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Heart Disease Diagnosis and Care – Conventional Medicine

DIAGNOSIS

If you think that you are having a heart attack, don’t wait to be sure — call 911 immediately. Treating a heart attack quickly can save your life, while delay can be fatal. In the emergency room, a doctor will ask you about your symptoms and perform a physical examination. He or she will immediately run tests to determine your heart function. They may include:

Electrocardiogram (ECG) — the first test done to check for a heart attack; you may be hooked up to a monitor even as the doctor is asking you questions. An ECG measures electrical activity of your heart.

Blood tests — Your doctor may look for certain enzymes that are released into your blood when you have a heart attack.

Other tests include:

  • Chest x-ray
  • Echocardiogram (uses sound waves to take a picture of your heart)
  • Coronary catheterization or angiogram (uses a liquid dye inserted through a catheter to see whether your arteries are blocked)
  • Stress test (involves walking on a treadmill while hooked up to an ECG machine to see how your heart responds to exercise)

TREATMENT – TRADITIONAL

The goal when treating a heart attack is to restore blood flow to the affected area of the heart immediately, to preserve as much heart muscle and heart function as possible. If your doctor has prescribed nitroglycerin, take it while you are waiting for emergency medical personnel to arrive. Once at the hospital, your doctor may use drug therapy, angioplasty (using one of several methods to clear the blocked blood vessel, such as inflating a balloon inside it or holding it open with a device called a stent), and surgery.

Once you have been treated for a heart attack, making changes in your lifestyle (especially in your diet and exercise habits), and taking medications as prescribed, is very important for avoiding recurrent heart attacks and even death. Although certain herbal remedies as well as relaxation techniques may also be used, they should never be used alone to treat a heart attack. A heart attack always requires emergency medical attention.

Medications

Aspirin — helps stop blood from clotting. You may be given aspirin in the ambulance or as soon as you get to the hospital (Note: Recent research is attributing brain decline with the use of aspirin and related headache medications).

Nitroglycerin — helps dilate (widen) blood vessels. You may be given nitroglycerin in the ambulance or at the hospital.

Pain reliever — Morphine is often given intravenously (IV) to relieve pain.

Thrombolytics — “Clot busting” drugs may be used, depending on the type of heart attack. These drugs may be given with other anticoagulants (blood thinners).

Anticoagulants (blood thinners) — Make your blood less likely to form clots.

After you recover, other drugs are often used by cardiologists to lower your risk of having another heart attack. They include:

ACE inhibitors — widen blood vessels and make it easier on your heart to pump blood. Side effects can include chronic cough. ACE inhibitors include:

  • Benazepril (Lotensin)
  • Captopril (Capoten)
  • Fosinopril (Monopril)
  • Lisinopril (Zestril)
  • Enlapril (Vasotec)

Beta-blockers — slows heart rate and lowers blood pressure. These drugs include:

  • Acebutolol (Sectral)
  • Atenolol (Tenormin)
  • Bisoprolol (Zebeta)
  • Carteolol (Cartrol)
  • Metoprolol (Toprol XL)
  • Nadolol (Corgard)
  • Propranolol (Inderal)

Statins — help lower cholesterol. They include:

  • Lovastatin (Mevacor)
  • Simvastatin (Zocor)
  • Pravastatin (Pravachol)
  • Atorvastatin (Lipitor)
  • Fluvastatin (Lescol)
  • Rosuvastatin (Crestor)

Niacin (nicotinic acid) — In prescription form, is sometimes used to lower cholesterol. Dietary supplements of niacin should not be used instead of prescription niacin, as it can cause side effects. Only take niacin for high cholesterol with your doctor’s supervision.

Bile acid sequestrants — lowers cholesterol but known to have complications for those with high levels of triglycerides (fats in the blood). These drugs include:

  • Cholestyramine (Questran)
  • Colestipol (Colestid)
  • Colesevelam (Welchol)

Fibric acid derivatives — lower triglycerides and moderately lower LDL cholesterol. They include Gemfibrozil (Lopid).

Anticoagulants (blood thinners) — help keep clots from forming. Your doctor may prescribe aspirin, warfarin (Coumadin), or Clopidogrel (Plavix)

Surgical Treatments

Percutaneous coronary intervention (PCI) — In primary PCI, the doctor performs a coronary angiogram (injecting dye into the arteries) to see where the artery is blocked. The doctor then performs balloon angioplasty (widening an artery with a balloon), often with stent placement, to keep the artery open.

Coronary artery bypass graft (CABG) — This surgery bypasses the blocked arteries by using a graft of another blood vessel (usually from your arm or leg) to restore blood flow to the heart.

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