What medicine is good for myocardial ischemia?

Myocardial ischemia refers to a condition caused by reduced blood supply to the heart, abnormal myocardial energy metabolism, low blood pressure, and reduced blood supply to the aorta. When a patient suffers from myocardial ischemia, he or she generally experiences symptoms such as chest tightness, shortness of breath, insomnia, sudden bradycardia, low blood pressure, and dizziness. Since myocardial ischemia may also lead to the risk of myocardial infarction, it should be treated promptly when myocardial ischemia is discovered. It is best to go to the hospital and follow the doctor's instructions for timely treatment.

Main causes: There are many reasons that can cause myocardial ischemia. Low blood pressure, reduced blood supply to the aorta, and obstruction of coronary arteries can directly lead to reduced blood supply to the heart. Heart valve disease, changes in blood viscosity, and myocardial lesions can also reduce blood supply to the heart. The most common cause is coronary atherosclerosis, followed by inflammation (rheumatic, syphilitic, Kawasaki disease and thromboangiitis obliterans, etc.), spasm, embolism, connective tissue disease, trauma and congenital malformations.

Treatment: 1. Treatment principles: Since myocardial ischemia carries the risk of myocardial infarction and sudden death, early treatment is required when myocardial ischemia is discovered. Actively prevent the occurrence of atherosclerosis. If it has occurred, it should be treated actively to prevent the progression of the lesion and strive to reverse it. Those who have developed complications should receive timely treatment to prevent deterioration and prolong the patient's life. 2. Drug treatment Since the mechanism of myocardial ischemia is mainly the imbalance between myocardial blood (blood oxygen) supply and demand, the treatment of myocardial ischemia is nothing more than increasing myocardial oxygen supply and (or) reducing myocardial oxygen consumption, so that the myocardial oxygen supply and demand can be restored to a balanced state.

(1) Antiplatelet drugs: prevent and treat thrombosis, prevent coronary artery and cerebral artery thromboembolism, and reduce the risk of myocardial infarction, stroke and cardiovascular death in patients with stable angina pectoris. If there are no contraindications, they should be taken for a long time. Commonly used drugs include aspirin, clopidogrel, etc. (2) β-blockers, such as metoprolol or its sustained-release tablets, can slow down the heart rate, reduce myocardial oxygen deprivation, and prevent sudden death. Beta-blockers are the first choice for stable angina pectoris. They can be used in combination with nitrates to complement each other. Generally, the dose should be started at a small dose and adjusted according to the treatment response and heart rate changes. (3) Calcium ion blockers can inhibit myocardial contraction, reduce myocardial oxygen consumption, dilate coronary arteries, relieve coronary artery spasm, and improve myocardial blood supply. Commonly used drugs include verapamil, nifedipine, etc. (4) Statins - lower plasma cholesterol, stabilize arterial plaques, and prevent plaque detachment and the formation of blood clots, such as atorvastatin and rosuvastatin. (5) RAS (renin-angiotensin-aldosterone system) system blockers, such as benazepril and valsartan, can prevent ventricular remodeling and improve cardiac function. (6) Nitrate drugs: dilate coronary arteries and increase myocardial blood supply, such as isosorbide mononitrate. (7) Thrombolytic drugs: dissolve acutely formed blood clots and are used for acute myocardial infarction.

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