Stephen J. Schueler, M.D.

Ashd (atherosclerotic heart disease) Treatment

Coronary artery disease may reduce the flow of blood to the heart muscle. Symptoms of angina occur when the blood flow does not meet the demands of the heart. The treatment for angina requires medications that reduce stress on the heart and prevent blood clots from forming in the bloodstream. New or worsening angina, called unstable angina, requires immediate treatment in the emergency room. If severe coronary artery disease results in a heart attack, treatment involves thrombolytic therapy, emergency coronary angioplasty, or emergency bypass surgery.

Without angina, the treatment for coronary artery disease depends on the extent of the blockage. In some cases, mild coronary artery disease may be treated with medications that reduce the risk for worsening coronary artery disease. Treatment for more advanced coronary artery disease includes coronary artery angioplasty and stenting, or coronary artery bypass surgery, which restore the normal blood flow to the heart muscle.

Initial treatment of angina due to coronary artery disease in the emergency department includes:


Key steps in the treatment of angina due to coronary artery disease include:

Angina SeverityTreatment Options
Stable / mild or moderateControl of cardiac risk factors; drug therapy
Unstable / mild to moderateHospitalization; control of cardiac risk factors; drug therapy
Unstable / severe symptomsDrug treatment; angioplasty; coronary artery bypass grafting

The long-term treatment of coronary artery disease may include:

For more information:

Ashd (atherosclerotic heart disease) Angioplasty

Angioplasty is an effective treatment for reversing the effects of coronary artery disease. Angioplasty is performed during cardiac catheterization.

During angioplasty, a catheter (thin plastic tube) is advanced into the narrowed part of the coronary artery. A balloon at the end of the catheter is inflated, in order to force open the narrowed artery. Alternative techniques include cutting or burning away the blockage with a tiny blade or laser.

Examples:


After angioplasty, a stent may be used to help hold the artery open. Stents are tiny struts that expand against the inside wall of the artery. They prop open the blood vessel after it has been opened.

Examples:
  • Coronary artery stent
  • Coronary artery stenting

Rare complications of angioplasty include:
  • Allergic reaction to the dye
  • Heart attack
  • Coronary artery rupture
  • A small number of opened arteries become narrowed again. However, stents are used to protect against this complication.

Ashd (atherosclerotic heart disease) Cardiac Rehab

Those who suffer a heart attack or undergo bypass surgery lose physical strength because the heart is weakened and their activity has been limited. Cardiac rehabilitation helps the heart to recover. It provides a supervised exercise program that can restore exercise capacity and endurance.

Cardiac rehabilitation programs:

  • Limit the effects that heart disease has on the body
  • Limit the psychological impact of heart disease
  • Lower the risk of heart attack and death
  • Slow, halt, or possibly reverse coronary artery disease

Ashd (atherosclerotic heart disease) Drugs

Medications that improve blood flow through the coronary arteries include:

  • Aspirin:
    • Thins the blood, in to order lower the risk of blood clots in the coronary arteries
  • Heparin:
    • Thins the blood, in to order lower the risk of blood clots in the coronary arteries
  • Nitrates:
    • Open coronary arteries and let the heart work more efficiently
  • Platelet inhibitors:
    • Thins the blood, in order to lower the risk of blood clots in the coronary arteries
  • Thrombolytics:
    • Clot busting medication
  • Morphine:
    • Reduces anxiety and increased blood flow through coronary arteries

Additional medications that benefit the heart:

For more information:

Ashd (atherosclerotic heart disease) Long-Term Care

The long-term treatment of coronary artery disease depends on the severity, the condition of the heart and the presence of other diseases.

Angina SeverityTreatment Options
Stable / mild or moderateControl of cardiac risk factors; drug therapy
Unstable / mild to moderateHospitalization; control of cardiac risk factors; drug therapy
Unstable / severe symptomsDrug treatment; angioplasty; coronary artery bypass grafting

General measures to treat coronary disease:

Medicines commonly used in coronary artery disease patients include:

Ashd (atherosclerotic heart disease) Questions For Doctor

The following are some important questions to ask before and after the treatment of coronary artery disease.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • What else can I do to reduce my risk for complications?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Ashd (atherosclerotic heart disease) Specialist

Physicians from the following specialties evaluate and treat coronary artery disease:

Ashd (atherosclerotic heart disease) Surgery

Blocked coronary arteries require bypass surgery. The aim is to provide blood flow to the artery beyond the blockage, bypassing the obstruction. Small arteries in the chest wall, or veins from the legs, are removed for this purpose. A small segment of the bypass vessel is attached to the wall of the diseased vessel, where blood flow is strong. And then, the other end of the bypass vessel is attached to the blocked vessel, beyond the blockage. This allows blood to flow around the blockage, restoring the delivery of oxygen and nutrients to the part of the heart that was supplied by the vessel before it became blocked.

Example:

  • Coronary artery bypass surgery

The risks for bypass surgery include:

Continue to Ashd (atherosclerotic heart disease) Home Care

Last Updated: Jun 7, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Ashd (atherosclerotic heart disease) References
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  2. Bild DE, Bluemke DA, Burke GL, et al: Multi-ethnic study of atherosclerosis: objectives and design. Am J Epidemiol 2002 Nov 1; 156(9): 871-81. [12397006]
  3. Brown TL, Merrill J, Hill P, Bengel FM. Relationship of coronary calcium and myocardial perfusion in individuals with chest pain. Assessed by integrated rubidium-82 PET-CT. Nuklearmedizin. 2008;47(6):255-260. [19057799]
  4. Thuresson M, Jarlov MB, Lindahl B, Svensson L, Zedigh C, Herlitz J. Symptoms and type of symptom onset in acute coronary syndrome in relation to ST elevation, sex, age, and a history of diabetes. Am Heart J. 2005 Aug;150(2):234-42. [16086924]
  5. Viles-Gonzalez JF, Fuster V, Corti R, Badimon JJ. Emerging importance of HDL cholesterol in developing high-risk coronary plaques in acute coronary syndromes. Curr Opin Cardiol. 2003 Jul;18(4):286-94. [12858127]
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