencing chest pain with exercise, a history of Kawasaki disease, Marfan syndrome (this is an emergency), and for those patients with persistent chest pain
-
Costochondritis: Treated with NSAIDs until resolved
-
Pericarditis: Treated with aspirin or NSAIDs; requires cardiology follow-up until resolved, rarely requires pericardiocentesis
-
Appropriate therapy of identified pulmonary, gastrointestinal, or musculoskeletal problems
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Chest pain:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
Ask the patient when his chest pain began. Did it develop suddenly or gradually? Is it more severe or frequent now than when it first started? Does anything relieve the pain? Does anything aggravate the pain? Ask the patient about associated symptoms. Sudden, severe chest pain requires prompt evaluation and treatment because it may herald a life-threatening disorder. (See Managing severe chest pain, pages 134 and 135.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
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
Chest pain:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Ask the patient when his chest pain began. Did it develop suddenly or gradually? Is it more severe or frequent now than when it first started? Does anything relieve the pain? Does anything aggravate it? Ask the patient about associated symptoms. Sudden, severe chest pain requires prompt evaluation and treatment because it may herald a life-threatening disorder. (See Managing severe chest pain, pages 162 and 163.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
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
Chest pain:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
As needed, prepare the patient for cardiopulmonary studies, such as an ECG and a lung scan. Perform a venipuncture to collect a serum sample for cardiac enzyme and other studies. Assess the cardiovascular system frequently. Interpret changes in cardiac rhythm. Be prepared for emergency procedures.
Keep in mind that a patient with chest pain may deny his discomfort, so stress the importance of reporting symptoms to allow adjustment of his treatment.
Patient teaching
Explain the purpose and procedure of each diagnostic test to the patient to help alleviate his anxiety. Prepare him if cardiac catheterization or fibrinolytic therapy is indicated. Explain the purpose of any prescribed drugs and make sure that he understands the dosage, schedule, and possible adverse effects. Teach the patient with coronary artery disease to recognize the typical features of cardiac ischemia as well as symptoms that require prompt medical attention. Teach him how to administer sublingual nitroglycerin and advise him to seek medical attention if the pain lasts more than 20 minutes, fails to respond to nitroglycerin, or has a different pattern than the usual angina.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Chest pain:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach patients with coronary artery disease about the typical features of cardiac ischemia as well as the symptoms that should prompt them to seek medical attention. If the pain fails to disappear after sublingual nitroglycerin, lasts more than 20 minutes, or has a different pattern from the usual angina, the patient must be evaluated immediately.
Explain the purpose and procedure of each diagnostic test to the patient to help alleviate his anxiety. Also explain the purpose of any prescribed drugs, and make sure that the patient understands the dosage, schedule, and possible adverse effects.
Keep in mind that a patient with chest pain may deny his discomfort, so stress the importance of reporting symptoms to allow adjustment of his treatment.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Chest pain:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for cardiopulmonary studies, such as an electrocardiogram, chest X-ray, magnetic resonance imaging, and a lung perfusion scan.
▪ Collect a serum sample for cardiac enzyme and electrolyte levels.
▪ Provide emotional support because chest pain produces increased anxiety.
Patient teaching
▪ Explain the purpose and procedure of each diagnostic test to the patient to help alleviate his anxiety.
▪ Teach the patient about the cause of his chest pain once a diagnosis is established.
▪ Explain the purpose of any prescribed drugs, and make sure that the patient understands the dosage, schedule, and possible adverse effects.
▪ Stress the importance of reporting symptoms to allow for the adjustment of treatment.
▪ Teach the patient with coronary artery disease about the typical features of cardiac ischemia as well as the symptoms that should prompt him to seek immediate medical attention.
▪ Discuss lifestyle changes that can reduce the risk of coronary artery disease.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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