The treatments for ischemic heart disease include medications, lifestyle changes, balloon angioplasty and coronary artery bypass surgery. The aim of these four types of treatment is to improve the flow of blood through the coronary arteries, which are narrowed or hardened by gradual accumulation of fatty deposits.
Types of Treatment
Medications include beta-blockers, nitrates, calcium channel blockers and anti-platelets. Each class of drug possesses a unique function to improve blood flow. Lifestyle changes aim to arrest further plaque deposits. Angioplasty with stent placement is an invasive cardiac procedure that releases the plaque obstruction in the blocked artery and keeps the artery open. Coronary artery bypass surgery is an open heart surgical procedure to replace a narrowed artery.
Indications for Each Treatment
Regardless of the severity of the disease, a physician will recommend lifestyle changes. A person needs to quit smoking, maintain a diet low in saturated fats, cholesterol and sodium, and take cholesterol-reducing medication. When lifestyle changes alone are not enough, medications are prescribed to reduce heart rate, dilate the blood vessels, relax the muscles surrounding the coronary arteries and prevent clot formation. An angioplasty with a stent placement is performed when more aggressive treatment is necessary to restore and improve blood flow. According to the Mayo Clinic, coronary artery bypass surgery is generally indicated for cases of more than one narrowed coronary artery.
Function of Treatments
A person with heart disease must quit smoking because nicotine constricts the blood vessels and carbon monoxide displaces the oxygen in the blood.
A heart-healthy diet along with a daily exercise program helps control weight, blood pressure and cholesterol.
Beta-blockers reduce heart rate and decrease blood pressure. Nitrates are short-acting vasodilators that control chest pain and open the coronary arteries. Both of these drugs reduce the demand for oxygen. Calcium channel blockers relax the muscles surrounding the coronary arteries, causing the vessels to open and increase the blood flow to the heart. Anti-platelets drugs, such as aspirin, irreversibly bind to platelets and prevent the formation of a clot on the fatty deposits.
Angioplasty is a procedure involving the insertion of a wire with an attached deflated balloon into the narrowest part of the blocked artery. A balloon is inflated and compresses the plaque against the walls of the artery. A stent is often inserted and kept in place to keep the artery open. During coronary artery bypass surgery, a surgeon uses a blood vessel from another part of the body to create a graft to bypass the narrowed coronary artery and improve blood flow to the heart.
Side Effects
Beta-blockers can cause fatigue, cold hands, dizziness, weakness and asthma attacks in asthmatic patients, as well as mask low blood sugar in diabetic patients. Headache can occur immediately following a dose of nitroglycerin. According to RxList, vertigo, dizziness, weakness and palpitations are occasionally experienced side effects of nitrates. Side effects of calcium channel blockers include constipation, headache, tachycardia, a rash, drowsiness, flushing, nausea, and swelling in the lower legs and feet. Side effects of low doses of aspirin used to treat ischemic heart disease include nausea, heartburn and an upset stomach.
Complications
Complications associated with angioplasty are injury to the artery caused by the insertion of the catheter, risk of clot formation or a tear caused by the balloon and heavy bleeding at the insertion site. Coronary artery bypass surgery carries the risk of blood loss, infection, breathing problems, heart attack or stroke, post-pericardiotomy syndrome, cardiac arrhythmias and loss of mental clarity.
