Medication post Heart Attack

23. 02. 2009 at 11:56


Nothing can really prepare you for the life changes following a heart attack. Apart from the uncertainty of the future, the restructure of life-style and diet, one of the main changes is medication.

For someone who refused to take tablets when I had a headache or pain, suddenly been told you have to take several, for life, is quite a shock, well not as big a shock as a  heart attack, but still.

Post heart attack there are several things that need to be controlled. In my case these can be split into four areas and involve taking five tablets-

  1. Blood Pressure (using ace inhibitor)
  2. Blood thickness/clotting ability (using aspirin and anti-platelet drug)
  3. Cholesterol (using statin)
  4. Heart rate (using beta-blocker)

Blood pressure is reduced using an ace inhibitor. Ace stands for Angiotensin Converting Enzyme. This drug reduces the activity of this enzyme, making arteries relax and widen, so the blood can travel under less pressure. The effect is your heart receives more oxygen. I take Ramipril.

Possible side effects
Dry cough

Anti Platelet
Blood clotting is one of the main causes of a heart attack. Blood clots in a narrowed artery and blocks the path so the heart cannot function correctly.  The reason for this is that the platelets (small blood cells that clump together to form a clot) are sticky. Anti-platelet drugs reduce the stickiness. I now take Asprin and Clopidogrel.

Possible side effects
Stomach bleeding

Cholesterol is seen to be a serious problem for our bodies. There are two types – one good one bad. The statin’s job is to reduce the cholesterol level but we can make big diet changes to reduce cholesterol naturally. Well, balance it actually, because the good cholesterol has important role – more about this when I touch on diet in a future blog
I take simvastatin,  the other common option is atorvastatin

Possible side effects
Sick feeling

Beta blocker
Reduces the amount of work the heart has to do slowing it down this reducing the risk of failure. It’s like driving at 56mph in a car. You get better petrol consumption and there’s less chance of blowing a gasket  (or what ever the mechanical/electronic term is today).
This drug blocks the affect of naturally occurring substances called catecholamines. I take Bisoprolol

Possible side effects (minor)
Cold hands and/or feet
Disturbed sleep
Depression and or anxiety
Shortness of breath

I also have a Nitrate spray which I have to carry should I get an attack of angina. This spray (sprayed under the tongue) instantly reduces the muscles in the walls of arteries so the blood supply to the heart increases and it gets a quick dose of oxygen.

Other medication you may be prescribed
Calcium channel blockers
Anti-arrhythmic drugs
Potassium channel activators
So lots of drugs and many times more potential side-effects. Fortunately I have just three…cold feet and hands, shakiness (a feeling of lack of sugar type of shaky not nervous) and un-restful sleep pattern

next time I’ll look at diet changes

…to be continued

ps: this is just a light guide of my observations please seek correct medical advice should you need it.

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The Treadmill test

12. 02. 2009 at 10:37


A few weeks past before I received an invitation to take a Treadmill test. As the Angiogram had proved I had a heart problem this test is required to see how the heart copes under pressure. Another name for it is an exercise stress test.  And the medical name is Exercise ECG.

Don’t have a heavy meal before your appointment and where light comfirtable clothes with trainers or running shoes.

At the hospital you meet up with the nurses. Two are present to ensure you are in safe hands.  You remove your top and the patches are stuck to your chest so the ECG can be connected.

You are monitored before going on the Treadmill. For those who don’t know what one is it’s just a flat surface, large enough to cope with a huge stride, and is like a caterpillar track that revolves around. The speed the track moves can be increased and as it moves you walk or run to keep up with the movement. There are bars at chest height that you can hold on to for stability.

You are then asked to step onto the treadmill and the exercise begins. You walk steadily for 3mins and then you are told that the speed will increase. The machine can also be set to simulate a hill so the incline is adjusted too. This means that you are starting to do more strenious exerice and the ECG and any discomfort you feel will tell the Doctors how the heart is coping.

Prior to the heart attack I considered myself very fit. At 5mins I was feeling the pressure, discomfort in the chest and weary. The speed and include is increased at 6mins and then I was really feeling it. They stoppped the test at 9mins.

Throughout the test ecgs were printed off so the Doctors could eximne the changes. And A further three were recorded in the five minutes following the test to see how the heart relaxed down.

I had to wait a few days for the results which were positive. I thought that was a good sign but in this terminology positive means there’s still a problem.

So the latest news is I’ve been referred to a specialist at the Northern General in Sheffield and I await the outcome of their finding and what course of action will be taken.

It’s now just over two months since I had the attack and I feel fine. Apart from when I lift things and I get peculiar chest feeling or when I walk fast. I’m still only allowed to walk for 30mins per session. So I usually wander off around the locality trying to vary the route each day to make it interesting.

It’s funny how you start to take more notice of your surrounds when there’s nothing else to do. I’ve never taking such an interest in how the locals arrange their gardens.

…. to be continued

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