Heart attacks.
A leading cause of death
The management of coronary artery diseases predominantly aims at restoring the blood flow to the heart, which is hindered becauseof the blocks. Depending upon the severity and extent of the disease in the heart, your doctor chooses the right approach for you. It is good to be informed about how different treatment modalities work to beat the blocks in the heart and help it function better.
Medical management
One can manage coronary artery disease with a combination of lifestyle changes, exercise, diet, and medical treatment. Your doctor may prescribe several medications. Most common medications which are prescribed are blood thinners, medications to control cholesterol levels, those to dilate the coronary vessels to improve blood supply to help prevent blockages.
Ask your doctor if a prescription medication to treat angina, orchest pain, that keeps coming back is right for you or if you could be a candidate for a minimally invasive procedure called PCI.
New minimally invasive therapy options
Until recently, it had been a challenge to restore blood flow for people with certain types of complicated coronary artery blockages.With advancements in medical technology, tools and techniques have advanced quickly, and offer outstanding, reliable results for many people with CAD.
Percutaneous Coronary Intervention (PCI)
Percutaneous coronary intervention, or PCI, is a set of minimally invasive procedures that use a catheter to place a small device such as a special balloon or stent within a blocked blood vessel to open the blockage and re-establish blood flow. There are many PCI treatments to treat CAD, and it’s best to talk to your doctor about which may be right for you.
Angioplasty and Stent placement
A coronary angioplasty is a type of minimally invasive procedure to treat CAD. For this procedure, an interventional cardiologist threads a small tube, called a catheter, throughan artery in your groin or arm. The tube then goes to an artery leading to the site of your blockage. A small balloon on the tipof the catheter is slowly inflated to open the blockage.
The interventional cardiologist can perform this procedure with a balloon catheter alone or can involve a stent implant for the heart. During stenting, the cardiologist puts a small mesh tube into your artery to widen it and restore blood flow to your heart. This mesh tube is called a stent. Once the stentis placed into the coronary artery, it expands with the inflation of a balloon catheter. The stent is left in the artery to keep it open and help restore blood flow to the heart.
Stents that are used to treat CAD include
Bare-metal stents: a metal tube specially designed to provide support to help keep the artery open after angioplasty.
Drug-eluting stents: a bare-metal stent coated with a drug, that is released from the stent into the arterial wall when a re-blockage is most likely to happen.
There are risks associated with any angioplasty or a stent placement procedure. It is important to talk about these risks with your cardiologist. They may include infection, allergic reactions, coronary vessel damage, blood clots or death. Depending on your needs,your doctor may use a small metal stent alone or choose one that is coated with a medicine that helps keep the artery from getting narrow or blocked again.
Coronary Artery Bypass Grafting
Heart bypass or coronary artery bypass surgery is open-heart surgery performed to treat CAD. During the procedure, the surgeon uses the arteries or veins from another part of the body like the leg, arm, or chest and reroutes the blood around blocked heart arteries. This helps to restore the blood supply to the heart which was compromised because of the blockage. It can thus reduce symptoms and help to improve the function of the heart. Surgeons who are called cardio-thoracic surgeons perform this surgery.
Understanding the difference between Bypass surgery and PCI Procedure5,6
Which is the right treatment for you?
Use this simple discussion guide to start a conversation with your doctor:
- https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.118.005195
- https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack
- https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/invasive-tests-and-procedures
- https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/noninvasive-tests-and-procedures
- https://www.nhs.uk/conditions/coronary-angioplasty/
- https://www.nhs.uk/conditions/coronary-artery-bypass-graft-cabg/
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