Chapter 5 : Treatment of Heart Disease

Once you’ve been diagnosed with heart disease, it’s easy to feel frightened and overwhelmed. Although it’s important to take heart disease seriously and follow your doctor’s instructions, you should know that we are fortunate enough to live in a time when treatment for heart disease is fairly advanced. There are many different treatment options available that can help you live a long, full life even after being diagnosed with a heart condition. Treatments fall into 3 basic categories: drugs, lifestyle changes and surgery. Your treatment plan may include some or all of these categories, depending on how advanced your condition is.


There are many drugs available to treat heart disease, and more are being introduced all the time. It can be difficult and confusing to keep track of what’s available and what’s right for you, especially given the barrage of drug ads that we are confronted with on a daily basis. Here is a brief rundown of the different types of drugs available, and their benefits and risks.

ACE Inhibitors

This class of drugs can widen your arteries and help your heart pump blood more effectively. Here is a list of some commonly used ACE inhibitors: Capoten, Vasotec, Prinivil, Zestril, Lotensin, Monopril, Altace, Accupril, and others. They are often prescribed on a short-term basis after a heart attack to help you recover, and on a long-term basis to treat heart failure and to prevent a heart attack in high-risk individuals. Side effects can include coughing, dizziness, a strange aftertaste in your mouth, increased levels of potassium in the body, swelling, vomiting and diarrhea. If any of these symptoms occur, contact your doctor immediately. If you experience swelling anywhere around your face while taking these drugs, you need to see a doctor immediately. If your doctor is not available, go to the emergency room and tell them what you are taking and the symptoms you are experiencing.


ARBs are drugs that are prescribed for people who are unable to take ACE Inhibitors. Examples of ARBs include Micardis, Atacand, Avapro, Diovan and Cozaar. ARBs help block the effect of certain chemicals that your body makes to narrow arteries, keeping your arteries open wider and your blood pumping freely. Side effects include dizziness, digestive disturbances, cramps, insomnia, inability to think clearly and dehydration. 

Beta Blockers

Beta blockers are another commonly prescribed category of drug. They help your heart to relax. Over time, this helps the heart to pump blood more efficiently.  They are used to treat heart failure, reduce blood pressure, and normalize heart rhythms for people with cardiac arrhythmia. Here is a list of commonly prescribed beta blockers: Lopressor, Toprol-XL Coreg, Normodyne, Trandate, Tenormin, Inderal, Brevibloc, Zebeta, and Sectral. Side effects of beta blockers can include weight gain,  dizziness, insomnia and bad dreams, digestive disturbances, exhaustion, and headaches. If you experience problems breathing, this is a very serious side effect and it requires immediate medical attention, at the ER if necessary.

Calcium Channel Blockers

Calcium channel blockers help your heart get more of the oxygen-rich blood that it needs. They relax blood vessels to allow blood to circulate more freely. Commonly prescribed drugs in this category include Procardia, Cardizem, Calan and Isoptin. These drugs are used to treat coronary artery disease and spasm, arrhythmia, angina, high blood pressure, cardiomyopathy and some forms of heart failure. Side effects can include sleepiness, weight gain, digestive disruptions, fainting and swelling.


These are drugs that help keep your heart beating at a normal pace. They include: Betapace, Cordarone, Procanbid and Tambocor. Side effects can include chest pain, arrhythmia, lightheadedness and fainting, swelling of the extremities, blurred vision and digestive issues. Call your physician immediately as the side effects of antiarrhythmics can be very serious if they are not addressed immediately.

Anti-Platelet Drugs

This class of drug helps keep blood clots from forming. Since clotting inside an artery can often trigger a heart attack, they are an important part of the drug regimen prescribed for many people who have heart disease. The most familiar anti-platelet drug is aspirin.  Other anti-platelets include Plavix and Ticlid. Anti-platelet drugs are used to treat coronary artery disease and peripheral artery disease, as well as to prevent and treat heart attacks. Minor side effects can include digestive upsets and rashes. Serious side effects include excessive bleeding, headache, lightheadedness, difficulty breathing, fever, chest pain and tinnunitis.

Clot-Busting Drugs

Clot-busting drugs are given intravenously in a hospital to break up clots that have already formed. Given early enough, they can help keep heart muscles from dying and forming scar tissue after a heart attack. These drugs include Tissue Plasminogen Activator, Tenecteplase, Alteplase, Urokinase, Reteplase, and Streptokinase. If you have received any of these drugs, make sure to contact a doctor or nurse immediately if you notice any signs of excessive or abnormal bleeding.


