BOSTON—Advances like artery-opening angioplasty, which restores healthy blood flow to oxygen-starved heart muscle without opening the chest, splitting apart the breastbone, and stopping the heart, are true marvels of modern medicine. The problem with marvels is that we come to expect too much from them.
That has happened with angioplasty, reports the December 2010 Harvard Heart Letter. This procedure uses a small wire tipped with a balloon to enlarge a narrowed artery. Although many people think of angioplasty as a cure for cholesterol-clogged arteries, it really isn’t. It can ease angina, the chest pain brought on by physical activity or stress, but it doesn’t fix the real source of the problem—the artery-clogging process known as atherosclerosis.
Angioplasty does not halt the spread of atherosclerosis or prevent the damage it causes. As a result, it doesn’t reduce the chances of having a future heart attack or improve survival.
Many people don’t know this, and doctors don’t always take the time to drive home this point. That means angioplasty can create a false sense of security that you have taken care of the problem, when in reality atherosclerosis continues to corrode arteries in your heart and elsewhere.
A new study of men and women planning to undergo elective angioplasty showed that 60% didn’t really need the procedure and would have been better off with intensive medical and lifestyle therapy, while a whopping 88% said they believed that the procedure would help protect them from having a heart attack down the road.
If you are having a heart attack or episode of unstable angina (chest pain at rest)—both of which are caused by a completely blocked artery—angioplasty is a terrific treatment. It removes the obstruction, allowing blood to once again reach all parts of the heart. Timely angioplasty can limit damage to the heart and can prevent a heart attack from turning into a deadly cardiac arrest.
During a heart attack, the huge benefit of angioplasty outweighs the risks. That isn’t necessarily the case when angioplasty is performed to open a narrowed but functioning artery. Although most people sail through angioplasty without a problem, about five in every 100 people who undergo the procedure have a complication. These range from prolonged bleeding to kidney damage, an abnormal heart rhythm, or heart attack or stroke.
If you are having a heart attack, angioplasty is a marvelous procedure. But if you are having angina now and then, or have a narrowed coronary artery that isn’t causing you any trouble at all, angioplasty adds little or nothing to intensive medical therapy and lifestyle changes.
Read the full-length article: “What can angioplasty do for you?”
Also in this issue:
- The best protein “packages” for the heart
- Who should be tested for an enlarged aorta?
- Alcohol: Moderation matters, especially with high blood pressure
- Snow shoveling and stents
The Harvard Heart Letter is available from Harvard Health Publications (www.health.harvard.edu), the publishing division of Harvard Medical School, for $28 per year. Subscribe at www.health.harvard.edu/heart or by calling 877-649-9457 (toll-free).
Media: Contact: Raquel Schott Raquel_Schott@hms.harvard.edu for a complimentary copy of the newsletter, or to receive our press releases directly.
