What to do with myocardial ischemia? There are 5 commonly used drugs to improve myocardial ischemia

An elderly friend told Huazi that his heart is not in good condition and he has myocardial ischemia. Whenever he gets anxious or gets a little more active, he will experience chest tightness and shortness of breath. What should he do? Is there any way to treat it?

Hua Zi said that myocardial ischemia refers to the narrowing of the coronary arteries that supply blood to the heart, which leads to insufficient blood supply to the heart, myocardial cell hypoxia and ischemia, which will cause chest tightness, chest pain, dyspnea and other symptoms. However, another common cause of similar symptoms is cardiac neurosis, which needs to be distinguished.

1. How to determine whether there is myocardial ischemia

The main cause of myocardial ischemia is atherosclerosis in the coronary arteries , and hardened plaques can cause narrowing of the arterial lumen. However, when the narrowing does not exceed 50%, there are generally no symptoms. When the narrowing of the coronary artery exceeds 50%, it is the diagnostic standard for coronary heart disease. At this time, during activities, it may cause chest pain, chest tightness, shortness of breath and other angina symptoms.

Cardiac neurosis caused by autonomic nervous system disorders can also cause symptoms similar to angina pectoris. The difference between cardiac neurosis and myocardial ischemia is that cardiac neurosis usually occurs when you are at rest or before going to bed, while myocardial ischemia caused by coronary heart disease usually occurs during activities or when you are tired .

The "gold standard" for diagnosing myocardial ischemia in hospitals is coronary CT or coronary angiography. However, electrocardiograms are easily interfered with and may lead to missed diagnoses.

2. 5 Commonly Used Drugs to Improve Myocardial Ischemia

1. Nitrate drugs : Commonly used drugs include nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, etc., which can release nitric oxide (NO), promote vasodilation, reduce cardiac load, relieve cardiac tension, reduce cardiac oxygen consumption and relieve angina symptoms.

However, nitrate drugs will quickly develop drug resistance and become ineffective when used continuously . Nitroglycerin is only suitable for sublingual administration to relieve symptoms during acute attacks of angina pectoris, and is not used for daily prevention. Other nitrate drugs need to be used with an "eccentric administration method" and a drug-free interval.

2. Nicorandil : Nicorandil also belongs to the nitrate compound, but its mechanism of action is different from that of nitrate drugs. It dilates coronary blood vessels by regulating the permeability of cell membranes to calcium and potassium ions. It has a long-lasting effect and no drug resistance.

3. Calcium channel blockers : including dipines (such as nifedipine, amlodipine, felodil, benidipine, etc.) and non-dipines (such as diltiazem, verapamil, etc.), which can dilate blood vessels, lower blood pressure and have a good therapeutic effect on variant angina. Among them, non-dipines can also slow down the heart rate and are used to treat arrhythmias.

4. β-blockers : Commonly used ones include metoprolol, bisoprolol, carvedilol, etc., which can improve the long-term prognosis of coronary heart disease by weakening myocardial contractility, slowing heart rate, lowering blood pressure, and reducing myocardial oxygen consumption.

5. Trimetazidine : It is not used as a symptomatic treatment for angina pectoris, but it can be used in combination with trimetazidine when other anti-angina drugs are ineffective. Trimetazidine can promote the energy metabolism of myocardial cells under hypoxia and ischemia, maintain the stability of the intracellular environment, protect myocardial cells, and increase the effect of other drugs.

3. Pay attention to prevention of myocardial ischemia

The factors that cause myocardial ischemia, except for age and genes, are changeable, while other factors such as smoking, blood pressure, blood lipids, blood sugar, etc. are changeable. **Quitting smoking and drinking, controlling weight, exercising, keeping a regular work and rest schedule, and controlling the "three highs" can effectively delay the progression of atherosclerosis and prevent the occurrence of myocardial ischemia.

In daily life, you should also be careful not to overeat, add or remove clothes according to changes in ambient temperature, take a bath with water that is neither too cold nor too hot, exercise according to your ability and avoid overexerting yourself, keep your emotions stable and don't get angry, so as to avoid inducing symptoms of myocardial ischemia.

In summary, if you experience chest tightness and shortness of breath when you are tired or active, you should go to the hospital for a check-up in time to confirm whether it is myocardial ischemia caused by coronary artery stenosis. Using medication under the guidance of a doctor can improve the symptoms of angina pectoris during myocardial ischemia. We must develop healthy living habits, and "disease prevention" is more important than "disease treatment." If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.