Introduction
Painkillers are safer than other medications, commonly known as analgesics, and help relieve pain. They are mostly used along with other medical procedures to manage pain. OTC (over-the-counter) drugs relieve pain for a variety of problems. Opioids and some anti-seizure and anti-depressants are also used to relieve pain.
What Is Heart Failure and What Are Its Symptoms?
Heart failure occurs when the heart muscle fails to pump blood as it should and blocks the blood and fluid buildup in the lungs and leads to dyspnea (shortness of breath), swelling in the legs, and causes cyanosis (bluish appearance on the skin).
Symptoms of heart failure are:
Heart failure can be fatal, and it is important to recognize its warning signs soon. The symptoms are:
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Pain radiates to the neck, arms, jaw, and back.
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Crushing and heaviness in the chest.
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A feeling of tightness, squeezing, pain, and pressure in the chest.
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Nausea and vomiting.
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Shortness of breath.
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Anxiety is similar to a panic attack.
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Wheezing and coughing.
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Dizziness and lightheadedness.
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Heartburn or indigestion.
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Fluid buildup in the lungs.
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Sweaty and clammy body.
Symptoms may vary in individuals. Some individuals show milder symptoms, and for some, they may result in serious consequences.
What Are the Risk Factors Leading to Heart Failure?
The risk factors that lead to heart failure include:
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Commonly seen in males.
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High blood pressure.
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Obesity and mainly type 2 diabetes.
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High cholesterol levels.
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Smoking is the biggest risk factor for heart conditions.
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Minimal alcohol intake can benefit the individual while more alcohol intake can make the condition worse and affect other body parts including the heart.
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Low activity levels.
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Family history.
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Genetics, in some cases hereditary conditions lead to an increased risk of getting heart-related conditions and heart failure.
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Processed foods, added sugars, fats, and salts.
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Stress.
What Do Painkillers Treat?
Over-the-counter (OTC) painkillers lower fever and pain in various issues like:
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Broken bones.
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Burns.
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Back strains and sprains.
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Tendonitis, bursitis, and arthritis.
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Headaches and migraines.
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Muscle pain and neck pain.
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Toothaches.
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Menstrual cramps.
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Cold, ear infections, and flu.
Which Painkillers Lead to Cardiac Failure?
Common painkillers like Ibuprofen are used worldwide and are associated with an increased risk of cardiac failure. Most of the nonsteroidal anti-inflammatory drugs used in the world are the main cause of abnormal heart rhythm and lead to stroke and heart failure. Drugs, together with a subgroup of anti-inflammatory effects known as COX-2 inhibitors, help in relieving inflammation and pain in individuals with arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) use awareness is rising because of hospitalization of heart failure, around 19 percent.
Are OTC Painkillers Safe in Cardiac Conditions?
OTC (over-the-counter) drugs are considered safe for most individuals and it does not require prescription. However, OTC drugs consuming individuals should take safety precautions and dosages, especially when they have underlying conditions or take any other medications along with them. Mainly three OTC medications are there, NSAIDs, topical medications, and Acetaminophen. Tylenol and topical pain medications are preferred in individuals with heart conditions.
NSAIDs are mainly used in lowering pain and inflammation. Aspirin is also an NSAID but not advised as a painkiller. Large doses of NSAIDs can increase the risk of stomach ulcers and bleeding, worsening heart conditions, and kidney damage. NSAIDs are not advisable along with the medications taken for kidney disease and heart failure.
How NSAIDs Harm the Heart?
NSAIDs pose a risk to the cardiac system mainly for two reasons: they change levels of the substance in the blood and lead to making clots. A clot can narrow the artery that leads blood to the heart and can trigger increased pressure and heart attack. Secondly, they can change the flow of blood in the kidneys and cause the body to retain more water and salt. This leads to increased blood pressure and also leads to the risk of stroke. Elevated pressure also leads to atrial fibrillation (a rapid quivering motion of the heart's upper chambers).
Are Gabapentinoids Safe?
Gabapentin and Pregabalin are gabapentinoids, they are primarily used to treat nerve pain. These medications cause weight gain as a side effect, which may be due to changes in fluid retention or appetite. Too much fluid in the body can cause more stress on the heart and make conditions worse. Individuals with heart failure who take these medications are more prone to get admitted to the hospital for emergency care.
Which Painkillers Increase the Risk of Heart Failure?
Painkillers raise the risk of heart failure. Short-term painkillers can be dangerous and mainly in individuals who take anti-hypertensive drugs.
Drugs that increase the risk of heart failure are:
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Naproxen: This drug doubles the risk of heart failure.
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Indocin: Triples the risk of getting heart failure.
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Ibuprofen: It increases the risk of heart failure by 43 percent.
What Are the Points to Remember While Prescribing Painkillers to Cardiac Patients?
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The providers should thoroughly consider the benefit and risk ratio and the patient's risk profile before prescribing medications for chronic pain with heart failure.
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To reduce adverse effects, medications should be restricted for shorter duration and lower effective doses.
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Other therapies like cognitive behavioral therapy, yoga, and mindfulness should be used as a treatment.
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Topical medications like Capsaicin and NSAIDs are favorable. Acetaminophen is preferred as an oral medication in treating pain with heart failure.
Conclusion
Heart failure is a complicated clinical syndrome, and the management of chronic pain is challenging both for the provider and the patient. Individuals with heart failure often experience chronic pain. Some medications for pain are safer while others do have mild side effects. Tylenol and topical pain relievers are preferred if an individual has heart failure, and other medications like opioids, gabapentinoids, and long-term NSAIDs are avoided.
Appropriate pain medications can help promote treatment and affect better quality in affected individuals. The specific risk of heart failure for each class of medication is taken into consideration in the treatment. Reduced perfusion to organs like the liver and kidney may impact the metabolism and elimination of the drugs. The risk and benefits of each class of medications are based on their judicious use in cases of heart failure.
