Last week, a 60-year-old man visited the outpatient department of the National Cardiac Centre, for a health checkup. He told the doctor that he had been regularly taking aspirin and statins for around a decade due to a blockage in the left coronary artery and had taken Indomethacin, a painkiller to relieve the back pain.

“Initial assessments, including electrocardiogram and echocardiogram indicated normal findings,” said Dr Om Murti Anil, an interventional cardiologist, who attended the patient. “However, a significantly elevated level of high-sensitivity Cardiac Troponin indicated a heart attack.”

This was a common refrain among many patients, who use nonsteroidal anti-inflammatory drugs to relieve pain but these increase the risk of stroke and heart attack. Experts say nonsteroidal anti-inflammatory drugs or common painkillers change levels of substances in the blood that make clots more likely. And the blood clot can block a narrow artery in the heart, which triggers a heart attack.

Anil said that the patient underwent an immediate coronary angiogram, which revealed a 95 percent blockage in the right coronary artery.

“We placed a stent for normal blood circulation,” said Anil. “We are familiar with these types of incidents, as such patients come to our hospital for treatment.”

Studies show that nonsteroidal anti-inflammatory drugs, commonly used to treat pain and inflammation, can increase the risk of heart attack and stroke. Doctors say the risk is greater in those who already have a heart disease.

In the given case, the patient had used the painkiller (Indomethacin) as advised by his doctor.

“Painkillers of several brands and companies are available in the market, which can be purchased over the counter,” said Anil. “Patients should not take any without the prescription of doctors. If one is a heart patient or is at risk of heart ailments, s/he should tell their physician about their health conditions.”

Cardiologists say the risk of experiencing a heart attack is heightened during cold weather, particularly for individuals using painkillers. Elderly, diabetic, and those who have known heart blockages, history of heart attacks, or suffering from chronic illnesses face an increased likelihood of thromboembolic events like heart attacks and strokes when using painkillers, according to them.

“Even the consumption of a few painkiller tablets could contribute to the onset of such serious conditions,” said Anil, who attends cardiac patients at the National Cardiac Centre and plays an active role in awareness about cardiac health. “Awareness plays a crucial role in lessening hazards of painkiller usage in individuals with cardiac issues and those at high risk.”

Painkillers are widely used to ease pain, lessen inflammation, and reduce fever—ibuprofen, Flexon and others, can be purchased over the counter in Nepal. Even the pharmacies sell prescription drugs over the counter.

Rampant use of painkillers and other prescription drugs is leading to serious issues like liver damage, stomach bleeding, and kidney disease among others, according to doctors.