Medication, stress on the heart, and heart attack

When you have a heart attack, your doctor may give you medicine to help reduce the stress on your heart and prevent damage to your heart muscle.

Advantages and disadvantages of medicines for a heart attack

Medicine	Advantages	Disadvantages
Beta-blockers Beta-blockers reduce the heart's work by slowing the heart rate and reducing blood pressure.	Reduce risk of death Reduce risk of a second heart attack Reduce risk of abnormal heartbeat (arrhythmia)	Can lower blood pressure or heart rate too much Can make heart failure worse Can aggravate asthma
ACE inhibitors ACE inhibitors lower blood pressure and help the heart muscle heal.	Reduce risk of death Reduce risk of second heart attack Reduce risk of developing heart failure	Can cause low blood pressure and increased blood potassium levels Can make kidney failure worse Can trigger allergic reactions

Beta-blockers

Beta-blockers were developed to help treat people with chest pain. They can slow your heart rate and reduce your blood pressure, which decreases the workload on your heart. This in turn decreases the amount of oxygen that your heart muscle needs.

Beta-blockers should be considered for anyone having a heart attack. Initially they can be given through an intravenous (IV) tube, to make sure the medication works immediately and to adjust the dose. Later they are provided in pill form.

Beta-blockers can slow the heart rate and decrease blood pressure to low levels and can worsen heart failure and trigger asthma attacks in some people.

Angiotensin-converting enzyme (ACE) inhibitors

ACE inhibitors were developed to treat people with hypertension but have proven very effective in preventing future heart problems, such as developing heart failure or a second heart attack.

Heart muscle damaged during a heart attack tends to become thin and stretched and lose its ability to squeeze (contract) forcefully. If this damage is not prevented, you may be at higher risk for developing heart failure. ACE inhibitors should be started within the first 24 hours after you are admitted to the hospital with a heart attack. The medication is most effective if it is started early.

People who have had a large heart attack that has significantly damaged a large amount of heart muscle appear to benefit most from ACE inhibitors.

ACE inhibitors may make kidney failure worse, contribute to low blood pressure, or increase levels of potassium in the bloodstream.