Treatment for coronary heart disease (CHD) aims to manage the symptoms and improve heart function.
Treatment can include:
- lifestyle changes
- medicines
- surgery - for more severe CHD
Things you can do to help manage CHD
You can help reduce your risk of further heart problems by focusing on your lifestyle.
Things that can help with heart health include:
- stop smoking - if you had a heart attack this can significantly reduce your risk of having another
- have a healthy diet
- be physically active
Medicines
Many medicines are used to treat CHD. Usually, they either reduce your blood pressure or widen your arteries.
Some heart medicines have side effects, so it may take a while to find one that works for you. A GP or specialist will discuss your options with you.
Do not suddenly stop taking your heart medicines - this may make your symptoms worse. Talk to your doctor first.
Antiplatelets
Antiplatelets are a type of medicine that can help reduce the risk of a heart attack. Antiplatelets thin your blood and stop it from clotting.
Common antiplatelet medicines include:
- low-dose aspirin
- clopidogrel
- ticagrelor
- prasugrel
Statins
Medicine called statins may be prescribed to lower your cholesterol if you have high cholesterol.
Types of statins include:
- atorvastatin
- simvastatin
- rosuvastatin
- pravastatin
Statins reduce the amount of cholesterol made by the liver. They also increase the number of low-density lipoprotein (LDL) receptors in the liver.
This helps remove LDL cholesterol from your blood.
Not all statins are suitable for everyone. You may need to try different types to find one that suits you.
Beta blockers
Beta blockers are often used to prevent angina and treat high blood pressure. They work by blocking the effects of a particular hormone in the body. Beta blockers slow down your heartbeat and improve blood flow.
Nitrates
Nitrates are used to temporarily widen your blood vessels. Doctors sometimes refer to nitrates as vasodilators. They're available in a variety of forms, including:
- tablets
- sprays
- skin patches
Nitrates relax your blood vessels, so more blood can pass through them. This lowers your blood pressure and relieves any chest pain you have.
Nitrates can have some mild side effects, including headaches, dizziness and flushed skin.
Angiotensin-converting enzyme (ACE) inhibitors
ACE inhibitors are commonly used to treat high blood pressure. Examples include ramipril and lisinopril. They block the activity of a hormone called angiotensin II. This hormone causes the blood vessels to narrow.
ACE inhibitors improve the flow of blood around the body.
When you take ACE inhibitors your doctor will:
- check your blood pressure
- do regular blood tests to check that your kidneys are working properly
Side effects of ACE inhibitors can include a dry cough and dizziness.
Angiotensin II receptor antagonists
Angiotensin II receptor antagonists work in a similar way to ACE inhibitors. They lower your blood pressure by blocking angiotensin II.
You can sometimes have mild dizziness with this medicine. They're often prescribed as an alternative to ACE inhibitors, as they do not cause a dry cough.
Calcium channel blockers
Calcium channel blockers work to lower blood pressure. They relax the muscles that make up the walls of your arteries. This causes the arteries to become wider, reducing your blood pressure.
Examples include:
- amlodipine
- verapamil
- diltiazem
- lercanidipine
You can get headaches and a flushed face with this medicine. But these side effects are mild and usually decrease over time.
Diuretics
Diuretics work by flushing excess water and salt from the body through urine. Diuretics are sometimes known as water pills.
Heart procedures
A procedure may be needed to open up or bypass narrow heart arteries if your:
- blood vessels are narrow as the result of a build-up of atheroma (fatty deposits)
- symptoms cannot be controlled using medicines
Procedures to treat blocked arteries include coronary angioplasty, coronary artery bypass graft and heart transplant.
Coronary angioplasty
Coronary angioplasty is also known as:
- percutaneous coronary intervention (PCI)
- percutaneous transluminal coronary angioplasty (PTCA)
- balloon angioplasty
Angioplasty may be a planned procedure for some people with angina. It can also be used as a more urgent treatment, for severe symptoms.
You usually have an angiogram (an x-ray of your blood vessels) to check if you're suitable for angioplasty.
Coronary angioplasty is also an emergency treatment during a heart attack. A small balloon is inserted to push the fatty tissue in the narrowed artery outwards. This helps the blood to flow more easily. A stent (a wire mesh tube) is usually placed in the artery to hold it open.
Some stents release medicine (drug-eluting stents) to stop the artery from narrowing again.
Coronary artery bypass graft
Coronary artery bypass grafting is also known as:
- bypass surgery
- a heart bypass
- coronary artery bypass surgery
A bypass is done if your arteries become narrowed or blocked.
You usually have an angiogram (an x-ray of your blood vessels) to check if you're suitable for bypass surgery.
Heart transplant
A heart transplant replaces a damaged heart with a healthy donor heart.
A heart transplant may be needed if:
- your heart is severely damaged
- medicine is not effective
- the heart cannot pump blood around the body
Content supplied by the NHS and adapted for Ireland by the HSE
