Angioplasty Overview: Meaning, Procedure, & Risks





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Angioplasty Overview: Meaning, Procedure, & Risks

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Coronary Artery Bypass Grafting (CABG)



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Angioplasty Overview


Angioplasty is a non-surgical procedure, which opens blocked coronary arteries and restores blood flow to the heart. 

The heart is a muscular organ at the centre of the circulatory system that contracts and relaxes rhythmically to pump blood into different blood vessels, which carries it to the different parts of the body. 

The coronary arteries supply oxygen-rich blood to the heart.
If any of the coronary arteries become narrow or blocked, due to cholesterol buildup and fatty deposits (plaque), the blood flow to that part of the heart becomes slow or gets blocked as a result. The plaque accumulates over time and the arteries harden. The hardened arteries are unable to expand to their fullest capacity, thereby reducing the flow of oxygen and blood supply to parts of the heart. 


When a particular part of the heart does not receive enough oxygen or blood, tissue damage or death may occur in that part, unless the blockage is quickly removed. This can result in a condition called Coronary Atherosclerosis or in simpler terms, clogged arteries, which can lead to chest pain (also known as angina), or even a stroke, or a heart attack. 


The signs and symptoms of Coronary Atherosclerosis include :


  • severe chest pain, which gets worse with emotional stress or vigorous physical activity
  • sensation much like an elephant sitting on the chest
  • irregular heart palpitations
  • shortness of breath
  • nausea
  • dizziness
  • weakness


The factors which can put people at a risk of developing Coronary Atherosclerosis include:

  • leading a sedentary lifestyle
  • excessive smoking and drinking (almost 40% of the heart patients in India are chain-smokers)
  • diabetes
  • high levels of cholesterol
  • an unhealthy diet
  • prolonged high blood pressure/low blood pressure
  • depression


This condition can be corrected with the help of an angioplasty procedure. 

Depending on the size of the blockage, the type of angioplasty, and the patient’s medical condition, the duration of the procedure may vary from 30 mins to 3 hours.  The cost of the procedure can range anywhere between Rs. 1,00,000 to Rs. 3,60,000 in India.



Usually, local anesthesia is used for the angioplasty, however, some cases require general anesthesia. Patients who are administered general anesthesia may require hospitalization for 2 days or less. Patients who tolerate the procedure well generally do not need to stay overnight in the hospital.


What kind of a doctor should I consult if I suffer from heart-related symptoms?


If you experience any of the aforementioned symptoms of coronary atherosclerosis or any other heart-related symptoms, you should immediately consult your family doctor or a general physician. The general physician, in turn, will refer you to a cardiologist. 

Cardiologists are the doctors who specialize in diagnosing and treating heart-related conditions and heart diseases.

Before the procedure, the cardiologist will review your medical history in detail to find out the risks involved, if any. If the tests performed confirm the diagnosis of coronary atherosclerosis you will be suggested to undergo the angioplasty procedure.


The angioplasty procedure is performed in a cardiac catheterization laboratory (cath lab) in a hospital. 


How is Coronary Atherosclerosis diagnosed? 


Coronary Atherosclerosis or clogged arteries can be diagnosed using several methods such as:



  • Electrocardiogram (ECG): A tool which measures and records the electrical impulses of the heart and displays how fast or irregular the heartbeat is.
  • Echocardiography: A scan performed utilizing sound waves to create moving images of the heart and shows how the heart is working.
  • Angiography: An imaging technique which uses a dye and x-rays to reveal blocked arteries.
  • Multislice Coronary Computed Tomography Scan (CT Scan): A scan which shows computer-generated pictures of the narrowed and hardened arteries.


What are the different types of angioplasty?


There are different forms of angioplasty.  The type of angioplasty the cardiologist chooses to perform varies according to the following factors:

  • the location of the block/plaque in the heart
  • the shape of the block (plaque)
  • whether the plaque responsible for the clogging of the artery is hard or soft


Depending on the factors mentioned above, the cardiologist may recommend any of the following types of angioplasty:

What is the cost of the different types of angioplasty in India? 


Depending on the patient’s condition and the hospital amenities, the cost of each type of angioplasty can range between Rs. 1,00,000 to Rs. 3,60,000.


What is the time taken to perform each type of angioplasty? 


Depending on the patient’s condition and requirement, a cardiologist can take anywhere between 30 minutes to 3 hours to perform each type of angioplasty.


How much time does it take to recover from each type of angioplasty?


In general, patients are able to walk around within a few hours after undergoing the angioplasty procedure, depending on how the procedure went and where the catheter was placed.

Complete recovery takes about 5 - 7 days. 


References


1. Grundfest, W., Litvack, F., Hickey, A., Doyle, L., Glick, D., Lee, M., Chaux, A., Treiman, R., Cohen, L., Foran, R., Levin, P., Cosman, D., Carroll, R., Morgenstern, L. and Forrester, J. (2018). [online] The current status of angioscopy and laser angioplasty.[online] Available http://www.jvascsurg.org/article/0741-5214(87)90251-5/fulltext [Accessed 22 Feb. 2018].

2. Hueb W, Soares P, Almeida de Oliveira S et al. Five-Year Follow-Up of the Medicine, Angioplasty, or Surgery Study (MASS): A Prospective, Randomized Trial of Medical Therapy, Balloon Angioplasty, or Bypass Surgery for Single Proximal Left Anterior Descending Coronary Artery Stenosis. 2018. Available at: http://circ.ahajournals.org/content/100/suppl_2/II-107. Accessed February 26, 2018.

3. Aoki T, Sugimura K, Tatebe S et al. Comprehensive evaluation of the effectiveness and safety of balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension: long-term effects and procedure-related complications. 2018. Available at: https://academic.oup.com/eurheartj/article-abstract/38/42/3152/4209323. Accessed February 26, 2018.


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