DISCHARGE PLAN

MGH Medications:
 ASA (Aspirin) 80 mg daily after lunch. (lessens the chance of heart attack and stroke)
 Clopidogrel 75 mgs 1 tablet after dinner. (prevents platelets from forming into clots)
 Atorvastatin 10 mg 1 tablet at bedtime. (Lowering your blood level of cholesterol and fats)
 Fenofibrate 50 mg  1tablet at bedtime 3x a week (M-W-F). ( to treat high cholesterol levels)
 Norvasc 5 mg 1 tablet daily. (lowers blood pressure by relaxing the heart muscle and your blood vessels)
 Metformin 500 mg twice a day with a meal. (used for managing blood sugar levels)

At home
Advise the patient to:
 Check Vital signs everyday. Monitor the blood pressure, and cholesterol level.
 Monitor the signs and symptoms
 To do diet plan and practice healthy lifestyle.
 To take his medicines at exact time instructed.
 Follow up check up every 2 weeks.
 Seek physician immediately if the symptoms occurs.

Diet
 Eat less fat. Read food labels and limit your fat intake.
 Choose foods low in saturated or animal fat.
 Limit the use of high-cholesterol foods like eggs, meat and dairy products .
 Eat more fiber such as oats, beans and fruit.
 Eat more complex carbohydrates (starches) such as whole grains, beans and root
vegetables.
 Eat less white flour and fewer processed foods.

Lifstyle
 Lifestyle changes include eating a healthy diet that low saturated fat, cholesterol and sodium. Eat a heart-
healthy diet and maintain a healthy weight.
 Also be advised by your doctors or your fitness wellness center to exercise in a way that is safe for your
condition. Aim atleast 30-60 minutes of daily activity.
 Should not smoke or reduce smoking if you are diagnosed with this condition or other similar disease related to
the heart.
 Doctor will probably advise you to quit and avoiding smoking and drinking less alcohol.
 Get quality sleep and manage stress.
 Get regular health screening (ECG).

The Cardiac Rehab Program

The first stages of most cardiac rehabilitation programs generally last about three months, but some people will follow the
program longer. In special situations, some people might be able to do an intensive program for several hours a day that
can last one or two weeks.

During cardiac rehabilitation, you likely work with a team of health care professionals, possibly including cardiologists,
nurse educators, nutrition specialists, exercise specialists, mental health specialists, and physical and occupational
therapists.

 Medical evaluation. Your health care team will generally perform an initial evaluation to check your physical
abilities, medical limitations and other conditions you may have.
 Physical activity. Cardiac rehabilitation can improve your cardiovascular fitness through physical activity. Your
health care team will likely suggest low impact activities that have a lower risk of injury, such as walking,
cycling, rowing, yoga and jogging. 
 Lifestyle education. This involves support and education on making healthy lifestyle changes, such as eating a
heart-healthy diet, exercising regularly, maintaining a healthy weight and quitting smoking.
 It can include guidance about managing conditions such as high blood pressure, diabetes, high cholesterol and
obesity.

 Support. Adjusting to a serious health problem often takes time. You might feel depressed or anxious, lose
touch with your social support system, or have to stop working for several weeks.

Follow-up
Checking the details of all medical appointment before leaving the hospital or make a advance appointment for the
follow up check up. Visit the clinic after 1 week. Bring Lipid profile result.  

REVIEW REALTED LITERATURE

Ischemic Heart Disease and Heart Failure: Role of Coronary Ion Channels

Heart failure is a complex syndrome responsible for high rates of death and hospitalization. Ischemic heart disease is one
of the most frequent causes of heart failure and it is normally attributed to coronary artery disease, defined by the
presence of one or more obstructive plaques, which determine a reduced coronary blood flow, causing myocardial
ischemia and consequent heart failure. However, coronary obstruction is only an element of a complex pathophysiological
process that leads to myocardial ischemia. In the literature, attention paid to the role of microcirculation, in the
pathophysiology of ischemic heart disease and heart failure, is growing. Coronary microvascular dysfunction determines an
inability of coronary circulation to satisfy myocardial metabolic demands, due to the imbalance of coronary blood flow
regulatory mechanisms, including ion channels, leading to the development of hypoxia, fibrosis and tissue death, which
may determine a loss of myocardial function, even beyond the presence of atherosclerotic epicardial plaques. For this
reason, ion channels may represent the link among coronary microvascular dysfunction, ischemic heart disease and
consequent heart failure.

Reference
Severino, P.; D’Amato, A.; Pucci, M.; Infusino, F.; Birtolo, L.I.; Mariani, M.V.; Lavalle, C.; Maestrini, V.; Mancone, M.;
Fedele, F. Ischemic Heart Disease and Heart Failure: Role of Coronary Ion Channels. Int. J. Mol. Sci. 2020, 21, 3167.
https://doi.org/10.3390/ijms21093167
Received: 17 March 2020 / Revised: 28 April 2020 / Accepted: 28 April 2020 / Published: 30 April 2020