Prevent Heart Attack Risk with Angioplasty: When to Consider Surgery

Currently, fake news about Amitabh Bachchan’s angioplasty has gone viral on social media. Amitabh had to clarify the talk about angioplasty as ‘misinformation’.

According to statistics, nearly 4.5 million people undergo angioplasty in India every year. At the same time, 40 to 50 million people in the country suffer from Ischemic Heart Disease (IHD), accounting for 15 to 20% of deaths. In this situation, there is a need to clear the arteries of the heart, which can become the cause of heart attacks.

Similarly, when there is a blockage in the arteries due to high cholesterol or clots, angioplasty is performed. This blockage leads to a decrease in blood supply to the heart, increasing the risk of a heart attack. This is why people who experience chest pain during exertion or weight gain often undergo angioplasty as a preventive measure.

So, what exactly is angioplasty? You can learn that as well:

When should angioplasty be done?

What to do after angioplasty?

Expert: Dr. Manish Bansal, Senior Director, Clinical and Preventive Cardiology, Cardiac Care, Medanta, Gurugram

Question: What is angioplasty?

Answer: Angioplasty is a procedure that opens blocked arteries and blood vessels. When angioplasty is done in the heart, it is called coronary angioplasty.

Doctors resort to angioplasty to save a patient’s life after a heart attack or stroke. It can be done through the hand (radial artery) or leg (femoral route).

After injecting into the artery, a small tube is inserted into the hand or leg to insert a catheter and a wire tube. This wire crosses the blockage path. The obstruction is then opened by a balloon, creating a passage. Then a stent is placed there to prevent re-blockage. Angioplasty is successful in 95% of cases and has become a standard procedure for managing heart conditions.

After this process, the patient is monitored in the ICU or CCU for some time. The patient is kept in the hospital for about 24 to 48 hours. Simply put, angioplasty or stent placement is a life-saving procedure under the supervision of a skilled cardiologist.

Question: When should angioplasty be done?

Answer: Angioplasty should be done when there is 70% or more blockage in the blood vessels. Typically, these symptoms are seen:

• Difficulty breathing during walking
• Chest pain
• More severe symptoms during exertion or weight gain.

If these symptoms are not controlled by medication, angioplasty should be considered. In serious conditions, when there is 80-90% blockage and severe symptoms, angioplasty can also prevent a heart attack. If there is not enough blockage (70-80%) and no symptoms are observed, medication can control it for some time.

Question: What precautions should be taken after angioplasty?

Answer: If angioplasty is done in the leg, it is very important to keep the area clean. Excessive activity or running can cause bleeding or bruising at the site. If this happens, you should contact your doctor immediately. Resting in bed for about a week is advised for healing. After that, you can slowly start walking or do light exercises.

Sometimes bleeding around the vein or red bumps may be seen in the area, which usually takes about 2 weeks to heal. For this, you can apply ice to the area.

If angioplasty is done through the hand, it is important not to hang the hand for a long time, as it can cause more pain. It is very important to check for any signs of blood clotting in the hand or arm.

If there is severe pain or swelling in the hand or arm, you should consult a doctor immediately.

In addition to this, regularly take the medicines prescribed by the doctor. If you do not take the medicine, there is a risk of re-blockage and heart attack.

Life after Angioplasty

Answer: Generally, life after angioplasty remains normal. Most often it depends on the function of the person’s pump. If you take medication regularly and maintain a healthy lifestyle, you can return to normal activities after a few days of rest. After recovery, a person can resume their work.

Question: How is life after heart attack?

Answer: It is important to know how much pumping capacity the heart has. For this, you can ask your doctor or check the 2D report. It is expressed as EF (Ejection fraction), meaning how much blood your heart can pump out at once. For example –

• When it is more than 50%, it is normal.
• There is mild dysfunction between 40-50%.
• Moderate dysfunction is between 40-30%.
• Below 30% is a serious dysfunction.
• Less than 20% is very serious, risking death.

Comparison between Balloon Angioplasty and Stent Angioplasty

Answer: Previously, when stent technology was not available, balloon technology was used. In this, the balloon was inflated with air or fluid to remove the blockage. In such a situation, there was a risk of blockage recurring or coming back to a similar condition. With stenting, there is no chance of the tube getting blocked; it stays open. There is no possibility of re-blockage in the pipe. Experts say that if stenting is possible, it should be done, otherwise balloon angioplasty should be done only when stenting angioplasty is not possible for any reason.