Medical Treatments

Many different medicines are used to treat coronary heart disease.  Several heart medications have side effects, so it may take a while to find one that suits you.

Some of the medicines that are commonly used to treat heart conditions are discussed below.

Anticoagulants

Anticoagulants such as warfarin stop the blood from clotting This medication must be used carefully as it can cause bleeding and increase bleeding from cuts. Blood tests need to be carried out frequently.

Low–dose aspirin

Blood clots in the coronary arteries are often the primary cause of heart attacks. Low-dose aspirin will help prevent your blood clotting and reduce your risk of angina and heart attack Low-dose aspirin is often prescribed by doctors for heart disease except for people with certain conditions such as bleeding disorders.

Statins

Statins are cholesterol-lowering drugs. A high level of ‘bad cholesterol’ (LDL) in your blood can cause a build-up of fatty deposits in your arteries that increases your risk of heart disease. Statins work by blocking the formation of cholesterol and increasing the number of LDL ‘receptors’ in the liver, which help to remove the LDL cholesterol from your blood. Doctors will prescribe this to you if you have a high blood cholesterol level thus decreasing the progression of coronary heart disease and heart attacks. The statins are generally well tolerated by most people and serious side effects are rare.

Beta blockers

Beta blockers are medicines that affect the body’s response to certain nerve impulses. This reduces the force and rate of the heart’s contractions, which lowers blood pressure and reduces the heart’s demand for oxygen. Beta blockers are often used to prevent angina and treat high blood pressure. They work by blocking the effects of stress hormones, which make your heart beat faster. This slows down your heartbeat, improves blood flow and helps your heart to pump more effectively. Beta blockers are not suitable if you have respiratory problems, such as asthma, or diabetes.

ACE (angiotensin-converting enzyme) inhibitors

ACE inhibitors are commonly used to treat heart disease and high blood pressure. They block the activity of a hormone which narrows blood vessels called angiotensin II,. This stops the heart working so hard and improves the flow of blood around the body.

Nitrates
Nitrates broaden your blood vessels. They are available in a many forms, including, sprays, tablets skin patches and creams. Nitrates relax blood vessels allowing more blood to penetrate them. This lowers your blood pressure and relieves angina. Nitrates can have some mild side effects, including headaches, dizziness and flushed skin.

Cardiac glycosides

Cardiac glycosides, such as digoxin, strengthen and slow the heartbeat. By making the heart muscles contract more strongly, blood is pushed around the body with more force. Cardiac glycosides are usually only taken in addition to other medicine, such as ACE inhibitors and diuretics.

Surgical procedures

If your blood vessels are too narrow due to a build up of fatty deposits or if your symptoms cannot be controlled using medication, surgery may be needed. Some of the main surgical procedures are discussed below.

Coronary angioplasty

Coronary angioplasty is sometimes used to treat mild coronary heart disease. An angioplasty opens up a blocked or narrowed coronary artery, improving the blood flow to the heart. For more information, go to our topic on coronary angioplasty

Coronary artery bypass

This is surgical rerouting of blood around a diseased vessel that supplies the heart by grafting either a piece of vein from the leg or the artery from under the breastbone. This improves the blood supply to the coronary circulation supplying the heart muscle  therefore reducing the risk of death from coronary artery disease. This surgery is usually performed with the heart stopped.

Heart transplant

A heart transplant is an option when the heart is no longer efficient at pumping blood around the body and medicine is not effective. A heart transplant involves replacing a heart that is damaged or is not working properly with a healthy donor heart.

Not all people are suitable candidates for having a heart transplant and finding a suitable donor may take a while. However, the success rate of heart transplant surgery has improved significantly over the past few decades, and many people who have had transplants more than ten years ago are still going strong.

To prevent the body from rejecting the donor heart, your surgeon will give you powerful drugs (immunosuppressants) immediately after surgery, and you must continue to take them for the rest of your life. These immunosuppressants drugs can have severe side effects in some people and cause kidney damage.

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