Brief Answer:
Yes it can cause congestive cardiac failure!

Detailed Answer:
Hi,Thanks for choosing health care magic for asking your query!

Diltiazem is a calcium channel blocker and is not indicate in follow up treatment of myocardial infarction because it can worsen the cardiac functions and may precipitate congestive cardiac failure.
On top of that it has no role in cardiac remodelling and does not either improves the ejection fraction in long term.
Normal ejection fraction is about 60%,ejection fraction 45% falls in mildly deranged ejetion fraction catagory, though chances of ending up in congestive cardiac failure are low ,yet diltiazem is neither indicated nor is the primary therapy for post myocardial infarction patients.
So, yes it can cause worsening of cardiac function eventually ending up in cardiac failure.

In case of any other query feel free to ask!
Thanks,
Dr Rishu Saxena
Cardiologist

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Brief Answer:
yes!

Detailed Answer:
Hi,
Yes therapy includes-

Coronary angiogram to find out the number of vessels blocked and degree of stenosis.
Please consult your cardiologist and request him/her to start you on-

1) cardioselective betablocker like Metoprolol, Carvedilol or Bisoprolol.
2) Ace inhibitor like ramipril, they prevent cardiac remodelling and help to increase ejection fraction.
3) Trimetazidine - significantly improves ejection fraction with in three months.
4) Anti platelet with statin therapy.

Thank you!

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Brief Answer:
Beta blockers are indicated life long post myocardial infarction!

Detailed Answer:
Hi again,
Cardioselective beta blockers are always given in patients post myocardial infarction.Initially after myocardial infarction they are given intravenous for 3 days,after that they are given life long orally!
Heart attack is not caused by spasm of the arteries,its caused due to blockage of coronary artery,when any of the coronary artery supplying heart is critically narrowed more then 90%,Myocardial infarction occurs.

Spasm of coronary vessels can cause microvascular angina,but not heart attack.

Please repost your query more clearly,otherwise attach copies of ecg,2d echo or coronary angiogram ;which your cardiologist had done to diagnose that it was a heart attack.

Thanks!

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