Heart Attack And Unstable Angina: Other Treatment

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Other Treatment

In the past decade, angioplasty, also known as percutaneous coronary intervention (PCI), has become a common procedure in large medical centers in the United States. Angioplasty is done during cardiac catheterization or coronary angiogram.

During a cardiac catheterization, a tiny tube (called a catheter) is threaded through an artery of an arm or leg up into the heart and a dye that contains iodine is then injected through the catheter. The dye makes the coronary arteries visible on a digital X-ray screen. The doctor can then see on a TV screen whether your coronary arteries are blocked and how your heart is beating. If an artery appears blocked, angioplasty with or without stent placement may be done during the catheterization to open the blockage.

Studies show that angioplasty with stent placement, compared with angioplasty only, reduces the chance that the artery will renarrow and possibly reduces the risk of death.¹⁸ (See a picture of stent placement ). Angioplasty with stent placement is less invasive and expensive than bypass surgery and is the preferred treatment for most people with a heart attack.

In some cases a heart attack causes enough muscle damage that your heart's pumping capacity is decreased. In this case, your doctor may recommend placement of a type of pacemaker called an implantable cardioverter-defibrillator (ICD), especially if you have life-threatening abnormal heart rhythms.

What to Think About

Even with stents, an artery can renarrow after angioplasty, although recent innovations are improving the long-term success of this procedure. Drug-eluting stents are coated with medicines that prevent the artery from renarrowing. Experts do not know yet how safe the drug-eluting stents are over the long term or how well they work over the long term.

Although studies are not conclusive, folate therapy (taking a combination of folic acid, vitamin B₆, and vitamin B₁₂) may be harmful after stent placement and probably should be avoided.²⁷ Instead, try to get enough vitamin B by eating a balanced diet.

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Last updated:	May 14, 2007
Author:	Robin Parks, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
Editors:	Kathleen M. Ariss, MS, Pat Truman