Heart Disease (Coronary Artery Disease) Slideshow Pictures Medical Illustrations of the Heart Image Collection Take the Heart Disease Quiz!

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Heart Attack Follow-Up

Medications that may be recommended on discharge from the hospital include:

• aspirin for its anti-platelet effect,
  
  
• a beta blocker to blunt the effect of adrenaline on the heart and make it beat more efficiently,
  
  
• a statin drug to control cholesterol and
  
  
• clopidogrel (Plavix) or prasugrel (Effient), other anti-platelet drugs.

Since the heart may have been damaged, further testing may be needed to assess its pumping capabilities. Echocardiography can measure ejection fraction, the amount of blood that heart pumps out to the body compared to how much it receives. A normal ejection fraction should be greater than 50% to 60%.

A monitored exercise program may be arranged.

Attempts will be made to minimize cardiac risk factors including:

• smoking cessation,
  
  
• weight loss,
  
  
• control blood pressure, and
  
  
• lower "bad" cholesterol.

Some patients will require coronary artery bypass surgery if their angiogram shows multiple areas of blockage.

Special Situations

Prinzmetal Angina

In some people, the coronary arteries can go into spasm and cause decreased blood flow to heart muscle. This can lead to chest pain known as Prinzmetal angina, even if there is no buildup of plaque in the blood vessels. In severe episodes the EKG can suggest a heart attack, and muscle damage can be confirmed by measuring cardiac enzymes.

Cocaine

There is a strong correlation between cocaine usage and heart attack. Aside from the artery spasm that cocaine induces, the drug turns on the adrenaline system of the body, increasing pulse rate and blood pressure, requiring the heart to do more work.