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Coronary Artery Disease
How is Coronary Artery Disease Treated?
The treatments for CAD include lifestyle changes, medications, and special procedures. The goals of treatment are to:
• Relieve symptoms
• Slow or stop atherosclerosis by controlling or reducing the risk factors
• Lower the risk for blood clots forming, which can cause a heart attack
• Widen or bypass clogged arteries
• Reduce cardiac events.
Lifestyle Changes
Everyone with CAD needs to make some lifestyle changes:
• Eat a healthy diet to prevent or reduce high blood pressure and high blood cholesterol, and maintain a healthy weight.
• If you smoke, quit.
• Exercise as directed by your doctor.
• Lose weight if you are overweight or obese
• Reduce stress.
For some people, these changes may be the only treatment needed.
Medications
Medications may be needed in addition to making lifestyle changes. Some medications decrease the workload on your heart and relieve your symptoms. Others decrease your chance of having a heart attack or sudden death, and prevent or delay the need for a special procedure (angioplasty or bypass surgery). Some common medications used to treat CAD are:
• Cholesterol-lowering medications.
• Anticoagulants (an-ty-ko-AG-u-lants) prevent clots from forming in your arteries and blocking blood flow.
• Aspirin, an antiplatelet medication to prevent clots from forming in your arteries and blocking blood flow. Aspirin may not be appropriate for some people because it increases the risk of bleeding. Discuss the benefits and risk with your doctor before starting aspirin therapy.
• Other antiplatelet (an-ty-PLAYT-lit) medications stop platelets from clumping together to form clots. These medications may be given to people who have had a heart attack, have angina, or who experience angina after angioplasty.
• ACE inhibitors lower blood pressure and reduce the strain on your heart. They also may reduce the risk for a future heart attack and heart failure.
• Beta-blockers slow your heart rate and lower your blood pressure to decrease the workload on your heart. Beta-blockers are used to relieve angina and may also reduce the risk of a future heart attack.
• Calcium channel blockers relax blood vessels and lower your blood pressure. These medications can reduce your heart's workload, help coronary arteries open, and relieve and control angina.
• Nitroglycerin to prevent or relieve chest pain.
• Long-acting nitrates open up the arteries to the heart, increasing blood flow to the heart muscle and relieving chest pain. Long-acting nitrates can limit the occurrence of chest pain when used regularly over a long period.
• Glycoprotein IIb-IIIa inhibitors are very strong antiplatelet medications that are used in the hospital during and after angioplasty or to treat angina.
• Thrombolytics dissolve the clots that can occur during heart attacks. You need to get to the hospital as soon as possible if you think you are having a heart attack to get thrombolytic therapy.
Special (Invasive) Procedures
• Angioplasty. This procedure is used to open blocked or narrowed coronary arteries. It can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack. Sometimes a stent is placed in the artery to keep it propped open after the procedure.
• Coronary artery bypass surgery. This surgery uses arteries or veins from other areas in your body to bypass your diseased coronary arteries. It can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.
Angioplasty or bypass surgery may be used to treat CAD if:
• Medications and lifestyle changes have not improved your symptoms
• Your symptoms are worsening.
Some people may need to have angioplasty or bypass surgery on an emergency basis during a heart attack to limit damage to the heart.
Cardiac Rehabilitation (Rehab)
Your doctor may prescribe cardiac rehab for angina or after bypass surgery, angioplasty, or a heart attack. Together with medical and surgical treatments, cardiac rehab can help you recover faster, feel better, and develop a healthier lifestyle.
Almost everyone with CAD can benefit from rehab.
Cardiac rehab often begins in the hospital after a heart attack, heart surgery, or other heart treatment. Rehab continues in an outpatient setting after you leave the hospital.
The cardiac rehab team may include:
• Doctors
o Your family doctor
o A heart specialist
o A surgeon
• Nurses
• Exercise specialists
• Physical therapists and occupational therapists
• Dietitians
• Psychologists or other behavior therapists.
Rehab has two parts:
• Exercise training to help you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your individual ability, needs, and interests.
• Education, counseling, and training to help you understand your heart condition and find ways to reduce your risk of future heart problems. The cardiac rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and to deal with your fears about the future.
"Recovering from Heart Problems Through Cardiac Rehabilitation: Patient Guide," from the U.S. Agency for Healthcare Quality and Research, provides more information on cardiac rehab.
What Is Coronary Artery Disease?
What Causes Coronary Artery Disease?
What Makes Coronary Artery Disease More Likely?
What Are the Signs and Symptoms of Coronary Artery Disease?
