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Health Matters: Elective Coronary Angioplasty Offers Relief for Heart Disease Symptoms

By Andrew Shanahan, MD

In the United States someone has a heart attack every 40 seconds, according to the Centers for Disease Control and Prevention.

Many heart attack patients will undergo emergency angioplasty to open their artery quickly and restore blood flow to the heart muscle.

But did you know you don’t have to wait until a heart attack strikes to benefit from angioplasty?

At Penn Medicine Princeton Medical Center (PMC), elective coronary angioplasty can be performed in a non-emergency setting and offer relief for heart disease symptoms, including chest pain and shortness of breath.

What is angioplasty?

Angioplasty is a procedure to open clogged arteries and increase the flow of blood and oxygen without the need for invasive heart surgery.

During the procedure, an interventional cardiologist inserts a small, thin tube called a catheter into the artery.

When the catheter is inserted, it is carefully maneuvered into the clogged artery on the outer surface of the heart. The cardiologist uses advanced technology and a high-definition screen to ensure precise placement.

Once the catheter is in place, a tiny balloon is inserted and quickly inflated and deflated. This pushes the cholesterol plaque that is blocking the artery into the artery wall, clearing the blockage and improving blood flow.

In most cases, a tiny metal cylinder or coil called a stent will also be put in place during the procedure. The stent contains a medicine on its surface that helps prevent the artery from becoming blocked again in the future.

Patients are normally under moderate sedation during the minimally invasive procedure to keep them comfortable.

Is elective coronary angioplasty right for you?

You may be a good candidate for the procedure if you have a significant narrowing or blockage of a coronary artery, or you have symptoms of heart disease caused by a hardening of the arteries.

Heart disease symptoms can include:

• Chest pain or discomfort, also called angina.
• Shortness of breath.
• Dizziness.
• Swelling of the legs.

Your physician may recommend elective coronary angioplasty if you:

• Have had a heart attack.
• Have significant narrowing or blocking of your coronary arteries.
• Have had an abnormal cardiac stress test.
• Have a heart rhythm disorder.
• Are not feeling better despite medicines and lifestyle changes to treat hardening of the arteries.
• Have previously had a coronary bypass grafting (CABG) to treat a blockage or narrowing of one or more of the coronary arteries and an area has closed or narrowed.

If you or a loved one is suffering from symptoms of heart disease or shortness of breath that interfere with daily life, talk to your primary care physician or cardiologist about the benefits of elective coronary angioplasty and whether you are a candidate.

What to Expect After Elective Angioplasty

The majority of patients recover quickly from elective coronary angioplasty and experience immediate improvement in symptoms such as chest pain, pressure, or shortness of breath.

As with many procedures, there are risks. However, the risk of complications, most commonly bleeding at the incision site, is low.

Most patients go home the same day or the next morning and recovery time at home is minimal. Most patients find that they can resume their normal activities within a week after the procedure.

It is important to note that having the procedure does not mean your heart disease goes away. You may need to take medication and make lifestyle changes to improve your heart health.

For instance, after the procedure, your cardiologist may prescribe medications such as aspirin and aspirin-like blood thinners to help keep the stent clear.

Your cardiologist may also prescribe medicines to help manage your cholesterol level, regulate your blood pressure, or both. You may also be advised to make lifestyle changes to help prevent future heart disease, such as quitting smoking, eating a healthy diet and becoming more active.

In some cases, your doctor may recommend a cardiac rehabilitation program to help you learn how to live a healthier lifestyle and manage your long-term heart health.

For patients who undergo angioplasty with a stent and who take the medicines prescribed by their doctor and follow other heart health recommendations, there is a slight risk — just under 10% — of the treated artery becoming clogged again.

Following an angioplasty, most patients continue under the care of their primary care physician and a cardiologist to regularly monitor their blood pressure and cholesterol and to help maintain overall good health.

Expert Cardiac Care

Penn Medicine Princeton Medical Center’s Cardiac Care program provides comprehensive cardiac care, including emergency and elective coronary angioplasty as well as advanced cardiac testing cardiac rehabilitation, for patients with heart disease.

PMC received the 2022 Get With The Guidelines®–Heart Failure Gold Plus Quality Achievement Award from the American Heart Association (AHA). The Get With The Guidelines®–Heart Failure program is intended to speed recovery, reduce hospital readmissions, and improve the quality of life for people living with heart failure. Hospitals are recognized for their commitment to ensuring patients with heart failure receive the most appropriate care according to guidelines rooted in the latest scientific research.

PMC has been rated high performing in treating heart failure for eight years in a row by U.S. News & World Report.

To find a cardiologist affiliated with PMC, or for more information about the Cardiac Care program, call 888-742-7496 or visit www.princetonhcs.org.

Andrew Shanahan, MD, is board certified in internal medicine, cardiovascular disease, and interventional cardiology. He is the director of the Catheterization Laboratory and Coronary Intervention Program at Penn Medicine Princeton Medical Center.

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