Classification of cardiac drugs

October 12, 2021

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The international classification of cardiac drugs includes a group of cardiac glycosides, antiarrhythmic drugs, non-glycoside cardiotonic drugs, peripheral vasodilators and other cardiac drugs. They are intended for the treatment of cardiovascular diseases with various pathologies.

Cardiac glycosides restore the functioning of the heart muscle, eliminate arrhythmia and stimulate heart activity. Obtained from plants: foxglove, lily of the valley, adonis.
Antiarrhythmic drugs eliminate disruptions and restore normal heart rhythm. Prescribed for the treatment of arrhythmia, tachycardia, ventricular fibrillation.
Non-glycoside cardiotonic drugs stimulate the heart and increase contraction of the heart muscle. Used in case of diagnosis of heart failure, hypotension.
Peripheral vasodilators dilate blood vessels and help normalize blood circulation. They facilitate the work of the heart and increase the saturation of vital organs with oxygen.
Other heart medications include a wide range of medications that help quickly improve heart function.

What pills to take for different heart pains

The classification of cardiac drugs used by doctors includes essential drugs to relieve heart pain. It is better not to ignore this symptom, and always have heart medications in your home medicine cabinet. In case of weakness, shortness of breath, acute pain, pale face and cold sweat, you must urgently call an ambulance.

Pain in the heart may indicate a person’s emergency condition:

myocardial damage and malfunction of the heart muscle;
coronary (coronary) vessels that deliver oxygenated blood to the heart;
cardiac membranes, valves;
pain can also appear from organs and tissues located near the heart - lungs, bronchi, muscles, ligaments and even bones.

There are many reasons for the appearance of these symptoms, so in each case different pills for heart pain are indicated.

Relief of acute pain arising behind the sternum is carried out with Nitroglycerin. This first aid remedy in the form of small tablets should always be in your first aid kit. It works against angina attacks. The patient is also advised to rest completely; it is necessary to go to the hospital and undergo an examination.

Delay in this case can lead to a heart attack.

The doctor prescribes treatment to relieve pain attacks and prevent relapses. The choice of drugs is based on the diagnosis, the presence of chronic diseases, age, and characteristics of the body. Pain relief is carried out with the help of analgesics to directly affect the receptors; drugs are also used to relieve spasms, enhance metabolism, and others.

Types and symptoms of angina

Angina is divided into:

stable;
unstable;
vasospastic.

The first signs of angina pectoris are an attack that begins with a sharp pain in the left side behind the sternum and gradually moves to the forearm and arm. Lasts up to 15 seconds, then subsides. The pain is pressing, squeezing, sometimes there is a feeling of fullness or burning. The attack is accompanied by an increase in pressure, sweating and paleness of the skin appear.

How to relieve acute pain in the heart

First aid medications are designed for different types of heart pain - sharp and burning, dull and pressing, intermittent and arising under the influence of stress.

Validol is applied under the tongue, it dissolves slowly and has an effect in a condition characteristic of a panic attack. The patient complains of pain in the heart area, malaise, lack of air, cold sweat.
Nitroglycerin is also available without a prescription and is effective for attacks of chest pain and the development of coronary heart disease. The tablet or capsule is taken under the tongue, so it is absorbed into the blood faster. If necessary, you can put another one, the effect occurs in 3 – 5 minutes. It is forbidden to take more.
Corvalol tablets, drops in a bottle can also be bought without a prescription. The complex composition includes ethyl bromizovalerianate, peppermint oil, and phenobarbital. Take 20 drops per glass of water or one tablet also under the tongue. Relieves pressing pain in the heart, also relieves stabbing and cutting pain, a feeling of heaviness.
Cardiket tablets with a prolonged effect contain isosorbide dinitrate, which has a pronounced vasodilating effect. It relieves arterial spasm, lowers blood pressure, and has a long-lasting effect.
Novo-passit is a sedative, available in tablets and syrup, prescribed for vague pain in the heart area, with the appearance of anxiety, depression. They are also used in complex therapy in case of cardiac pathologies. It is prohibited to use by drivers of vehicles, as well as with alcohol.

Causes of angina

Long-term study of angina pectoris allows us to accurately name the physiological mechanism of the development of the disease. Due to nutritional and metabolic disorders, the lumen of the arteries gradually narrows due to atherosclerotic plaques. Deterioration of blood flow causes oxygen starvation of the heart muscle cells, which causes obvious and quite severe pain. At the same time, vascular spasm may occur, caused by nervous overstrain or hypothermia of the body.

The appearance and accumulation of atherosclerotic plaques on the walls of blood vessels is often provoked by:

symptoms of arterial hypertension;
smoking;
obesity;
symptoms of diabetes;
physical inactivity, sedentary lifestyle;
unsatisfactory food quality.

