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Coronary Artery Disease Treatment – medical

Treatment of coronary artery disease is aimed at controlling symptoms and slowing or stopping the progression of disease. The method of treatment is based on many factors determined by your symptoms, a physical exam, and diagnostic testing. In many cases, if the blockage is less than 70 percent, medications may be the first line of treatment.

Take your medications

Medications may be needed to help your heart work more efficiently and receive more oxygen-rich blood. The medications you are on depend on you and your specific heart problem. Check the drug search to find out more about your medications.

It is important to know:
  • the names of your medications
  • what they are for
  • how often and at what times to take your medications

Your doctor or nurse should review your medications with you. Keep a list of your medications and bring them to each of your doctor visits. If you have questions about your medications, ask your doctor or pharmacist.

A note about nitroglycerin:

Nitroglycerin is the most common vasodilator used for acute cases of angina. It works to dilate or widen the arteries, increasing blood flow to the heart muscle and to relax the veins, lessening the amount of blood that returns to the heart from the body. This decreases the amount of work for the heart.

Nitroglycerin comes in tablet or spray form. If you have angina, it is important that you keep this medication with you at all times.

  • Nitroglycerin must be kept in a dark container.
  • Keep it away from heat or moisture.
  • Check the expiration date on the container.
  • Once the container is opened, it must be replaced every 6 months.

If you have angina:
  • Stop your activity. Sit down and rest.
  • Place 1 nitroglycerin tablet under your tongue and let it dissolve, or spray the nitroglycerin under your tongue.
  • Wait 5 minutes.
  • If you still have angina, take another dose of nitroglycerin. Wait 5 minutes and if angina is still present, take a third dose.
  • If you still have angina after taking 3 doses of nitroglycerin (15 minutes):
    • call for emergency help (dial 911 in most areas),
    • consider taking an aspirin, AND

    • do not drive yourself to the hospital. In many cases, the emergency personnel can begin to give you heart-saving care right away.

To prevent damage to your heart muscle, do not delay seeking medical treatment.

Modify Risk Factors

Risk factors are traits related to the development and progression of heart disease. By decreasing your risk factors, you can improve your long term survival and quality of life.

Risk factors can be divided into:

  • Non-modifiable risk factors - risk factors you cannot change
  • Modifiable risk factors - those you can change

Non-modifiable risk factors include:

  • family history of early heart disease (before age 60)
  • being a male
  • being a female after menopause
  • age (over 45 years old)

These help define your basic likelihood for developing heart disease. If you have any non-modifiable risk factors, it is even more important to work on the risk factors you can change:

Modifiable risk factors:

Stop smoking and the use of tobacco products

Smoking is directly related to an increased risk of heart attack and its complications. If you smoke, ask your doctor about about counseling, nicotine replacement medications and programs to help you quit. You and your family should try to avoid second hand smoke.

Lower high blood cholesterol

A high-fat diet can contribute to increased fat in your blood. Ask your doctor to have a measurement of your fasting lipid measurement. Follow a low-fat, low-cholesterol eating plan. When proper eating does not control your cholesterol levels, your doctor may prescribe medications.

Control high blood pressure

High blood pressure can damage the lining of your coronary arteries and lead to coronary artery disease. Check your blood pressure on a regular basis. A healthy diet, exercise, medications and controlling sodium in your diet can help control high blood pressure.

Maintain tight diabetes control

High blood sugars are linked to the progression of coronary artery disease. If you have diabetes, it is important to maintain a HbA1c less than 7 percent. You can control high blood sugar through monitoring blood sugars, diet, exercise, and medications.

Follow a regular exercise plan

A regular exercise program helps to regain or maintain your energy level, lower cholesterol, manage weight, control diabetes and relieve stress. Check with your doctor first before beginning an exercise program.

Achieve and maintain your ideal body weight

Obesity is defined as being very overweight (greater than 25 percent body fat for men or 30 percent body fat for women). When you are very overweight, your heart has to do more work, and you are at increased risk of high blood pressure, high cholesterol levels and diabetes. Ask your doctor what your ideal weight should be. A healthy diet and exercise program aimed at weight loss can help improve your health.

Control Stress and Anger

Uncontrolled stress or anger is linked to increased coronary artery disease risk. You may need to learn skills such as time management, relaxation, or yoga to help lower your stress levels.

Eat a diet low in saturated fat and cholesterol

Ask your doctor, based on your lipid results, how strict your diet should be. Most people should eat a low fat diet (less than 7 percent of calories from saturated fat). A registered dietitian is a good source for dietary information.

Ask your doctor about new risk factors

New markers, such as homocysteine and high-sensitivity c-reactive protein, have both been linked to an increased risk for heart disease. These can both be determined by a blood test. Ask your doctor about new tests to screen for heart disease risk.

Your risk for heart disease increases with each risk factor you have and the length of time you have had them. Do not take lifestyle changes lightly. These steps are important to decrease your risk for plaque development and future heart attacks. Eliminate as many risk factors as possible and increase your chances of good health. It is up to you! Click here to learn more about important strategies to decrease your risk for heart disease.

Cardiac Rehabilitation

For many people with coronary artery disease, a cardiac rehabilitation program provides an excellent opportunity to begin an exercise program, learn about your heart disease, and learn strategies to change your lifestyle to prevent further progression of your disease. Your family doctor can give you information about programs in your local area (cardiac rehabilitation is covered by most insurance companies) or you may go to the American Association of Cardiovascular and Pulmonary Rehabilitation* website to search for a program, or call the Cardiac Prevention and Rehabilitation program at the Cleveland Clinic Foundation 216/444-9353. Click here to learn more about choosing a cardiac rehabilitation program.

Further treatment

When medications and lifestyle changes are not able to control symptoms or the narrowing progresses to a point that the heart muscle is at risk for damage, interventional procedures or surgery may be required to treat your heart disease. In either case, lifestyle modification and possibly medications, will be a part of your lifelong program of disease management.

Sources:

*a new browser window will open with this link. The inclusion of links to other web sites does not imply any endorsement of the material on the web sites or any association with their operators

 

©Cleveland Clinic Foundation, Rev. 4/03

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This information is provided for education purposes only and is not intended to replace the medical advice of your doctor or health care provider. While we strive to keep our website current, medical practices sometimes change quickly. Please consult your health care provider for advice about a specific medical condition or contact the Cleveland Clinic if you would like an appointment.