Heart Disease Heart Attack FAQ's

Answers to Your Medical Health Questions

Heart Disease

Dr. Razavi

Heart Disease - Cardiovascular Drugs and Medications FAQ


Why does smoking put a person at more risk for a heart attack?

Nicotine can cause vasoconstriction, ie decrease the diameter of the blood vessels. It can also increase the heart rate initially. In addition to nicotine cigarettes may contain other toxic substances which may damage the blood vessels. I mention smoking here in this section because nicotine should be thought of as a drug, and specifically a drug that can complicate cardiovascular disease.

What does taking a baby aspirin each day do to help prevent a heart attack?

Aspirin makes it less likely for the blood to clot.

Platelets and platelet products are needed for blood to clot. This is useful when we have a cut or a nose bleed, but the same process may also facilitate the clot formation which leads to a heart attack. Aspirin blocks the formation of a factor called prostaglandin which is needed to produce another clotting factor called thromboxane A2, a powerful promoter of platelet aggregation. It therefore, indirectly, lowers the platelets’ ability to clump together to form a clot. Small amounts of aspirin 75-100 mg are needed for this process. Typical baby asprin measure 81 mg each.

Who should be taking a baby aspirin as a preventative treatment each day?

Not everyone is recommended to take aspirin as a heart medication.

Evidence from basic research has provided strong support for the net benefits of aspirin in decreasing the risk of cardiovascular disease (CVD) in a wide range of patients. People who are at high risk for heart disease or other vascular diseases ( primary prevention) or people who have already suffered a cardiovascular event such as a heart attack, angina, or stroke ( secondary prevention) should take aspirin.

You should not start aspirin therapy without first consulting your physician. The risks and benefits of aspirin therapy vary for each person. If you’re taking aspirin and you must undergo even a simple surgical procedure or dental extraction, you must tell the surgeon or dentist your aspirin dosage.

What is a clot busting drug?

Tissue plasminogen activator (tPA) which is a thrombolytic or clot busting agent.

When would a person be given a clot busting drug?

This is usually done if the patient goes to a hospital that doesn’t have the capability to do angioplasty. The patient is usually then transferred after the tPA treatment to a facility that is able to do the angioplasty procedure.

What are the side effects of clot busting drugs?

Stroke, gastrointestinal bleed.

What is nitro glycerin?

It is a vasodilator that dilates all blood vessels and not just the heart blood vessels. This is why a common side effect is headache.

Is that the same nitro glycerin that explodes like dynamite?

Yes.

What does nitro do to your heart that helps?

It drops the blood pressure and the heart beats more effectively.

When should you take a nitroglycerin pill?

It should be taken for chest pain that occurs on exertion, or any typical cardiac chest pain with which the patient is familiar and recognizes as heart pain as opposed to muscular pain.

Why do you put nitro under your tongue instead of swallowing them?

Absorption into the arterial system occurs faster thus providing better treatment.

Does nitro lose it’s potency over time?

Yes. Monitor the expiration date on the bottle and keep your nitroglycerin prescription updated regularly.

What kinds of things make nitro loose potency faster?

Heat and sunlight. It should be kept in an airtight sealed container in a cool dark place.

Who should carry nitro with them all the time?

Any one with a history of heart attack or angina.

What is the best way to carry nitro?

In the brown bottle that it comes in which reduces the light exposure.

Should a heart attack patient take erectile dysfunction medication?

Yes, they may as long as the patient is stable and he is not taking nitroglycerin type medications. There are some nitroglycerin type medications that are taken regularly or there are circumstances where nitroglycerin may have been taken on that day.

Are there common non-prescription drugs that a heart attack patient should avoid?

In general it is best to check with your doctor about over the counter medications. There are certain medications such as Sudafed which may increase the heart rate or blood pressure and therefore increase the demand on the heart. If the patient is on aspirin or other blood thinner then ibuprofen or other non-steroidal anti-inflammatory medications should be avoided.

What is a beta blocker drug?

Beta blockers are a class of medications which is used after heart attacks and in treatment of arrhythmias. Their main cardioprotective effect is to lower the heart rate.

Why would a patient want their heart rate lowered?

This reduces the oxygen supply and demand ratio in favor of the patient.

Are there different types of beta blockers?

The 2 main types of beta blockers are cardio-selective which mainly effect the heart cells and to a smaller extent the lung, and the non-cardio-selective B-blockers which effect the body in general. Examples of the cardio-selective blockers are atenolol, bisoprolol, and metoprolol. Non-cardio-selective blockers include propranolol, carvedilol, and nadolol.

What are the side effects of beta blocker drugs?

Some common side effects of beta blockers are Fatigue, depression, erectile dysfunction, or asthma exacerbation.

Why would a person take the drug Plavix after a heart attack?

Plavix (clopidrogel) is taken to reduce the risk of another heart attack by reducing blood clot formation.

What does Plavix do that makes it different from taking asprin?

There are multiple stages to the clotting process. While aspirin effects this process indirectly as described in the previous question, Plavix works directly on the platelet.

Clopidogrel works by preventing a natural substance called ADP (adenosine diphosphatase) from binding to its receptors on platelets. ADP is one of the chemicals in the body that cause platelets to clump together and start the process of blood clotting. As clopidogrel stops ADP from binding to platelets, it reduces the likelihood of clots forming in the blood.

What can you say about cholestorol drugs?

The number of questions and the level of information nessessitated an FAQ just for cholestorol drugs.