The process of reducing the lumen of the artery occurs gradually. When it narrows by 50% or more, the blood flow noticeably deteriorates, which leads to disturbances in the functioning of the heart muscle. Physical activity and psycho-emotional stress contribute to the aggravation of the situation, forcing the heart to work intensively against the background of oxygen starvation. Lack of oxygen causes malnutrition of muscle tissue, which causes a characteristic pain syndrome with signs of suffocation and pressure in the heart area.

Risk factors that trigger the process of vasoconstriction due to the formation of sclerotic plaques

When making a primary diagnosis, the specialist must take into account the possible effect of one or more of the following factors:

hyperlipidemia – disorders of cholesterol metabolism with a simultaneous decrease in high-density lipoproteins;
obesity caused by the predominance of animal fats and high-calorie foods in the diet against the background of a lack of cereals, vegetables, fruits and legumes;
physical inactivity is a lack of movement that triggers the development of obesity due to the accumulation of cholesterol;
arterial hypertension is a companion to coronary heart disease due to oxygen deficiency;
anemia - a decrease in hemoglobin level against the background of general weakness of the body;
type 2 diabetes mellitus, which is considered one of the most dangerous risk factors;
tobacco addiction - helps to reduce the volume of oxygen in the blood, increases blood pressure and promotes spasm of arteries narrowed due to the accumulation of atherosclerotic plaques.

The action of at least two factors is sufficient for angina to become serious and require immediate intervention by a specialist.

The heart is pressing - pills that help

Pressing pain behind the sternum is relieved with tablets from the nitrate group of drugs (Nitroglycerin). In accordance with the generally accepted classification of cardiac drugs, you can choose different cardiac drugs as prescribed by your doctor.

For this purpose, the patient needs to call an ambulance. Before the doctor arrives, you can take 1 tablet with an interval of 5 minutes:

Nitroglycerin under the tongue, sublingually;
Aspirin Cardio tablet crushed into powder inside, orally;
Or analogues of this drug - Acetylcardio-Lect, Thrombopol, Aspicard, Trombogard, Aspinat, CardiAsk and others.

Further treatment will be prescribed by a cardiologist after a comprehensive examination of the patient. Complaints include pressing pain in the heart area, radiating to the left arm and little finger, lack of oxygen, convulsions, nausea, panic and fainting.

Angina pectoris

Atherosclerosis

Diabetes

Stroke

23802 May 20

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Angina pectoris: causes, symptoms, diagnosis and treatment methods.

Definition

Angina is a clinical syndrome manifested by a feeling of tightness or squeezing pressing pain in the chest, which is most often localized behind the sternum and can radiate (“give”) to the left arm, neck, lower jaw, and to the epigastric region (epigastric region).

Pain occurs during physical activity or exposure to other factors that increase the heart's need for oxygen, and lasts from 1 to 15 minutes. It goes away with rest (when you stop exercising) or 1-3 minutes after taking nitroglycerin.

Translated from ancient Greek, angina means “narrow (weak, cramped) heart.”
Causes of angina
The development of angina is based on three mechanisms:

atherosclerotic lesions of the coronary arteries;
transient vascular thrombus formation;
decreased coronary blood flow due to spasm or increased tone of the coronary arteries.

Angina pectoris makes itself felt during physical activity or stressful situations when there is a narrowing of the lumen of the coronary artery by 50-70%.

The severity of angina depends on the degree of coronary artery stenosis, its location and extent, the number and number of affected arteries. An atherosclerotic plaque can block a vessel completely or partially. With an increase in blood pressure, the inner layer of the coronary arteries (endothelium), damaged by the atherosclerotic process, can be easily damaged, blood penetrates into the plaque, the blood clotting process is activated and a blood clot is formed, which can partially or completely block the vessel.

The formation of a blood clot, especially against the background of a vessel spasm, can lead to its complete or partial blockage.

When myocardial tissue is damaged, pain mediators (serotonin, histamine, bradykinin, etc.) are released, which affect pain receptors.

There are modifiable (those that can be influenced) and non-modifiable factors that can provoke the development of angina. Modifiable diseases include dyslipoproteinemia (violation of the normal ratio of blood lipids), arterial hypertension, diabetes mellitus, smoking, low physical activity, obesity, and stress. Non-modifiable factors - male gender, age, family history of cardiovascular diseases (myocardial infarction or ischemic stroke in close relatives - up to 65 years (for women) and up to 55 years (for men)).

Classification of the disease

The most widespread classification of angina pectoris, developed
on the basis of WHO expert recommendations
:

Stable angina pectoris (indicating functional class from I to IV).

