Treatments for Coronary Artery Disease
Medical Management
Manage heart disease through lifestyle changes and understanding the symptoms of heart attack. Decrease risk factors by not smoking, keeping cholesterol in check, exercising, managing stress and eating healthfully. Take prescribed medications and see a cardiologist regularly.
Medications can relieve the heart from working so hard. Nitroglycerin widens arteries, aspirin can prevent clots, beta blockers improve blood flow, Ranolazine helps chronic angina, ace inhibitors improve survival after heart attack, lipid management helps control cholesterol that can block arteries.
A type of medicine given in the hospital through the veins (intravenous) to break up blood clots. Heart attack (caused by a blood clot in a coronary artery) and ischemic stroke (caused by a blood clot in an artery in the brain) are the two main conditions for which thrombolytic medications may be prescribed.
A first line treatment to lower high cholesterol in patients with or at risk for coronary artery disease, statins also provide additional benefits to the blood vessels that result in a decrease incidence in cardiovascular events.
Small doses (80 to 160 mg/day) of this common drug are prescribed for some people to prevent blood clots, decrease pain, and reduce risk of heart attack and stroke. Risks are stomach ulcers, gastrointestinal bleeding, or bleeding in the brain during stroke. A doctor can make appropriate recommendations.
Clopidogrel
It takes about two months for your heart to heal. It’s normal to feel depressed, angry or afraid. Focus on regaining your health. Pace your activity, adopt a heart-healthy diet, manage stress, exercise regularly, maintain cholesterol levels and see a doctor regularly.
Various medications can help break up artery clots and can reduce heart damage, widen blood vessels, decrease pain and help regulate heart rhythm. Procedures can open up narrowed or blocked arteries (angioplasty or stents). In severe cases, bypass surgery is performed to restore the heart’s blood supply.
Non-invasive Therapies
This non-invasive therapy is an option for people with chronic angina (chest pain). Cuffs are wrapped around the calves, thighs and buttocks. Air pressure inflates and deflates the cuffs, feeling like a strong hug. The pressure stimulates blood vessel openings to create a natural bypass around blockages.
Catheter Procedures
Procedures to open narrowed blood vessels and prevent heart attack involve inserting a catheter (thin tube) into vessels and passing a device (tiny balloon) through the tube to open the artery. Success rates are nearly equal for women and men, but women are more likely to have procedural complications and pain afterward.
Blockages are identified when a thin tube is inserted into the coronary artery and an X-ray is performed to diagnose the heart problem. Then, non-surgical treatments using balloons, stents or rotablation are performed to open narrowed coronary arteries and improve blood flow to the heart.
Minimally Invasive & Robotically Assisted Surgery
Surgery techniques include keyhole approaches using port holes and smaller incisions, and robotic-assisted surgery. Minimally invasive surgeries involve smaller scars, reduced risk of infection, less bleeding, less pain and trauma, decreased hospital stays and faster recovery.
Also called “beating heart” surgery, this procedure is performed without the heart-lung machine (used in traditional bypass surgery). The surgeon can stabilize portions of the heart and bypass the blocked artery while the rest of the heart keeps pumping and circulating blood to the body.
This technique uses the smallest incisions (less than 2 inches). Robotic arms open the sac surrounding the heart, and remove the mammary artery through the incision. In comparison, traditional open-heart surgery requires a 6- to 8-inch incision in the sternum to operate.
Traditional Surgery
Coronary artery bypass surgery involves using grafts from the patient’s own veins and arteries to form new passageways around blockages. Thoracic arteries in the chest wall are the best grafts, though surgeons continue exploration and perform using veins from the leg, stomach and forearm.
This procedure can restore normal blood flow to the heart by creating new pathways around blocked arteries, potentially using grafts from the patient’s own arteries and veins. An opening is made below the blockage. The graft is sewn into the opening to redirect blood flow to the heart.
When other surgeries to stop angina (chest pain) fail, laser heart surgery can improve blood flow to areas of the heart that were not treated by angioplasty or surgery. A laser creates small channels in the heart to improve blood flow. Surgery is performed through a small incision on the left chest.
Supplements & Holistic Therapies
Foods rich in antioxidants (whole grains, fruits, veggies) can fight environmental free radicals that damage cells and can lead to heart disease. There’s no proof that Vitamin E supplements are beneficial can reduce risk of cardiovascular death and stroke. Beta carotene supplements may increase risk.
When mixed with medications that treat heart problems, some dietary supplements may interfere with prescription drugs. The following herbal remedies taken internally can cause heart problems: aloe, arnica, black cohosh, feverfew, ginger, ginseng, nettle.
It’s dangerous to take natural remedies before heart surgery because they can modify the blood and have dangerous side effects including: internal bleeding, cardiovascular instability and low blood sugar. During surgery they can affect anesthesia and cause changes in how other drugs are metabolized.
If you need more information or would like to make an appointment with a specialist, contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
© Copyright 2010 Cleveland Clinic. All rights reserved. 06/2010
