LEARNING TO LIVE WITH THE EFFECTS OF A HEART ATTACK: BECOMING PRODUCTIVE AND ENJOYING LIFE AGAIN

A typical example will demonstrate the importance of complying with drug therapy.

A 45-year-old down-hill skiier who had also been active in other kinds of sports (soccer and skiing instruction) developed coronary heart disease (he smoked and was overweight.) In the past two years he had given up his ski tours because of his angina pectoris and his growing fear of hurting himself. Only another avid skiier can understand what such a sacrifice actually means.

After a comprehensive program of rehabilitation including weight-loss, anti-smoking clinics, and long-term drug therapy, the patient again took up cross-country skiing and returned to the regular skiing slopes. Since he had a tendency to develop a high pulse rate as a result of exhaustion, he had received a prescription for beta blockers and had been advised to take nitrate tablets whenever he needed them. The patient had, however, misunderstood this advice.

The patient was under the impression that he could take the tablets only after suffering an attack of angina pectoris which he could not overcome by "walking through" it. His ski trips were miserable until he became accustomed to taking the tablets 15 minutes prior to skiing. He now enjoys skiing as much as he had earlier.

This advice to prevent angina pectoris of course also applies to emotional stress and physical activities other than skiing which cause angina pectoris.

The patient had also developed headaches after taking a whole nitrate tablet (5mg). He was able to eliminate this side-effect by taking only half the tablet at a time, waiting 10 minutes to take the second half.

If we as physicians expect a high degree of compliance from the patient and in fact would like him to become a specialist in his particular disease, then we should provide him with the necessary information about long-term drug therapy.

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Cardio & Blood