Class I – the patient tolerates physical activity well, angina attacks occur only during high-intensity exercise; Class II - slight limitation of usual physical activity, angina attacks occur when walking on level ground for a distance of more than 500 m, when climbing more than one floor; Class III – pronounced limitation of normal physical activity, attacks occur when walking at a normal pace on level ground for a distance of 100-150 m, or when climbing one floor; Class IV - angina occurs with little physical activity, walking on level ground at a distance of less than 100 m.

Unstable angina:

new-onset angina (less than 1 month from the onset of attacks);
progressive angina (increasing attacks in frequency, duration, intensity with expanding localization and irradiation);
early post-infarction (within 2 weeks after acute myocardial infarction) or post-operative angina.

Spontaneous (vasospastic, variant, Prinzmetal) angina.

In practice, doctors also use the clinical classification of stable angina
:

stable exertional angina (indicating the functional class);
vasospastic angina;
microvascular angina.

Symptoms of angina
Pain from angina can sometimes be perceived not as true pain, but as a feeling of discomfort, a feeling of heaviness, squeezing, tightness, distension, burning or lack of air.

Most often, the pain is localized behind the sternum or along the left edge of the sternum. It can radiate to the neck, lower jaw, teeth, interscapular space, and less often to the elbow or wrist joints, mastoid processes.

Pain with angina pectoris usually lasts from 1 to 15 minutes.

Pain occurs at the peak of physical or emotional stress. Stressful situations, due to increased activity of the sympathoadrenal system, lead to an increase in heart rate, increased blood pressure and myocardial contractility, which means the myocardial need for oxygen increases. After taking nitroglycerin or stopping the exercise, the pain stops, and the pain attack stops faster in a sitting or standing position.

As angina progresses, a moment comes when attacks occur even with minimal exertion, and then even under conditions of physical rest.

Angina at rest joins angina pectoris and is combined with it. In such cases, attacks occur during times of increased oxygen consumption by the heart muscle, for example, during REM sleep, when the heart begins to beat faster.

In some patients, an attack of angina may occur in a horizontal position due to increased blood flow to the heart.

Vasospastic angina develops independently of physical and emotional stress, is caused by spasm of the coronary arteries, and usually occurs at a younger age than exertional angina due to atherosclerosis of the coronary arteries. In patients with vasospastic angina, many typical risk factors for atherosclerosis cannot be identified. The disease may be accompanied by threatening disturbances in heart rhythm, leading to the development of myocardial infarction and/or sudden death.

A feature of vasospastic angina is very severe attacks, usually localized in a typical location. They occur at night or early in the morning, and also when exposed to cold on exposed areas of the body.

Microvascular angina is characterized by attacks that occur some time after physical activity, during emotional stress and at rest; they are poorly controlled by nitroglycerin. The cause of microvascular angina is considered to be dysfunction of small coronary arteries (100-200 μm in diameter) in the prearteriolar segment of the coronary bed. In more than 70% of cases, microvascular angina coexists with classical angina in patients with atherosclerotic stenoses.

Diagnosis of angina pectoris

The diagnosis of angina is established on the basis of a combination of complaints (pain characteristic of angina) and information received from the patient about the course of the disease.

For all patients with suspected coronary heart disease, the following questions are asked:

current or past smoking;
the presence of cardiovascular diseases and/or deaths from cardiovascular diseases in the patient’s immediate relatives (father, mother, siblings);
previous cases of seeking medical help and the presence of previously registered electrocardiograms, studies and conclusions;
the presence of concomitant diseases in order to assess additional risks;
currently taken medications.

To clarify the diagnosis and existing complications, data from laboratory and instrumental examination methods are used.
All patients with suspected angina are recommended to have a lipid profile tested to detect dyslipoproteinemia:

triglycerides (Triglycerides);

What to take if you have severe heart pain

The patient's complaints also include shortness of breath, lack of oxygen, dizziness, weakness, and cold sweat. Increased temperature and fever may also appear. Severe pain in the heart may indicate the development of:

myocardial infarction;
aortic pathologies;
myocarditis;
thromboembolism;
pericarditis;
endocarditis;
other pathologies.

Pulmonary hypertension is characterized by increased pressure in the pulmonary artery, which is complicated by severe heart failure, which can be fatal. According to the classification of PH, there are 5 types: arterial, venous, thromboembolic, hypoxic and mixed type.

The patient needs to be kept calm and urgently call an ambulance. If you have severe pain in the heart that lasts more than 5 minutes, you cannot relieve it on your own; in this case, you need a doctor.

Treatment of angina

Since stenography develops against the background of coronary heart disease, it is important to eliminate the root cause of the disease in order to then cope with associated symptoms. At the same time, measures are taken to relieve pain and prevent new attacks.

