Heart 2 Heart Back
Know about Angioplasty and Stents
What is Coronary angiogram or angiography?
Coronary Arteries are the vessels that carry blood, oxygen and nutrients to the Heart muscles. Coronary angiogram or angiography is a test to analyze the coronary arteries and find out blocks in them.
How is the test done?
Angiogram can be done as a day care procedure. The patient will be admitted in the hospital on the day of the procedure. Fasting is required for 4-6 hours before the test. Some medication may be given just before the procedure to help the patient to relax. An area of skin in the right groin (thigh) or the wrist will be cleaned and shaved if necessary to allow access to the arteries of the heart.
A local anesthetic will be given to numb the skin at the access site. A tube will be placed into the blood vessel of the groin or wrist, through which a Catheter is inserted to reach the origin of
the coronary arteries. Dye is directly injected in to the Coronary Arteriesand Visualized using X rays. This lasts about 5 or 10 Minutes, after the test, the tube in the groin, wrist or elbow will be removed and pressure is placed on the site for 10-15 minutes by hand to avoid bleeding. Usually the patient will be discharged on the same day unless if there is any complication.
What is Angioplasty?
Coronary angioplasty is a treatment procedure used to open blocked or narrowed arteries of the heart
How Angioplasty is performed?
A catheter is placed in the origin of the Coronary artery. A Thin wire is passed down the length of the affected coronary artery, over which a small balloon will be delivered to the
affected section of artery. This is then inflated to widen the artery, squashing fatty deposits against the artery wall so that blood can flow through it more freely when the deflated balloon
is removed. Then a stentwill be placed in the previously narrowed segment of the Artery to prevent Recoiling of the Plaque.
A coronary angioplasty usually takes between 30 minutes and two hours depending upon the individual lesion. After the procedure, the patient will be put under observation and monitored overnight. If, no complication is found then the next day the patient will be discharged.
Is there a limit to the number of stents to be implanted in angioplasty?
The number of stents to be implanted is determined by the lesion characteristics. Normally, doctors prefer to use lesser number of stents to maximize procedural outcome and minimize the complications.
Is Obesity a risk factor for cardio vascular problems?
Obesity is associated with numerous co-morbidities such as cardiovascular diseases (CVD), type 2 diabetes, hypertension, certain cancers and sleep apnea/sleep-disordered breathing. On
the whole, overweight/obesity predisposes cardiac complications such as coronary heart disease, heart failure and sudden death through its impact on the cardiovascular system. Obesity
is also associated with reduced life expectancy.
What are the ways to avoid cardio vascular problems?
Adopting healthy life style such as smoking cessation, restricting alcohol consumption improving physical activity, maintaining optimal body weight, eating high fiber diet with lesser consumption of fat and keeping blood sugars and blood pressures under control will help
prevent cardiovascular problems.
What is the reason for re-occlusion in the place where stent is implanted?
The re occlusion in the stent may happen due to many reasons.The occlusion of the stents is due to Platelet activation, poor adherence to Dual Antiplatelet therapy,failure of antiplatelet therapy, small diameter of the Vessel, long segment disease, association of heart failure, comorbidities like renal failure, etc.
Who is at risk for open heart surgery?
People with Left main and or triple vessel disease with Proximal Left Anterior Descending disease, Poor Left Ventricular function will benefit from CABG. It depends on severity of
disease, calcification, long standing diabetes etc. may need open heart surgery.
Queries from the Readers:
My parents are not diabetic and do not have medical history for high levels of cholesterol. But I have cholesterol. Is that a risk factor for cardio vascular problems?
Cholesterol is a soft, waxy substance found in the bloodstream and in all the body’s cells. It is important to the healthy functioning of our body. Cholesterol is carried through our blood by
particles called lipoproteins: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
High levels of LDL cholesterol lead to atherosclerosis increasing the risk of heart attack and ischemic stroke. HDL cholesterol reduces the risk of cardiovascular disease as it carries cholesterol away from the blood stream. I had thrombolysis 2 years back. I have chest pain while climbing steps. Medical history shows 85% block in 2 arteries.
What do you suggest?
You have Chest pain and documented disease in the Coronary angiogram. The angiogram needs to be reviewed. As you have a history of Heart attack and thrombolysis in the past, it is important to assess the following: Pumping function of the heart, Presence of Valvular regurgitation and myocardial viability.
Revascularization options like Coronary Angioplasty with stenting or Coronary Bypass surgery may be decided after thorough assessment.
I am 55, obese and weighing 98kg, diabetes under control, BP is slightly low, not able to reduce weight. I am worried about future. Am I at a risk for heart attack?
Diabetes and obesity are both associated with a clustering of atherogenic risk. Increased risk of cardiovascular disease is two-fold in men and three-fold in women.
Comprehensive care should include not only normalization of the blood sugar, but also weight reduction, dietary fat restriction, strict blood pressure and lipid control, exercise, and avoidance of tobacco.I am a 50 year olds male, frequent traveller. Highly stressed because of position and multi tasking, BP is 150/100. I strictly follow a proper diet pattern. Suggest me the ways to relieve stress and avoid cardio vascular problems. Go for regular walking, do Aerobics and try to relax with meditation and music. Meet your physician periodically and keep your Blood Pressures under Control. Rule out other comorbidities like Diabetes and High Cholesterol.
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