Coronary Angioplasty

What is a coronary angioplasty?

A coronary angioplasty is a procedure used to help clear blocked or narrowed coronary arteries (the main blood vessels supplying the heart). If a stent is inserted during the coronary angioplasty, the procedure may be called percutaneous coronary intervention (PCI).

A patient with reduced blood flow to the heart may have chest pain called angina. This condition (also known as coronary artery disease) is usually treated with medication. When medication becomes ineffective, coronary angioplasty may be done electively to improve the blood supply. Coronary angioplasty can also be done by a cardiologist as an emergency treatment after a heart attack.

When should I see a specialist for a coronary angioplasty?

You may consider seeing a specialist if your angina bothers you, or if you are not feeling as well as you would like to. It is likely that your cardiologist may perform an angiogram first to determine the extent of the blockage in your arteries.

Did you know?

South Asians, especially Indians, are more vulnerable to developing coronary heart disease at a younger age (less than 45 years old). In these patients, the most commonly associated risk factor is smoking. Those who are obese and currently smoking have poorer outcomes¹.

What are the risks of a coronary angioplasty?

A coronary angioplasty is one of the most common types of treatment for coronary artery disease.
The risk of developing serious complications is considered to be low but this is dependent on your

● age
● general health
● previous history of a heart attack

Serious complications that can occur during the procedure include excessive bleeding, a heart attack, or a stroke.

How should I prepare for my appointment?

As your cardiologist will ask you for your past medical and family history, be prepared with the following information:
● Current symptoms that you are experiencing including those that seem unrelated
● Current or previous medical conditions including any treatments such as diabetes or stroke
● Results of previous laboratory tests such cholesterol tests
● List of medications, vitamins, or supplements currently being consumed.
● Be prepared to discuss your diet and your smoking and exercise habits. If you don’t already follow a diet or exercise routine, discuss getting started with one.

If possible, bring someone along with you to help remember what the cardiologist tells you.

To enable you to decide on whether you would want a coronary angioplasty, you may wish to ask the cardiologist the following questions:

● How many arteries are blocked?
● What is the extent of the blockages?
● What are the signs that I need to go to a hospital or seek treatment right away?
● Are there any alternatives to the treatments suggested?
● I have other health conditions. How do I manage them together?

What can I expect during a coronary angioplasty?

The coronary angioplasty is done using local anaesthetic which means that you will be awake during the procedure. A very thin tube called a catheter will be inserted into one of your arteries either in your groin, wrist or arm. Using an X-ray camera, the catheter will be guided to your heart. The cardiologist will inject some contrast dye to better visualise the anatomy of the heart.

When the catheter is in place, a thin wire containing a balloon will be fed through to the affected artery. The balloon will be inflated to press the fatty deposits blocking the artery against the artery wall so that blood can flow more freely. The balloon is then deflated and removed.

If a stent is inserted, the stent will be placed outside of the balloon and will expand as the balloon is inflated. When the balloon is removed, the stent will be left behind to keep the affected artery open.

A coronary angioplasty usually takes between 30 minutes and two hours.

What happens after my coronary angioplasty?

If you are being treated for angina, you are likely to be allowed to go home either on the day of or the day after the procedure. If you are having this done because of a heart attack, you may need to stay in hospital for several days.

You are likely to be advised to drink plenty of fluids to flush the contrast dye from your system and avoid any heavy lifting or strenuous exercise for at least a week. This allows the area in the coronary artery as well as the groin or arm arteries to heal.

If you have any of the following signs after the procedure, you should contact your cardiologist.

● Signs of infection such as fever, swelling at the site where the catheter was inserted
● Change in colour, pain, or bleeding at the site of catheter insertion
● Feeling faint or weak
● Shortness of breath

1. Aggarwal A, Srivastava S, Velmurugan M. Newer perspectives of coronary artery disease in young. World J Cardiol. 2016;8(12):728-734. doi:10.4330/wjc.v8.i12.728.