Cardiac ischemia, also referred to as myocardial ischemia, occurs when plaque-filled arteries block blood supply to the heart. As a result, the heart does not get enough oxygen and responds by reducing its output of blood. Michael H. Crawford M.D., author of "Current Diagnosis and Treatments in Cardiology" notes that there are two types of cardiac ischemia patients: those who show signs of the complication such as chest pain, and those without symptoms. There are several treatments for cardiac ischemia.
Nitrates
Nitrates were the first class of drugs used in treating ischemia. These medications work by increasing the diameter of the body's blood vessels in allowing greater blood flow. Nitrates provide fast relief of ischemic symptoms such as angina; however, they are not considered a long-term method of treatment. Available in several forms, nitrates are administered under the tongue via dissolvable tablet or spray in cases of unstable angina, or by a transdermal patch to treat stable angina. Examples of nitrates include nitroglycerin, isosorbide dinitrate and isosorbide mononitrate. Taking nitrates frequently to treat ischemia can lead to a decreased affect as the body gets used to the drug. Furthermore, long-term nitrate use could prove to be harmful and worsen ischemia, explains Yasuyuki Nakamura M.D., author of "Long-Term Nitrate Use May Be Deleterious in Ischemic Heart Disease" published in the American Heart Journal. Common side effects of these drugs include headache, dizziness and palpitations.
Beta Blockers
Beta blockers work by lowering heart rate and the force at which the heart contracts, in turn, reducing its oxygen demand and relieving ischemia. Atenolol, propranolol, metoprolol, carvedilol and acebutolol are some examples of orally administered beta blocker drugs. The side effects of these drugs can be harsh and include fatigue, mental impairment and impotence. For these reasons, beta blockers are an intolerable form of cardiac ischemia treatment for many, says physician-author Crawford.
Calcium Channel Blockers
Calcium channel blockers, another common pharmacological treatment, relieve ischemia by decreasing oxygen demand of the heart and increasing its supply of oxygen. This is accomplished through an increase in diameter of the body's veins and coronary arteries. Cardiologist Crawford explains, calcium channel blockers are very effective in treating cardiac ischemia because they prevent chest pain, lower blood pressure and control heart rate. Examples of these drugs include nifedipine, amlodipine, verapamil and diltiazem. Calcium channel blockers usually cause very few side effects; however, development of nausea and headaches can occur.
References
- "Current Diagnosis and Treatments in Cardiology"; Chronic Ischemic Heart Disease; Michael H. Crawford, M.D.; 2009
- "American Heart Journal"; Long-Term Nitrate Use May Be Deleterious in Ischemic Heart Disease: A Study Using the Databases from Two Large-Scale Postinfarction Studies; Yasuyuki Nakamura, M.D.; September 1999
