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CAD - Coronary Heart Disease

Treatment & Monitoring

What are the treatments for the disease?

Several types of medicines are often used together to reduce the symptoms of stable angina caused by CHD.

Beta-blockers, such as atenolol or metoprolol, are used to decrease the work level of the heart.

Nitrates, such as nitroglycerin or isosorbide mononitrate, help to expand the blood vessels that supply the heart.

Aspirin may prevent heart attacks and warfarin may prevent blood clots. However, the use of warfarin in treating stable angina remains controversial.

Calcium channel blockers, such as diltiazem, nifedipine, or verapamil, have been used for more than 20 years to open the coronary arteries and lower high blood pressure. However, two recent studies have found that people who take a calcium channel blocker have a much higher incidence of complications than people taking other medicines for high blood pressure. One study, for example, found that the risk of heart attack was 27% greater, and the risk of congestive heart failure was 26% higher. The American Heart Association recommends that people discuss risks and benefits of the medicine with the healthcare provider.

Several surgical procedures can be used to reduce the symptoms of stable angina from coronary artery disease, such as:

angioplasty, a procedure in which a tube with a balloon is inserted to reopen the artery

atherectomy, which involves removing plaques that cause narrowing of a blood vessel

laser surgery, which uses light waves to dissolve plaques

placement of a stent, a rigid tube, into the artery at the reopened area to keep it from narrowing again

What are the side effects of the treatments?

Side effects vary depending on the treatment used:

Aspirin and warfarin increase the risk of bleeding.

Beta-blockers can cause a slow heartbeat, low blood pressure, depression, erectile dysfunction, and unpleasant dreams.

Calcium channel blockers can cause flushing, nausea, headache, swelling of the ankles, low blood pressure, and weakness. These medicines have recently been linked with a higher risk of heart attack and congestive heart failure.

Nitrates can cause headaches and low blood pressure.

Surgery can result in infection, bleeding, allergic reaction to anesthesia, and even death.

What happens after treatment for the disease?

Most people who have coronary heart disease are advised to start a regular exercise program. A person who has CHD should make every effort to reduce coronary risk factors. This may include smoking cessation, control of other diseases such as diabetes and high blood pressure, and following a healthy diet for heart disease. Medicines may need to be adjusted to get the best response.

How is the disease monitored?

The person will have regular examinations and tests by the healthcare provider to check the progress of the coronary heart disease. Any new or worsening symptoms should be reported to the healthcare provider.

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