The nitrites (nitroglycerin and amyl nitrite) relieve severe angina attacks most dramatically. You just place a pellet of nitroglycerin under your tongue or break one of the tablets of amyl nitrite in your handkerchief and breathe it, and presto, the attack subsides.
How do these remedies provide relief? They force the heart to work harder and help to dilate the arteries, and this lowers the blood pressure and relieves the attack.
However, it is imperative that we realise that no matter how welcome the relief may be, the basic condition has not changed. Furthermore, it is important to mention that as the use of these remedies is continued, the attacks often recur with more frequency and greater severity.
We have seen many sufferers from angina who started with one nitroglycerin tablet occasionally, but who ultimately ended up by taking them as often as every 15 minutes. Doctors know that nitrites will combine with the bodys oxygen, and reduce its availability for functional use. Thus, a vicious circle is established.
Now, if these drugs are inadvisable, what should be done to obviate the need for them ? Our first objective is to improve circulation to the heart, and to overcome the periodic spasms that cause these attacks. While there is no single or stereotyped program that can be applied in all cases alike, we wish to point out that a program that embodies the use of simple, natural, easily digestible foods, and a restricted dietary regimen, even complete abstinence from food for limited periods of time when necessary, plus plenty of rest, often works wonders in these cases.
This is a sound approach and should be followed in all types of heart disease. In those cases where digitalis and the mercurial diuretics have been used routinely and where, because of the condition of the patient, cannot be discontinued immediately or completely, this basic approach will help to strengthen and rebuild the damaged and weakened heart and reduce the need for them, and, in many cases, may ultimately make their use entirely unnecessary.
We have seen many cases where mercurial diuretics were used as often as two or three times a week but where by eliminating food for short periods of time and reducing the fluid intake, plus the application of the nursing care outlined in this section, the need for them was considerably reduced or the patient was enabled to do without them altogether.