Medical Management of Heart Disease

Heart disease, in many cases, can be treated by decreasing your risk factors and by taking medication. One of the most important things to consider when treating the heart medically is to maintain a balance between the supply and demand of the blood by the heart. Chest pain (or angina) occurs when the heart muscle is not getting enough oxygen. Oxygen comes to the heart muscle via blood, so if the muscle is not getting enough blood, it is also not getting enough oxygen. Medications can be given to increase the amount of blood that gets to the heart muscle, or decreases the amount the heart muscle needs. Three of the most common types of medications used to control angina are: nitrates, calcium channel blockers, and beta blockers.

Nitrates
Nitroglycerin is the most commonly prescribed medication for people with angina. Nitroglycerin reduces the amount of oxygen needed by the heart. It can be given in several different forms including: tablets under the tongue, adhesive patches on the skin, tablets or capsules that are swallowed, topical ointment or aerosol spray.

If your doctor orders nitroglycerin tablets for you, carry them wherever you go. They may cause dizziness so be sure to take them while sitting or lying down. Another common side effect is headaches. Replace your supply of sublingual tablets (under the tongue) every 3-6 months to ensure freshness. Do not store in the sun, such as on a windowsill.

Calcium channel blockers
These drugs block calcium ions from crossing over into cardiac and smooth muscle cells. This decreases the contractility of the heart in turn decreasing the oxygen demand of the heart. They also dilate (open up) the arteries of the heart thus getting more oxygen to the heart muscle.

Beta blockers
Reduce the work load of the heart by blocking increases in the heart rate, blood pressure and force of the heart's contraction.

Other medications often used for medical management of the heart include:

Antihypertensives
Decrease your blood pressure.

Digitalis
Slows the heart rate and makes the heart beat stronger and more efficiently.

Anticoagulants
Decrease the rate at which blood forms clots often called "blood thinners".

Antiarrhythmic medications
Control erratic, irregular heart rhythms.

Fat (lipid) reducing drugs
Decrease cholesterol and triglycerides.

Inotropes
Increase the force of the heart beat. Usually given through a vein.

Vasodilators
Relax or open up the blood vessels.