Coronary angioplasty is a treatment to improve blood flow to the heart. This procedure helps patients reduce or get rid of chest pain, fatigue, and breathlessness that is caused by restriction of blood flow in a heart blood vessel due to cholesterol buildup. In this article, consultant cardiologist Dr Arjun Ghosh explains all about this procedure and when it is necessary.
Coronary angioplasty is used to reduce the symptoms of coronary heart disease, namely angina and dyspnoea. This can be done as an elective day-case procedure or as an emergency treatment for a heart attack.
Heart blood vessels can become obstructed over time due to too many fatty deposits in the blood which settle on heart vessel walls causing plaques, a condition that is called atherosclerosis. When the blood flow isn’t as it should be, the heart muscle does not get enough oxygen leading to chest pain and sometimes shortness of breath.
What happens during a coronary angioplasty?
The procedure is conducted by inserting a catheter into the femoral (groin) or, more often, the radial (wrist) artery and pushing it up to the coronary (heart) artery. When the catheter is in place, a wire is fed through with a balloon at the end, which is inflated after insertion to widen and create space in the artery. Usually, the procedure will then involve placing stents in the blood vessel opened up by the balloon., Stents are small metallic mesh tubes that act as a sort of scaffold, supporting the structure of the blood vessels and keeping them open. This procedure is also called a percutaneous coronary intervention (PCI).
When is a coronary angioplasty considered?
In the elective setting, coronary angioplasty is used in cases where patients are suffering from angina and medication has not been helpful. Normally, angina is treated with:
beta blockers which act in a variety of ways to decrease heart oxygen demand
nitrates which relax the heart blood vessels and allow more blood to flow
statins which lower LDL cholesterol that causes the fatty deposits
calcium channel blockers which try to decrease heart workload
Angioplasty can also be carried out in non heart arteries such as in the legs if there is significant cholesterol build up there causing leg pain with activity (claudication). In emergency cases, this procedure can be used for those having a heart attack, to open up blocked heart arteries.
What are the benefits and disadvantages of coronary angioplasty?
Coronary angioplasty is one of the most common types of coronary procedures and is safe and minimally invasive as there will only be one incision point for the catheter. The risk for serious complications is low but can include serious complications like heart attack and stroke. This is explained in more detail in the consent process.
This procedure can take less than an hour and normally is conducted as a day case though some patients may need to stay at the hospital overnight. After coronary angioplasty, patients can return to their full normal activities within two weeks. Patients should feel relief from anginal chest pain and breathlessness soon afterwards, and feel as though they have more energy and capability to do physical activities more often and for longer.
If you are having heart issues, you can arrange an appointment with Dr Ghosh today on his Top Doctors profile.
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