Q1. What is coronary artery disease?
Coronary artery disease takes place when an upsurge of plaque i.e. fatty deposits, cholesterol and calcium get stuck to the walls of the arteries, causing narrowing and blockages, therefore reducing the flow of blood to the heart. Such kind of blockages often result in pain known as angina. If the disease goes untreated, clots may form, resulting in a heart attack.
Q2. What are the risk factors for coronary artery disease?
Following are risk factors for coronary artery disease:
Q3. What is Coronary angiography, Angioplasty and a Stent?
Coronary angiography is a diagnostic process that is performed for detecting the blockages in the blood vessels of the heart. A radio-opaque dye is injected in the coronary arteries with the help of a thin tube and images are taken under cath-lab. It shows the narrowing of the lumen of blood vessels if there is blockage.
Coronary Angioplasty is a medical procedure used to restore the blood flow through a blocked artery. In this non-surgical procedure, a thin tube with a balloon is inserted to expand the site of blockage in the coronary artery. It is also referred to as PTCA (percutaneous transluminal coronary angioplasty).
A stent is a stretchy wire mesh tube that is inserted into the expanded artery for keeping it open and allowing the flow of blood.
Stents are of two types:
Q4. Why are coronary angiogram and angioplasty/stents performed?
Coronary angiography is not only an all-encompassing process, but also the most conclusive tool for diagnosing the suspected heart disease and also find out the option for the best treatment. The expansion of the arteries that are blocked through angioplasty and also keeping the arteries open with stents brings improvement in the flow of blood to the heart, which reduces the risk of heart attack and irregular heart rhythms.
Q5. How long does the process take?
The time that is needed in this process varies, but angiogram generally takes around 30 to 45 minutes, with approximately four hours of recovery time after the procedure.
Angioplasty and an insertion of the stents might take about a half an hour's time up to many hours which depends on the nature and extent of the coronary disease.
Q6. What occurs after angiogram and angioplasty/stents?
After angiogram, the patient is monitored while in the recovery area before given a discharge. If the process was of angioplasty/stents, one has to stay overnight, during which the patient is closely observed. In both the cases, the patient must have someone to accompany since one is not in a condition to drive.
The doctor discusses the preliminary results of the angiogram before the patient is discharged. There is discussion about any side effects that a patient might experience at home. Sometimes, the use of clot-preventing medicines are also prescribed after the process.
Q7. Is Angioplasty done only for the heart?
The procedure of angioplasty can be conducted for broadening blockage in several blood vessels of the body. If it is being done for coronary blood vessels, it is known as coronary angioplasty. Angioplasty can also be done for blocks in other blood vessels such as carotid artery.
Q8. What is a patient asked to do after the angioplasty?
A patient is asked to drink lots of water to help flush away the iodine contrast dye from the body system. On the site of insertion, a sandbag or pressure bandage is placed to prevent the bleeding and will be asked to take rest for next few hours.
Q9. When should a doctor be contacted?
One should contact a doctor if:
Q10. What are the risks involved in the process of angioplasty?
Following are the risks involved in the procedure of angioplasty:
Q11. Can a patient lead healthy normal life again after angioplasty?
There are excellent chances of leading a healthy life & go back to work. Most people are back to their earlier lifestyle within 3 days after angiography if they have not suffered for heart attack & if ejection fraction of heart is >50%.
All that needed is to make a few modifications in lifestyle in terms of Diet, Exercise etc which will help to become normal much faster and prevent the chances of Restenosis.
Q12. Can a patient get coronary artery disease again?
Angioplasty opens dangerous block but other portion of that artery & other arteries can also get deposition as patient grows older. So, no one can say whether one can get Coronary Artery Disease again or not.
BUT, one thing is for sure that if all the controllable risk factors like Exercise, Diet, Blood Pressure, and Diabetes etc. are well taken care of then the chances of recurrence are very less.
Q13. Can a patient smoke after angioplasty?
Smoking causes blood vessels to constrict.Imagine what will happen to already narrowed and damaged blood vessels. SO QUIT.
Q14. When can a patient go back to work?
90% of the patients resume work within a week. What kind of work one should take depends on the severity of the damage and the job profile.
Getting busy and involved will result in quicker recovery. But the best person to advice when to start working is the doctor.
Q15. What kind of diet is to be followed?
- Avoid fried, fatty thing especially saturated trans-fat.
- Eat more vegetables & fruits
- Select whole grain and high fiber diet
Q16.What kind of exercise is to be followed?
Avoid isometric exercise like weight lifting,dumbbell, bench press etc. Isotonic exercises like walking, swimming, cycling is good for heart patients.
Duration & intensity depends upon individual capacity. It should be symptom limited exercise in the first few months.
Q17. Can the stent change its position or slip from the place where it was deployed after it is implanted?
No. The stent is implanted into the artery firmly with a balloon at high pressures by a balloon. Moreover, after a few weeks, the stent gets covered by the lining of the artery and becomes a part of the artery so there is no chance of the stent moving from its place.
Q18. Does a stent rust in the body since is made of steel?
The material that is used to manufacture a stent is a special type of medical grade steel which is a rust proof material. This does not rust inside the body. These days stents are usually made of Cobalt Chromium & Platinum.
Q19. Can a stent get deformed by putting pressure on chest externally or will it pinch the heart or other organs around it?
The heart is inside the chest cavity and no amount of pressure externally will reach the stent deployed inside the artery. The stent is placed inside the artery and as such gets covered by lining of the artery and hence can never pinch or prick any other part of body.
Q20. Can a patient go through an X-Ray or CT scan or MRI post stenting?
X-Ray or CT scan can be done at any time, MRI can be done after one and half month of procedure (please consult your Doctor before MRI).
Q21. Will the presence of the metallic stent inside the artery cause the security or metal alarm go on during security checks etc. like on airport security checks?
NO