Angina pectoris, which is more commonly known as angina, is severe chest pain caused by a lack of blood (ischemia) in the heart muscle.
The commonest cause of angina is blocks in the coronary arteries which cause obstruction to the blood flow.
The common drugs which are used to treat angina are as follow:
1. Beta-Blockers: This is a class of drug which reduces the heart rate. Thereby, they reduce the oxygen requirement of the heart. This causes relief in angina.
The drugs approved for this condition are Metoprolol, Bisoprolol, Atenolol, Nebivolol and Carvedilol. These drugs are started in normal doses and then increased till the time patient is free of his symptoms. Majority of the patients tolerate them well. They need to be monitored for the side effects like bronchospasm and slow heart rate.
If a patient is unable to tolerate the beta-blockers, the alternative group of drug which can be prescribed is called Calcium channel blockers. Some of the drugs used are Diltiazem and Verapamil. They can be used in patients with lung problems as they have no effects on lung function unlike beta-blockers.
2. Aspirin: the commonest drug prescribed to all cardiac patients. This is an anti-platelet drug and thus prevents clot formation in the arteries. It is given in a dose of 75-150 mg a day. It should be consumed after food to avoid gastric irritation.
3. Statins: These are drugs which reduce cholesterol and triglyceride levels. The prevent the formation of plaques or blocks in the coronary arteries. They also reduce the incidence of heart attacks in the patients. The common ones used are Atrovastatin, Rosuvastatin, Simvastatin etc. They are to be taken after dinner for maximum effect.
4. Nitrates: There are drugs which cause dilatation of the coronary arteries and are very helpful in relieving angina. They can be taken by keeping the tablet below the tongue (Tab Sorbitrate) or consumed with glass of water. They are also available as oral sprays or skin patches. They can cause headache or giddiness as their side-effect.
Most of the patients with angina can be easily controlled with drugs and can be symptom-free (pain free). The non-medical options are angioplasty or bypass surgery which can be reserved for patients with intractable symptoms.
Heart attack is the lay man’s term for a myocardial infarction. Myocardial infarction is nothing but damage to the heart due to blockage of the artery carrying blood to the heart.
So once the individual is stabilized, what are the medications he/she needs to take to improve his symptoms and reduce long term events (events like chest pain or a repeat heart attack)?
These are as follows:
1. Aspirin: This is blood thinner and prevents clot formation. The dosage recommended is 75 or 150 mg a day. It is preferable to take it after meals to avoid gastric irritation.
2. Statin: This is one of the most popular drug and know to reduce repeat heart attacks and long term mortality (death rates). These are anti-cholesterol medicines which reduce the bad fats thereby reducing blockages in the heart. The commonly used drugs here are Atorvastatin, Rosuvastatin and Simvastatin. The goal of therapy is to achieve a LDL-cholesterol value of less than 100 mg/dl.
3. Beta-blockers: These drugs reduce the heart rate and the blood pressure. This reduces the blood requirement of the heart and thus improves healing. It also reduces events like sudden cardiac arrest and angina pain. The commonly used drugs are Metoprolol, Bisoprolol, Atenolol and Carvedilol.
4. ACE inhibitors: Again a group of drug know to reduce blood pressure and long term mortality. It should be given to patients with heart pumping less than 40%. It reduces the load on the heart and thus prevents further damage. The commonly used drugs here are Enalapril, Ramipril, Lisinopril etc.
All the above drugs should be take only after consultation with your doctor.
Also most of the time, the treatment is Long term!
Most of the patients tend to discontinue their medications. This is not recommended as the benefits with the drugs are immense. So one should consult his Cardiologist and ensure that they are on the necessary medicines. In case of side-effects, there are good alternatives which should be discussed with the Cardiologist.