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Heart Disease

Heart Attack

Congestive Heart Failure

Generic Drugs

Alternative Heart Disease Treatment

Heart Disease 

Heart Disease Treatment

Heart Disease Treatment

From Emedicine.com

Self-Care at Home

If you think you are having a heart attack, seek help immediately. Do not ignore chest pain or discomfort. Time is of vital importance. Call 911 for emergency transport to the hospital. Do not try to drive yourself or being driven by someone else.

If you have regular-strength or baby aspirin available and you are not strongly allergic, chew and swallow 1 regular aspirin or 2 baby aspirins.

  • At this dose, aspirin may help maintain blood flow through a clot-filled artery by inhibiting blood clotting.
  • Chewing gets the aspirin into your system faster than swallowing it whole.

If you have had angina and been given nitroglycerin, take as recommended by your health care provider. Exact instructions will depend on the form of the nitroglycerin.

If you have had a heart attack before, or if you have several risk factors, the following steps may help prevent heart attacks and save you from severe disability or even death.

  • Take a low-dose aspirin tablet (160 or 325 mg) every day. Aspirin increases the risk of bleeding in some people. Ask your health care provider before taking daily aspirin.
  • If you smoke, quit. This is the single best lifestyle change you can make. After 3 years of not smoking, the risk of heart disease drops to the level of a nonsmoker. Your health care provider can help you quit smoking through behavioral changes, medications, or use of nicotine replacement products.
  • Lower the cholesterol level in your blood. Lowering your cholesterol, especially the level of "bad" LDL cholesterol, keeps plaques from building up in the coronary arteries. The total cholesterol level should be kept below 200 mg/dL, and the LDL cholesterol level below 130 mg/dL (under 100 mg/dL in those with known heart disease or diabetes). Some people are able to control their cholesterol level by changing what they eat; others require medication.
  • Keep your intake of calories from fat under 30% of your total calories. This translates to an intake of less than 60 grams of fat per day for an adult. Most diets in Western countries contain more fat than is recommended.
  • Control blood pressure. Uncontrolled high blood pressure is one of the most common causes of heart disease.
  • Control diabetes carefully. Uncontrolled diabetes increases your risk of heart disease, heart attacks, and circulation problems.
  • If you take hormone replacement therapy (HRT), talk with your health care provider right away. HRT is no longer considered to protect women from heart disease and heart attacks.

Medical Treatment

Medical treatment may be started immediately, before a definite diagnosis of a heart problem is made.

General treatment measures include the following:

  • Oxygen through a tube in the nose or face mask
  • Nitroglycerin under the tongue
  • Pain medicines (morphine or meperidine)
  • Aspirin: Those with allergy to aspirin may be given clopidogrel (Plavix).

Clot-dissolving medicines: The tissue plasminogen activators (tPAs) can actually dissolve clots in some circumstances.

  • The earlier these drugs are given, the better the chance of opening the blocked artery and of protecting the cardiac muscle from further injury.
  • If more than 6 hours has passed since the onset of chest pain, these drugs are less helpful.
  • Potential risks of this therapy include bleeding.
  • The most serious risk is a stroke (bleeding into the brain).

Angioplasty: Emergency coronary angiography and coronary balloon angioplasty (percutaneous transluminal coronary angioplasty, or PTCA) are available in hospitals equipped with a full-service cardiac catheterization laboratory. This is the most direct method of relieving blockage in a coronary artery.

  • Coronary balloon angioplasty is an extension of coronary angiography.
  • A long, thin tube (catheter) is inserted in an artery in the groin or arm.
  • At the tip of the catheter is a tiny, elongated balloon, which is threaded over a hair-thin guidewire into the narrowed coronary artery.
  • Once the balloon is positioned at the blockage in the coronary artery, it is inflated.
  • The balloon pushes aside the plaque and clot that are blocking the artery, allowing blood to flow more freely.
  • The balloon is then deflated and removed with the catheter.

Stenting: A stent is a small, springlike device that may be inserted into a coronary artery after balloon angioplasty. After the catheter and balloon are removed, the stent stays in place, holding the artery open. A stent is better than angioplasty alone at keeping the artery from narrowing again.

Atherectomy: Sometimes the plaques are too rigid, bulky, or calcified to be treated by balloon angioplasty. In these cases, the plaque often can be removed by cutting it out with a drill-like rotary blade or a laser or other tool.


If you are having a heart attack, you will almost certainly be given some or all of these medications while you are in the hospital. Some you will continue taking at home.

  • Intravenous (IV) nitroglycerin has been shown to improve blood flow to the heart muscle by relaxing (dilating) the coronary arteries and increasing blood flow. It is usually given for 24-48 hours continuously.
  • Heparin is a "blood thinner," or anticoagulant, which may be given after a heart attack. Heparin does not remove an existing clot, but it reduces the tendency of blood to clot in the coronary arteries. Some newer forms of heparin have recently been introduced that can be given as a shot instead of through an IV line.
  • Beta-blockers are medications that decrease the heart rate and blood pressure. This reduces the heart's workload and thus the amount of oxygen it needs. Beta-blockers may provide immediate as well as long-term benefit for people who have a heart attack.
  • Angiotensin-converting enzyme (ACE) inhibitors may prevent repeat heart attacks and other problems when started early during a heart attack. They are especially useful in people with diabetes and those with a weakened heart muscle congestive heart failure).


Sometimes cardiac catheterization reveals extensive coronary artery disease. In such cases, you will need to undergo coronary bypass surgery.

  • Standard coronary artery bypass grafting (CABG) is performed if many coronary arteries are narrowed or blocked. This is especially recommended when the left main coronary artery shows significant blockage. This is "open heart surgery," meaning that the chest wall is opened. When performing a bypass, heart surgeons use sections of the mammary artery from the chest or veins from the legs to create detours around the blocked arteries. For this surgery, you will be connected to a bypass pump, which does the work of the heart during the operation. Although this sounds dangerous, this surgery is considered very safe and has a very low rate of complications.
  • Off-pump bypass surgery: Sometimes the surgeon can perform open heart surgery without using a bypass pump. The heart continues to beat during surgery. This type of surgery has even fewer complications than the standard procedure but is not always feasible.
  • Minimally invasive coronary bypass: If just the front or the right coronary artery needs bypass, the bypass may be performed via a small keyhole-type incision without a large incision in the chest. The internal mammary artery is used for the bypass.

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