Written by Aryan Pratyush Nayak and Deepak Kumar Nayak

Coronary arteries (arteries supplying the muscles of the heart) irregularities begin when formation or accumulation in the inner layer of the wall of an artery begins. This irregular accumulation is called atheroma and can start among people from an age as young as 5-6 years old.

 There are three noted ways in which you can treat this condition:

1. Medical management: This includes providing antiplatelet, statins, beta-blockers.
2. By-pass surgery: use of arteries or veins to bypass the blockages.
3. Angioplasty: putting in stents to restore blood flow in the artery.

Angioplasty is generally performed by a cardiologist who puts in a guidewire in the coronary artery through the wrist or groin. Over the guidewire a catheter with an inflatable balloon is advanced and once the blockage in the coronary artery is negotiated the balloon is inflated. This inflated balloon pushes the debris inside the artery against the artery walls and makes way for blood flow. After this is done a drug-eluting stent is inserted which keeps the artery patent.

Angioplasty happens to be among the procedures in India as about 4.5 lakh patients undergo this annually. 

It started in the late 70s, where artery blockages used to be dilated by using inflatable balloons. Modern-day angioplasties are performed with stents that are expandable metal jackets put in the coronary arteries through the hand or leg. Initially, bare-metal stents were used, but now with the evolution in medical science, they have been replaced with stents that are laced with drugs. These drug-laced stents are specifically used to reduce the possibility of thrombogenicity(formation of clot due to exposure to foreign material). 

Although angioplasty happens to be practiced in such vast numbers in India, it should still be considered that this procedure is very subjective to the condition of the patient in particular, and one should opt for it only under necessary conditions. 

 

When does Angioplasty need to be performed?

 A patient should primarily consult with their doctor before heading off with any treatment. Therefore, whether to opt for angioplasty or not should solely be decided as per the doctor’s recommendation.

There happen to be certain conditions for which your doctor may recommend you for an angioplasty:

• If you have chest pain, irregularity in breathing, shortness of breath due to CAD(Coronary Artery Disease). 
• If you have significant narrowing or blocking in one or two coronary arteries.
• If you have had a heart attack recently.
• If your medication is not giving up positive results to the body.
• If you have a coronary by-pass graft that has closed or narrowed.

Risk Factors of Angioplasty

 Every medical procedure is associated with a certain amount of risk. Many of these risks can be managed and you can significantly reduce them by taking medication exactly as prescribed by your physician. However, we’ll discuss ten risks associated with angioplasty: 

1.  One must be aware that if a higher number of arteries are involved during Angioplasty, more is the risk.
2. There are chances of bleeding, clotting, or inflammation at the point of insertion of the catheter.
3. An allergic reaction can occur to the dye or to the stent after undergoing Angioplasty.
4. Scar tissue can develop within the stent (restenosis), or a blood clot can form inside the stent (stent thrombosis) and may require immediate medical treatment.
5. One can notice an irregularity in the heartbeat (arrhythmia) after this procedure.
6. If the blockages are too severe and numerous, Angioplasty is not recommended. Coronary artery bypass surgery (CABG) has to be performed.
7. Patients with preexisting kidney disorders can have the risk of kidney failure.
8. Angioplasty, in some cases, can damage or infect the blood vessel, heart valve, and artery.
9. It is also rarely associated with a risk of a heart attack.
10. Lastly, there can be side effects from the intake of medications.

 

Diet and Lifestyle post Angioplasty

Life post angioplasty happens to be a critical period for every patient; hence he/she must go through all necessary changes to let the body adapt to the new change in it.

Post angioplasty, the patient should focus on a healthy diet that would reduce the chances of blockage in their heart and ensure a speedy recovery. Studies have shown that a diet rich in heart-healthy nutrients like – vitamins, minerals, antioxidants, and dietary fiber is hugely beneficial for patients after surgery.

A healthy diet should consist of:  

• Better to avoid meat and alternatives such as, tofu, legumes, and nuts are a must, but you should consume it in a decent amount. You should ensure that if at all you consume meat, it should not be in excess amount, or else it can further result in cholesterol formation.
• Fish: Fish happens to be a rich source of omega-3 fats, highly instrumental for good heart health. Hence two serves of oily fish per week are recommended.
• Whole grains: A good wholegrain choice includes wholemeal or wholegrain bread or crackers, brown rice, wholemeal pasta, quinoa, etc. Wholegrains can reduce cholesterol and can also reduce the chances of any heart disease by 30%.
• Dairy Products: Low-fat dairy products help maintain the proper functioning of the heart.
• Water: Water is essential to keep you hydrated under all circumstances, and hence you should drink at least 2 to 3 liters of water every day. 
• Along with it, you must refrain from habits of consuming alcohol or smoking as they are instrumental in endothelial dysfunction.
• You should also make sure that you don’t consume a high amount of sugar products, and you should also check your salt intake.
• Diet forms a significant segment of the proper lifestyle, and the other part consists of adequate exercise and physical activities. You must indulge in regular yoga and exercise to ensure that all critical factors determining heart health are under control and there is no further formation of debris in the Coronary Artery.

 

Conclusion 

After getting done with a complex procedure like Angioplasty, the post-procedure adherence to suggestions and medications hold the key to decent long term outcomes. Each of us must appreciate that even small errors in implementing follow-up advice or discontinuation of essentials can result in dreadful consequences.