First aid for angina pectoris is to take nitroglycerin, which reduces pain. A permanent treatment course focuses on taking anti-ischemic drugs, thanks to which the heart continues to work stably in conditions of lack of oxygen. Stenting and coronary artery bypass surgery allow the lumen of blood vessels to expand, restoring the conductive capacity of the arteries. Other clinical recommendations for angina pectoris are selected taking into account the patient’s condition, his age and the severity of cardiac pathology.

Palpitations, how to relieve them

Increased or slowed heart rate, as well as extrasystole, do not always indicate the formation of a pathological process. Perhaps there is an acute lack of oxygen for cardiac activity, the person feels panic, excitement, and stress. There may not be an urgent need to correct the functioning of the cardiovascular system with various drugs.

In more severe cases, treatment is prescribed:

antiarrhythmic drugs;
β-blockers;
ARBs (angiotensin receptor blockers);
surgery for implantation of a pacemaker is indicated.

Popular drugs for heart pain

The classification of cardiac drugs includes drugs that relieve acute pain and various painful sensations in the heart area. These include:

Antiarrhythmics, Panangin or Asparkam, Cordarone, Amiodarone, Cardiodarone;
Anticoagulants: Angioks, Heparin sodium, others;
Acetylsalicylic acid (Aspirin), Valsartan;
β-blockers: Sotalol, Timolol, Concor, Biprol, containing Bisoprolol and others.

These medications are prescribed after a heart attack.

Popular drugs include:

Valerian, Corvalol (drops and tablets p/o) with a pronounced sedative effect.
Nitroglycerin, Validol, Cormentol with a moderate vasodilator effect.
Novo-passit, Persen-cardio with sedative and antiarrhythmic effects.
Kratal, Cardiplant, stimulating myocardial activity.
Panangin, Asparkam contains potassium and magnesium salts of aspartic acid, indicated for combination therapy of coronary artery disease, heart failure, arrhythmias in case of overdose of cardiac glycosides.

Heart pills prescribed for older people

With age, the body reacts differently to medications, and if previously some tablets helped, then during exacerbation of chronic diseases they may be contraindicated for use. In any case, it is better to consult a doctor and undergo the necessary examination, do an electrocardiogram.

The cardiologist will make an accurate diagnosis and prescribe treatment in accordance with the characteristics of the body and the presence of individual indications. Along with heart medications, medications can be prescribed to prevent atherosclerosis, antithrombosis and strengthen the walls of blood vessels, lowering blood pressure.

For older people, different heart pills may be recommended:

Adonis-Bromine, Celanide, Digoxin, containing cardiac glycosides with a pronounced cardiotonic effect, for stimulation of the myocardium and correction of arrhythmia.
Nitroglycerin or Nitrocor, Monosan, Cardiket are used to relieve attacks of angina pectoris and are classified as vasodilators.
Concor, Biprol, Atenol, Betacard, Korgard and other β-blockers for the prevention of heart attack, with high blood pressure and severe heart contractions.
Corinfar, Cordaflex, Verapamil or Lekoptin, Veracard and other calcium channel blockers dilate arteries, relax the walls of blood vessels, and act against arterial hypertension.
Cocarboxylase, ATP, Vitrum Cardio Omega-3, metabolic drugs to improve metabolism.

Many other cardiotonic drugs from the groups included in the Classification of Cardiological Drugs are also prescribed, according to clinical recommendations adopted by the Russian Society of Cardiology. The use of advanced experience and developments of scientists, research and educational institutions in this field of medicine allows us to successfully implement the most effective methods for treating diseases.

Diagnosis of the disease

Diagnostics begins “from the threshold.” The first step is to collect an anamnesis and interview the patient about the nature of the attack, the duration of the course, and the intensity of the pain syndrome. What actions of the patient or nervous disturbances are the impetus for the occurrence of angina pectoris. The physical condition of the person (including weight) is necessarily assessed, blood pressure is measured and heart rate is calculated. Then the CBC (complete blood count) is examined, including biochemical analysis and blood sugar. An ECG is performed to determine the degree of cardiac ischemia.

Holter monitoring is possible - a monitor is attached to the patient for a day, which shows the work of the heart. Based on the daily readings of the device, the type of cardiac dysfunction, the frequency of attacks and their duration are determined.

For more severe cases, coronary angiography is performed to diagnose the condition of the vessels. The degree of vasoconstriction and the presence of atherosclerotic lesions are revealed. During this study, an X-ray examination of the heart vessels is performed during the administration of a contrast agent.

In addition to the above, stress tests are sometimes performed on a bicycle ergometer. The doctor evaluates the work of the heart under stress.