Cardiac Catheterization
If your doctor suspects you have coronary heart disease, he or she may recommend that you undergo cardiac catheterization (also called an angiogram). During
catheterization, x-ray dye is injected into the coronary arteries and pictures are taken. In patients with coronary heart disease, the pictures show the actual blockages and their severity. Treatment Options
Several options are available for treating patients with coronary heart disease. Medications
Medications can help reduce symptoms of angina either by improving the supply of oxygen to the heart muscle and/or by reducing the heart's need for oxygen. However, drugs do not get rid of existing coronary blockages.
Bypass Surgery
Bypass surgery is an operation in which surgeons create a bypass (detour) to allow blood to go around blockages in the coronary arteries. To make a bypass, surgeons use a graft–a blood vessel from the leg or chest. With the graft in place, blood can now flow freely to the heart muscle, bypassing the blocked or narrowed section of the artery. A week's stay in the hospital is usually necessary after the surgery. It may take up to three months to fully recover after this type of surgery.
Coronary angioplasty is a technique used to open narrowed arteries without surgery. A special catheter with a small balloon at its tip is passed into the artery. The balloon is inflated, compressing the
fatty plaque against the artery's walls. The larger opening allows better blood flow to the heart muscle. Although angioplasty is successful in most cases, it also has limitations. In particular, the blockage in
the artery may recur. To help prevent the artery from closing off, doctors may decide to implant a coronary stent. Coronary Stent
A coronary stent is a small device that's placed in an artery to keep it open. The stent is mounted on a balloon catheter and delivered to the site of blockage. When the balloon is inflated, the stent expands and is pressed against the inside wall of the artery. After the balloon is deflated and removed, the stent remains in place, keeping the artery open. Preparing for Angioplasty
Unless you are already hospitalized, you probably will be admitted to the hospital on the day of the
procedure or the night before. Several routine lab tests will be performed, including an ECG and blood tests. (Blood tests may be done one or two days before the procedure.) The doctor performing the angioplasty
will review your medical history and examine you. (You may be seen by the doctor at the office several days before the procedure.) The doctor will explain the technique, its purpose, potential benefits, and possible
risks. This is a good time to ask questions and, most importantly, to share any feelings or concerns you may have about angioplasty. You will then be asked to sign a consent form. A nurse will shave and
cleanse the area where the catheters will be inserted. In most cases, this will be the groin; in some cases, the crease of the arm. Shaving and cleansing makes it easier to insert the catheters and helps to
avoid infection. <BACK CONTINUED>
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