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Calcium Channel Blockers in Treating Chest Pain.

Chest painis an imprecise term and everyone who tells that he or she has a ‘chest pain’ means different things. This can be discomfort, or pain, some pressure or squeezing, choking or numbness that you feel anywhere along the front of your body between your neck and upper abdomen. It can any of the mention above in the neck or upper abdomen, these also refer to the term ‘chest pain’. Chest pain is often associated with pain in the jaw, head, or arms.

The duration and the character of that discomfort or pain can be also different: from several seconds to several weeks. The chest pain can occur in some occasions, predictably, or sporadically.

Chest pain is not a diagnosis or a disease. It is a symptom of anything from a serious health problem to a trivial medical disorder. Don’t also forget that chest pain tells you that something is wrong with some of your body function.

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Whatcalcium channel blockers have to do with it?

Calcium channel blockers are medications that are used for different of illnesses and health disorders, including chest pain (mainly angina pectoris).

  • To treat high blood pressure
  • To treat chest pain
  • To treat chest pain due to a spasm

They are used to treat high blood pressure and heart rhythm disturbances. Calcium channel blockers are commonly used for chronic stable or unstable angina, vasospastic angina and dysrhythmias. Sometimes they are used to enhance the effectiveness of some other medications. For chest pain, calcium channel blockers are often prescribed along with nitrates.

What are calcium channel blockers?

Calcium is required for muscles to contract and for the blood vessels to narrow. Calcium channel blockers are medications that are called so because they close off the channels in the cell membrane that allow calcium to return to the cell after contraction. In other words, they prevent calcium from entering the smooth muscle cells of the heart and blood vessels. They relax blood vessels of the heart, that allows to increase blood flow, thus relieving the angina pain. CC blockers also slow down the rate in which electrical impulses are conducted, so the heart rate is slowed, thus causing blood pressure to fall.

There are two types of calcium channel blocker:

  • the dihydropyridines – this type does not slow the heart rate or cause other abnormal heart rhythms (such as arrhythmias). This type is most often used to treat high blood pressure. Some examples of that type are Nifedipine and Amlodipine.
  • the non-dihydropyridines – the type that is used for patience with heart failure or certain types of abnormal heart rhythms (as they may make these conditions worse). This type is most often used to treat chest pain. Known examples of the type are Verapamil and Diltiazem.

Also they come in different form:

  • in a short-acting form – these channel blockers increase the risk of heart attack and stroke when used over a long period of time (so they are no longer used to treat high blood pressure)
  • in a long-acting (sustained release) form

Calcium channel blockers have shown its effectiveness in the number of studies. For example in researches the patients with stable effort angina pectoris where studied while using nisoldipine. They were asked to do some supine leg exercise. Chest pain was induced in all patients during the control exercise test. Those who take calcium channel blockers after the exercises feel relief, and the pain doesn’t induce any longer (or with some of them was of lessened severity).

Calcium channel blockers are given orally in form of either capsules or tablets.

For chest pain the following calcium channel blockers are used:

  • Nifedipine – is a dihydropyridine calcium channel blocker that is used mainly for angina pectoris (chest pain caused by lack of oxygen to the heart due to clogged arteries or spasm of the arteries) and hypertension. Brand names for them are Adalat, Nifedical, and Procardia.
  • Amlodipine - a long-acting dihydropyridine calcium channel blocker used as an anti-hypertensive and in the treatment of angina. Brand names are Norvasc® (North America) and Istin® (United Kingdom by Pfizer). If taken regularly, amlodipine controls chest pain, but it does not stop chest pain once it starts.
  • Verapamil - is an L-type calcium channel blocker used in the treatment cardiac arrthythmia, hypertension, angina pectoris and headaches. Are available on the market under names Isoptin, Verelan, Calan, Bosoptin. Verapamil has also been used as a vasodilator during cryopreservation of blood vessels. The fast-acting brands (Calan and Isoptin) are taken for angina. The longer-acting brands (Calan SR, Isoptin SR, Verelan, and Verelan PM) are typically used only for high blood pressure. Covera-HS is prescribed for both high blood pressure and angina. Some doctors also prescribe verapamil to prevent migraine headache and asthma and to treat manic depression and panic attacks
  • Diltiazem – is a calcium channel blocker used as an anti-hypertensive, in the treatment of angina and some types of arrthythmia.

The most common side effects of calcium channel blockers are a brief headache (it will pass over time), edema in the legs (swelling), constipation, stomach irritation, and fatigue. Verapamil can cause constipation and excessive slowing of the heartbeat. New studies showed that calcium channel blockers do not increase the risk of many types of cancer (including breast and uterine cancer), as it was thought earlier. Also do not use it if you have been diagnosed with low blood pressure, abnormally low heart rate and with second- or third-degree heart block (a delayed or complete lack of electrical communication between the upper chambers of the heart and the lower chambers of the heart). Do not use calcium channel blockers during pregnancy (the safety is unknown) and when you nursing. If the treatment is so essential for your health then breastfeeding should be stopped.

But of course it is better to prevent then to cure, so don’t smoke, maintain a healthy weight, eat nutritious low-fat foods, do your exercises, use alcohol moderately and control your high blood pressure and high cholesterol.

Valentyna Ant.

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