Digoxin is a powerful heart medication that was originally synthesized from the foxglove plant. It is given to people with arrythmia and heart failure. Side effects can include digestive disturbances, changes in vision or in clarity of thought, and irregular heartbeat.

Inotropic Therapy

Inotropic drugs are the drugs of last resort for heart failure. They are prescribed at the end stages of the disease, when other medications no longer work. They are administered intravenously, either at a hospital or at home. Side effects can include headache, digestive upset, rapid heartbeat shortness of breath, fever, and high blood pressure.


Statins are used in people who have coronary artery disease or simply have high cholesterol that puts them at risk of developing coronary artery disease. These drugs help lower bad cholesterol by stopping the liver from producing it. Usually, you will try to lower cholesterol through improving your diet first. However, your doctor may recommend statins immediately if you’ve already had a heart attack or are at a high risk to have one in the future.

For more information about any of these different types of drugs, it is best to ask your doctor. Also, remember that drugs can interact with other drugs, over-the-counter medication,  supplements, and even certain foods. Make sure to discuss possible interactions with your doctor each time you are prescribed a new medication. If you see many different doctors, it’s a good idea to bring a list of all the medications you take on regular basis to each appointment. This will reduce the likelihood of your doctor unknowingly prescribing a drug that can have harmful interactions with medicine you are already taking.

Lifestyle Changes

Lifestyle changes are another crucial part of any treatment plan for heart disease. As hard as changing your habits or losing your favorite foods can be, it’s not enough just to take pills each day. No medication has yet been invented that can completely erase all of our bad habits-we have to change those ourselves. As you may have noticed when reading Chapter 4, many possible causes of heart disease are lifestyle-related. Here is a quick look at some of the changes you may be asked to make if you receive a diagnosis of heart disease.

  • Exercise regularly - If you have had surgery or a heart attack, you may be placed in a cardiac rehab program where you will engage in supervised, controlled levels of exercise. Or, your doctor may simply provide you with guidelines for exercizing on your own.
  • Eat a heart-healthy diet - A diet that is low in saturated fat, trans-fatty acids and cholestoral can help keep plaque from forming on your arteries, which will slow the progression of coronary artery disease. 
  • Quit smoking - Remember, nicotine damages artery walls and leads to plaque build-up, as well as increasing blood pressure.
  • Get down to a healthy weight - If you are overweight, your doctor will give you guidelines for how to lose weight in a healthy way through diet and exercise.
  • Reduce stress - You may be advised to avoid stressful situations, or your doctor may give you tips on how to handle it more effectively.

Surgery and other Medical Procedures

In an emergency situation, or in situations where drug therapy and lifestyle changes are not helping, surgery may be the only option. There are several different types of surgeries that are used to help people with heart disease. There are also some medical procedures that can be done nonsurgically, through a thin tube called a catheter that is threaded through a blood vessel up to your heart. Your doctor will decide which one is right for you.

Coronary Bypass Surgery

If your coronary arteries are blocked, your heart is not getting the blood that it needs. Sometimes, the best option is simply to reroute the blood supply to the heart to bypass the blocked artery, much like a traffic detour would bypass construction. This is accomplished by removing a piece of blood vessel from another part of your body and grafting it onto the heart.


In angioplasty, a cardiac catheterization specialist can use any one of a number of techniques to open up a clogged artery. These techniques can include inflating a “balloon” at the site of the plaque to push the artery back open, or implanting a stent to brace the walls of the artery apart.

Ablation Therapy

Ablation therapy is a type of surgery that is used to treat heart arrhythmias. It can be done either through open-heart surgery or through a catheter. This type of surgery cuts off the electrical impulses that are throwing your heart off from its normal rhythm.

Implantable devices

For people with cardiac arrhythmia or who are at risk of sudden cardiac death, devices that can regulate the heart’s rhythm are sometimes surgically implanted. For example, an implantable cardioverter defibrillator or ICD is basically a miniature implantable heart monitor and defibrillator. If your heart begins to beat abnormally, this device will shock it back into a normal rhythm. Another type of implantable device is the pacemaker. Instead of simply monitoring the heart for abnormal rhythm and correcting it when needed, the pacemaker sends an electrical impulse out to tell the heart when to beat.

Valve repair and replacement

When a heart valve ceases to function as it should, it can cause the heart to pump inefficiently and overwork itself. If the problem is severe, the valve will have to be either repaired or replaced. Your doctor will evaluate you beforehand to decide if repair is possible. If it’s not, a defective valve can be replaced with a mechanical device, a replacement valve from a pig or a cow, or a replacement valve from a donor heart.

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