A guide to understanding the differences between Medication, Angioplasty (with or without stenting), and Bypass Surgery.
Important Information:
Each treatment has benefits and risks that should be discussed with your doctor to fully understand the options and determine the best course of treatment for you. When determining the best treatment for you, many factors come into play. Factors such as age, lifestyle, and pre-existing medical conditions, are all considered. You and your doctor should determine the best treatment option for your situation.
Medication
(alone or in combination with a medical procedure)
Medication can include: Aspirin, anti-platelet medications (prevent blood clotting), statins (lower cholesterol), nitrates (open arteries of the heart), ACE inhibitors (widens arteries to improve blood flow), beta-blockers and/or calcium channel blockers (over time can improve the hearts pumping ability).
No hospital stay is traditionally required.
Heart disease may be treated with medicine alone or in combination with a medical procedure. Relief of symptoms, such as chest pain and shortness of breath, is likely over time.
Medication is used to:
- Treat narrowing of coronary arteries
- Control coronary artery disease risk factors such as high blood pressure, cholesterol, etc.
- Help reduce the workload of the heart
- Potentially reduce the risk of heart attack and prolong life compared to no treatment
Patient Type:
- Patients with existing risk factors for coronary artery disease
- Chest pain and/or shortness of breath during exertion (walking, climbing stairs, etc.)
Angioplasty (with or without stenting)
Angioplasty is a procedure that is performed through a catheter traditionally routed from a vessel located in the leg up to the heart. A medical device, such as a balloon, will be used to open the heart artery narrowed by plaque. It may involve placement of a stent (mesh tube) to help keep the vessel open. The stent may be coated with medicine. The patient is under local anesthetic and is awake during the procedure.
Traditional hospital stay is overnight.
Heart disease treated with angioplasty usually provides rapid relief of symptoms such as
chest pain and/or shortness of breath. The majority of patients return to regular life activities without chest pain in a short period of time.
Angioplasty is used to:
- Restore blood flow to the affected area of the heart by treating narrowed coronary arteries
- Provide prompt relief of chest pain and/or shortness of breath after procedure
- Potentially reduce the risk of heart attack and prolong life compared to no treatment
Patient Type:
- Chest pain during exertion if medication has failed or is not selected
- Continual or increasing chest pain and/or shortness of breath
- Often used for patients who are not candidates for surgery
Angioplasty with Stenting:
Coronary artery disease occurs when plaque builds up in the coronary
arteries and slows or blocks blood flow to the heart muscle.
Angioplasty is a procedure in which your doctor expands a tiny balloon
that presses the plaque blockage against the artery so that blood may flow more
freely through the vessel. A stent is inserted into an artery after angioplasty
to help ensure that blood continues to flow freely through the vessel
and to reduce the chance that plaque will block the artery again.
Bypass Surgery (or Coronary Artery Bypass Graft)
Bypass Surgery is open heart surgery that reroutes blood flow around a blocked vessel (or vessels) of the heart. The patient is under general anesthetic and is not awake during surgery.
Traditional hospital stay is 5-6 days.
Heart disease treated with bypass surgery reduces the need for repeat procedures in most cases. After recovery, it also provides symptom relief for the majority of patients and allows them to return to regular life activities without chest pain.
Bypass surgery is used to:
- Restore blood flow to the heart by rerouting the flow around blocked arteries
- Provide prompt relief of chest pain and/or shortness of breath after surgery
- Potentially reduce the risk of heart attack and prolong life compared to no treatment
Patient Type:
- Chest pain during exertion if medication has failed or is not selected
- Continual or increasing chest pain and/or shortness of breath.
- Often used for patients who are not candidates for angioplasty
Coronary Artery Bypass Graft
CABG is a surgery in which arteries or veins from elsewhere in the body are used to reroute blood around a blocked vessel of the heart.
Next Steps
Medication, angioplasty and bypass surgery treat the symptoms, but do not cure heart disease. Your follow up with prescribed medication and lifestyle changes (including exercise, weight control and no smoking) are all important steps that need to be taken following any treatment.
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