Who has the option of choosing angioplasty?
Choosing a treatment may seem like a decision that your doctor should
make. But you can take part in this important choice if:
- You have mild heart disease. This means that
you do not have too much narrowing of the arteries that give blood and oxygen
to your heart (coronary arteries). It also means that your risk of
having a heart attack is not too high.
- You have stable angina. This
is chest pain that occurs only with emotional or physical stress and goes away
when you rest or after you take
Your doctor can tell you if you meet these
You will want to talk to your doctor about angioplasty
before you have an
angiogram test. During the test, you will not be able
to take part in the decision about angioplasty because you will be sleepy from
medicines. So, before the test, talk with your doctor about what the test might
show and what the doctor's options are in each case. You can tell the doctor
what you would prefer based on the test results.
How is angioplasty done?
angioplasty, the doctor puts a thin, flexible tube
called a catheter into an artery in your groin or arm. The doctor guides the
tube into the narrowed artery. He or she inflates a small balloon at the end of
the tube. This widens the artery to allow blood to flow. The doctor may put a
small wire-mesh tube called a stent in the artery to keep it open. See a
picture of angioplasty with stent placement .
What are the risks of this procedure?
has some rare but serious risks. They are:
- The need for emergency open-heart surgery
during the procedure.
Most people recover from angioplasty fairly quickly. They
usually go home after an overnight stay in the hospital. They can return to
normal activities within a few days. After angioplasty, they need to follow a
heart-healthy diet and exercise. They also need to quit smoking if they smoke.
Taking their medicines is also important.
Keep in mind that the
chances of having a serious problem with this procedure are higher if you are
older than 70.
What is medical therapy for stable angina?
therapy includes making lifestyle changes and taking medicines. Lifestyle
changes play a big role in helping you live longer. They include eating a
healthy diet, not smoking, and getting daily exercise. Changing your habits may
not be easy, but it could keep your heart disease from getting worse. It could
even reverse some of the damage.
Your doctor will ask you
- Exercise almost every day. The American Heart
Association suggests that you exercise for at least 30 minutes on all or most
days of the week.
- Eat a
heart-healthy diet. This includes lots of fruits and
vegetables, whole grains, and lean protein. Try to eat fish at least 2 times a
- Know your numbers. Keep track of your
blood pressure and
cholesterol, and take your medicines to keep your
numbers in a healthy range.
- Stay at a healthy
- Keep your blood sugar as close to normal as possible if you
- Stop smoking. Quitting smoking
can greatly lower your chance of having a heart attack and dying.
Whatever choice you make about angioplasty, making these
lifestyle changes will give you the best chance of keeping heart disease from
getting worse. These changes are important for all people who have heart
Taking medicines every day is another key part of medical
therapy. You may need to take:
- Medicines, such as
statins, to help lower cholesterol.
Beta-blockers to keep your heart from working too
hard. The medicine slows the heart rate and lowers blood pressure. It can help
make chest pain better and may prevent it.
ACE inhibitors to
lower blood pressure and the risk of heart attack.
Aspirin or other medicines to reduce the risk of blood
clots and heart attacks.
Nitrates, such as nitroglycerin, to
stop chest pain.
Calcium channel blockers to increase
blood flow to the heart. They also can improve or prevent chest pain. This
medicine is sometimes added to the other medicines.
What are the side effects of these medicines?
medicines have side effects. Your doctor may lower the dose or give you another
drug if side effects bother you.
- Statins: The most common side effects include
an upset stomach, gas, constipation, belly pain or cramps, and feeling more
tired than usual. Rarely, statins can cause liver problems or muscle pain and
- Beta-blockers: Side effects include dizziness, feeling
more tired than usual, losing your sex drive or having trouble getting an
erection, and depression. People with asthma may not be able to take
- ACE inhibitors: Side effects include a dry cough,
nausea, diarrhea, and swelling of the face and hands.
- Aspirin and
other medicines to reduce the risk of blood clots: They can cause an upset
stomach and bleeding.
- Nitrates: Normal, temporary side effects of
nitroglycerin include a warm or flushed feeling, a headache, dizziness, or
lightheadedness. You may also have a burning feeling when you put the pill
under your tongue.
- Calcium channel blockers: The most common side
effects include headaches, dizziness, constipation, and weakness.
Even if you choose to have angioplasty, you may need to
take at least some of these medicines.
How well does medical therapy or angioplasty work for stable angina?
Medical therapy and surgery can both stop chest pain.
They also can make it easier for you to exercise, which is a key part of
keeping your heart healthy.
Many people try medical therapy first.
But it doesn't always work. You may decide to have angioplasty if you still
have chest pain and can't exercise even after you have taken medicines and made
While angioplasty can ease chest pain, it has
not been proven to help you live any longer than medical therapy. Also,
angioplasty does not lower the risk of having a heart attack any more than
If you need more information, see the topic
Coronary Artery Disease.