Is Angioplasty needed immediately after a Heart Attack?

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Summary

Heart attack is a heart event in which blood-flow to the heart muscles stops, almost completely. While in the past, medication and other measures were attempted as an emergency response, in recent years, angioplasty with stenting under a heart specialist has emerged as the most effective solution. In this article, we will learn why and how.

Introduction to Heart Attack

The heart is a complex machinery which relentlessly pumps blood to all parts of the body, as long as we are alive. It is made up of a muscular wall, four chambers, valves, and a vast network of blood-vessels. Large arteries and large veins connect to the heart. Tissues that act as batteries provide the necessary electrical signals for the heart’s smooth functioning.

Like any other part of the body, the heart too needs its constant supply of oxygenated blood, which is why we have the network of blood-vessels. Atherosclerosis is a condition in which cholesterol, certain salts and minerals start depositing on the inner walls of the large arteries which supply blood to rest of the body, called as coronary arteries. The deposits gradually grow and thereby narrow down the section of the artery, with the condition being called ‘stenosis’. This reduces the blood flow to other parts of the body, as well as the heart itself.

The deposits even harden over time, to form a plaque. This makes it difficult to flush away the deposits with merely the blood-flow. When the stenosis reaches a certain point where blood flow to the muscles of the heart is negligible, it triggers an event called ‘myocardial infarction’, more popularly called as ‘heart attack’. In such a case, the person has to be rushed to a heart hospital for emergency response, else, it can have life-threatening consequences.

What is Angioplasty?

Atherosclerosis has been around for ages. In the past, medication was the only option to destroy the plaque deposits. And when the situation did not change with medication, such people would have to either go through an open-heart surgery to remove those blockages, or undergo a Coronary Artery Bypass Surgery (CABG) to create a bypass around the blockage for blood flow to resume.

Balloon Angioplasty gave the world the possibility of doing away with open surgery. This has benefited people suffering from various ailments including atherosclerosis. In this procedure, an incision is made on the skin, in the wrist or groin region. A catheter (thin and flexible tube) with a deflated balloon that its tip, is inserted through the incision, into an artery, and gently pushed or threaded all the way up to the heart, to the precise site of the blockage. The balloon is inflated which pushes the blockage against the walls of the artery. The balloon is enclosed by a collapsed metal spring called stent (similar to the spring seen in pen refills). Inflating the balloon expands the stent. It holds up the deposits that have been pushed against the walls now. This way, the deposits will not drop down and create a blockage again (called re-stenosis).

Angioplasty with stenting is done under local anaesthesia with sedatives given to the person to reduce his/her discomfort. Patient can be discharged within 24 hours. The chances of re-stenosis are also less compared to mere medication given to cure atherosclerosis.

When is Angioplasty done?

Angioplasty (with or without stenting) is necessary to improve blood-flow to the heart. So, what are all the instances when angioplasty done?

1. When medication and lifestyle changes have not improved the symptoms of atherosclerosis and blocked arteries. This includes:

• Constant sensation of fluttering and racing heartbeats
• Unexplained weakness and nausea
• A weak or absent pulse
• Excessive sweating and shortness of breath (called dyspnoea)

2. When angina, or chest pain caused by the blockages are getting worse by the day. Now, they are disrupting the person’s professional and personal life.

3. As an emergency response after a heart-attack.

Coronary Angioplasty after a heart-attack (Primary Angioplasty)

There is enough awareness in the world today on what a heart-attacks looks or feels like. Family members of the person who is suffering from or suffered a heart-attack are able to recognize this. They, more often than not, rush the person to a hospital. This is the right thing to do.

Once the person is brought to the cardiology hospital, he/she may be unconscious generally. In some cases, he/she may be conscious, but in great pain. Even breathing may be difficult, with breaths coming in short, and violent gasps. The person is given medicines to stabilize his/her vitals immediately. Soon after, an angioplasty with stenting is done. This is the best response and has many advantages.

Advantages

• It is the most efficient way of restoring blood-flow to the heart again, quickly, thereby limiting cardiac muscle damage
• Quick restoration of blood-flow reduces damage to the heart muscle. This is important to prevent other complications from developing, and shortens the hospital stay
• It relieves chest-pain (angina), reduces shortness of breath (dyspnoea)and prevents other outcomes associated with a heart attack. Proven to be a life-saving procedure.
• It reduces the odds that you will require an invasive, open-heart bypass surgery if blockages develop again in the future.
• It also reduces the risk of another heart attack, especially if the person is rushed immediately (within 90 minutes after the onset of chest pain).
• It increases the person’s chances of survival more than medications that are given to break-up blood clots or plaque deposits.

Outlook

To answer the question posed at the beginning of this article, yes, an angioplasty with stenting under the supervision of the best heart doctor in Salem is necessary after a heart attack. It is a life saver, with those persons having had the procedure showing higher survival rates than those who did not. It also ensures long-term heart-health by preventing another heart-attack, preserving heart pump function. Needless to say, medication and lifestyle changes are necessary to sustain the good work done by the procedure. But nevertheless, it offers hope to a lot of people who routinely face the eventuality of a heart attack in today’s world, with many of the persons being youngsters or in their early middle age.

Frequently Asked Questions

1. What is Angioplasty?

Angioplasty is a medical procedure that opens blocked arteries to restore blood flow to the heart. It often involves inserting a catheter with a balloon and a stent to keep the artery open.

2. When is Angioplasty necessary after a heart attack?

Angioplasty, often called Primary Angioplasty, is needed immediately after a heart attack to quickly restore blood flow to the heart and minimize muscle damage. It’s most effective when done within 90 minutes of the onset of chest pain.

3. How does Angioplasty help after a heart attack?

Angioplasty rapidly restores blood flow, reducing heart muscle damage and complications. It shortens hospital stays, decreases chest pain, and lowers the risk of future heart attacks.

4. What are the benefits of Angioplasty with stenting?

Benefits include quick blood flow restoration, reduced muscle damage, lower risk of invasive surgery, decreased risk of another heart attack, and higher survival rates.

5. What happens during an Angioplasty procedure?

A small incision is made, and a catheter with a deflated balloon is inserted into an artery. The balloon is inflated to push the blockage aside, with a stent to keep the artery open.

6. What are the signs that you might need Angioplasty?

Signs include chest pain, shortness of breath, racing heartbeats, or excessive sweating. If these symptoms persist despite medication, Angioplasty may be recommended.

7. How does Angioplasty differ from other heart procedures?

Unlike open-heart surgery, Angioplasty is minimally invasive and requires only a small incision. It’s quicker, with a shorter recovery time.

8. What is the success rate of Angioplasty?

Angioplasty has a high success rate, especially when performed promptly after a heart attack. It significantly improves survival chances compared to other treatments.

9. How can you maintain heart health after Angioplasty?

To maintain heart health, follow prescribed medications, adopt a heart-healthy lifestyle, exercise regularly, and avoid smoking.

 

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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