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ISCHEMIA TREATMENTS |
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Angina is treated with drug therapy and
surgery. Drugs such as nitrates, beta-blockers, and calcium channel
blockers relieve chest pain, but they cannot clear blocked arteries.
Aspirin helps prevent blood clots. Surgical procedures include
percutaneous transluminal coronary angioplasty and coronary artery
bypass graft surgery. Nitroglycerin is the classic treatment for angina. It quickly relieves pain and discomfort by opening the coronary arteries and allowing more blood to flow to the heart. Beta blockers reduce the amount of oxygen required by the heart during stress. Calcium channel blockers help keep the arteries open and reduce blood pressure. Aspirin helps prevent blood clots from forming on plaques. Percutaneous transluminal coronary angioplasty and coronary artery bypass graft surgery are invasive procedures which improve blood flow in the coronary arteries. Percutaneous transluminal coronary angioplasty is a non-surgical procedure in which a catheter tipped with a balloon is threaded from a blood vessel in the thigh into the blocked artery. The balloon is inflated, compressing the plaque to enlarge the blood vessel and open the blocked artery. The balloon is deflated and the catheter is removed. The procedure is performed by a cardiologist in a hospital and generally requires a two-day stay. Sometimes a metal stent is placed in the artery to prevent closing of the artery. In coronary artery bypass graft, called bypass surgery, a detour is built around the coronary artery blockage with a healthy leg vein or chest wall artery. The healthy vein or artery then supplies oxygen-rich blood to the heart. Bypass surgery is major surgery appropriate for patients with blockages in two or three major coronary arteries or severely narrowed left main coronary arteries, as well as those who have not responded to other treatments. It is performed in a hospital under general anesthesia using a heart-lung machine to support the patient while the healthy vein or artery is attached to the coronary artery. There are several experimental surgical procedures: atherectomy, where the surgeon shaves off and removes strips of plaque from the blocked artery; laser angioplasty, where a catheter with a laser tip is inserted to burn or break down the plaque; and insertion of a metal coil, called a stent, that can be implanted permanently to keep a blocked artery open. This stenting procedure is becoming more common. Another experimental procedure uses a laser to drill channels in the heart muscle to increase blood supply. TIAs are treated by drugs that control high blood pressure and reduce the likelihood of blood clots and surgery. Aspirin is commonly used and anticoagulants are sometimes used to prevent blood clots. In some cases, carotid endarterectomy surgery is performed to help prevent further TIAs. The procedure involves removing arterial plaque from inside blood vessels. The use of chelation therapy, a long-term injection by a physician of a cocktail of synthetic amino acid, ethylenediaminetetracetric acid, and anticoagulant drugs and nutrients, is controversial. Alternative treatment Ischemia can be life-threatening. Although there are alternative treatments for angina, traditional medical care may be necessary. Prevention of the cause of ischemia, primarily atherosclerosis, is primary. This becomes even more important for people with a family history of heart disease. Dietary modifications, especially the reduction or elimination of saturated fats (primarily found in meat), are essential. Increased fiber (found in fresh fruits and vegetables, grains, and beans) can help the body eliminate excessive cholesterol through the stools. Exercise, particularly aerobic exercise, is essential for circulation health. Not smoking will prevent damage from smoke and the harnful substances it contains. Abana, a mixture of herbs and minerals used in ayurvedic medicine, can reduce the frequency and severity of angina attacks. Western herbal medicine recommends hawthorn (Crataegus laevigata or C. oxyacantha) to relieve long-term angina, since it strengthens the contractility of the heart muscles. Nutritional supplements and botanical medicines that act as antioxidants, for example, vitamins C and E, selenium, gingko (Gingko biloba), bilberry (Vaccinium myrtillus), and hawthorn, can help prevent initial arterial injury that can lead to the formation of plaque deposits. Cactus (Cactus grandiflorus) is a homeopathic remedy used for pain relief during an attack. Mind/body relaxation techniques such as yoga and biofeedback can help control strong emotions and stress. |
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