Heart Disease - Treatment Options
Methods to clear your arteries and help save your life
If you were a car, your heart would be the engine that keeps you running. But your car can't run if it doesn't have gas. And your heart can't beat without a steady flow of blood.
Fortunately, mechanics can fix cars, and expert medical care can help keep hearts from stalling.
Blocked arteries
A common reason for reduced blood flow to the heart is atherosclerosis—the buildup of fatty deposits called plaque inside artery walls. Over time, hardened plaque can narrow the arteries, reducing or even stopping blood flow.
If the condition develops in arteries on the heart's surface, it's called coronary artery disease (CAD)—the leading cause of death for men and women in the U.S.
If you have CAD, your doctor may recommend angioplasty or coronary artery bypass graft surgery to keep the blood flowing. “For some patient’s angioplasty or coronary artery bypass surgery may be the best method of treatment. However, for all patients, whether or not they have surgery a healthy diet and an active lifestyle are essential to a healthy heart,” Stephen Jones, MD, Saint Alphonsus Cardiothoracic Surgeon.
The kind of treatment depends on how severe the blockages are, where they're located and what other medical conditions you may have.
Angioplasty is often used when the artery is not completely blocked and the blockage can be reached using a long, thin plastic tube called a catheter. The procedure can also be used during a heart attack to quickly open a blocked artery.
Bypass surgery could be recommended if you have severe heart disease or multiple arteries that are blocked or if you have diabetes or heart failure. In an emergency, it can be performed during a heart attack.
About angioplasty
During angioplasty, a cardiologist makes a small cut in your arm or upper thigh to insert a catheter with a deflated balloon at the tip.
The catheter is threaded through a blood vessel and into the artery in the heart until it reaches the blockage. The balloon is then inflated to push the plaque back against the artery wall.
Once the plaque is compressed, the balloon is removed. A small wire mesh tube called a stent may be placed in the artery to help hold it open and to reduce the chance that the artery will become blocked again.
Angioplasty reduces angina (chest pain) and shortness of breath associated with CAD. It can also minimize damage to the heart muscle from a heart attack and reduce the risk of death from heart disease in some people.
A hospital stay of a day or two is typical, and recovery can take less than a week.
Though angioplasty is generally considered safe, side effects can include blood vessel bleeding, an irregular heartbeat, heart attack or kidney damage.
About bypass surgery
Traditional bypass surgery requires cutting the breastbone open and stopping the heart while a heart-lung machine circulates blood. After the surgery is completed, mild electrical shocks restart the heart.
Sometimes a surgeon operates while the heart is still beating. This off-pump technique—so named because the technique doesn't require the use of the heart-lung machine—may reduce complications for people who have had a stroke, are 70 or older, or have diabetes or lung or kidney disease.
During either type of bypass surgery, a healthy artery or vein is removed from another part of the body and then connected—or grafted—to the blocked artery. This allows blood to flow through the bypass to the heart.
As many as four blocked major heart arteries can be bypassed during one surgery, according to the National Heart, Lung, and Blood Institute.
Traditional bypass surgery generally takes three to five hours to perform. You may need to recover in the hospital for up to a week and at home for up to 12 weeks or more. Risks include bleeding during or after the surgery, reactions to anesthesia, fever, pain, stroke, or a heart attack.
Off-pump surgery may require less recovery time and may have fewer complications.