When you have coronary artery disease (CAD), one or more of your heart’s arteries are severely blocked with plaque, not allowing blood to flow as well as it should to your heart. This blockage puts you at risk for a heart attack and may also cause symptoms such as chest pain.
Depending on how blocked the artery is and where the blockage occurs, your cardiologist may recommend angioplasty or stenting to open up these clogged arteries.
During coronary angioplasty, a very thin, flexible catheter is placed in an artery in your wrist or thigh. Through that catheter, a second tube with a thin, inflatable balloon at the tip is threaded through your aorta (the main artery of your body) to the blocked artery in your heart. When the balloon is inflated, it pushes the plaque to the sides of the artery, opening the blocked artery and restoring blood flow to the heart. The balloon is then removed.
Additionally, during a coronary stent procedure, a stent, a hollow tube made of wire mesh, is pre-mounted on the surface of the balloon. As the balloon is inflated at the site of blockage and compresses the plaque, the stent expands. When the catheter is pulled out, the stent is left behind like scaffolding to help keep the artery open.
Here are three more things you should know about these procedures.
1. Angioplasty and stenting are not cures for CAD.
Your arteries may become narrow again either at the same site or at new locations. To lower your chances of having another blocked artery, you’ll need to manage your CAD. This includes:
- Following a heart-healthy diet
- Stopping smoking (if you smoke)
- Reducing stress
- Taking medications to help lower your cholesterol – if your physician prescribes them
2. Sometimes medication is better.
For many patients, medication – and lifestyle changes – are the first lines of defense to control CAD. Your cardiologist will see you regularly to follow your progress and monitor the disease.
However, angioplasty and stenting can come into play if:
- Symptoms get worse affecting your quality of life
- Medication is not having the intended impact
- The procedures could improve survival for certain patients in certain situations
3. Angioplasty and stenting can save your life during a heart attack.
During a heart attack, the artery has become totally blocked and oxygen-rich blood can no longer feed your heart. Within a short period, your heart muscle cells begin to die causing permanent damage to your heart.
The amount of damage depends of the size of the area supplied by the blocked artery and the time between the beginning of the heart attack and getting treatment. It’s crucial to get help for a heart attack as soon as possible.
That means recognizing these symptoms from the American Heart Association:
- Chest discomfort in the center of your chest. Or, it can feel like uncomfortable pressure, squeezing, fullness or pain in your chest.
- Discomfort in one or both arms, the back, neck, jaw or stomach
- Shortness of breath
- Breaking out in a cold sweat, nausea or lightheadedness
Remember: Get help fast. Call 9-1-1. And, never drive yourself or loved one to the hospital. By calling 9-1-1, emergency medical services (EMS) personnel will be able to respond right away and begin treatment during this crucial, early phase of the heart attack.
Once in the hospital’s cath lab, angioplasty and stenting are used to open up the artery and get blood flowing to the heart again – saving the patient’s life and preventing further death of the heart muscle.
Praveen K. Tamirisa, MD, MS, MBA, FACC, is an interventional cardiologist with ProMedica Physicians Cardiology, formerly Northwest Ohio Cardiology Consultants. He does angioplasty and stenting at the ProMedica Toledo Hospital cath lab. Each year the lab performs close to 5,000 diagnostic cardiac catheterizations and 1,200 interventional procedures, such as angioplasty and stenting.
Recently, Toledo Hospital earned accreditation for cardiac catheterization and percutaneous coronary intervention by Accreditation for Cardiovascular Excellence™ (ACE). Toledo Hospital is the first hospital in Ohio to earn ACE™; only 1% of cath labs in the United States have achieved it.