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Content
Heart Disease
Heart Attack
Congestive Heart Failure
Generic Drugs
Alternative Heart Disease Treatment |
Heart Disease
Coronary Heart Disease Facts About Coronary
Heart Disease
From National Heart, Lung, and Blood Institute
Coronary heart disease is the most common form of heart disease, the leading
cause of death for Americans. About 12.6 million Americans suffer from Coronary
Heart Disease, which often results in a heart attack. About 1.1 million
Americans suffer a heart attack each year�about 515,000 of these heart attacks
are fatal.
Fortunately, Coronary Heart Disease can be prevented or controlled. This fact
sheet gives an overview of Coronary Heart Disease and its prevention, diagnosis,
and treatment. It describes the steps that Americans can take to protect their
heart health.
What Is Coronary Heart Disease?
The heart is a muscle that works 24 hours a day. To perform well, it needs a
constant supply of oxygen and nutrients, which is delivered by the blood through
the coronary arteries.
That blood flow can be reduced by a process called atherosclerosis, in which
plaques or fatty substances build up inside the walls of blood vessels. The
plaques attract blood components, which stick to the inside surface of the
vessel walls. Atherosclerosis can affect any blood vessels and causes them to
narrow and harden. It develops over many years and can begin early, even in
childhood.
In Coronary Heart Disease, atherosclerosis affects the coronary arteries. The
fatty buildup, or plaque, can break open and lead to the formation of a blood
clot. The clot covers the site of the rupture, also reducing blood flow.
Eventually, the clot becomes firm. The process of fatty buildup, plaque rupture,
and clot formation recurs, progressively narrowing the arteries. Ever less blood
reaches the heart muscle.
When too little blood reaches a part of the body, the condition is called
ischemia. When this occurs with the heart, it�s called cardiac ischemia. If the
blood supply is nearly or completely, and abruptly, cut off, a heart attack
results and cells in the heart muscle that do not receive enough oxygen begin to
die. The more time that passes without treatment to restore blood flow, the
greater the damage to the heart. Because heart cells cannot be replaced, the
cell loss is permanent.
Certain behaviors and conditions increase the risk that someone will develop
Coronary Heart Disease (see Box 1). They also can increase the chance that
Coronary Heart Disease, if already present, will worsen. They are called �risk
factors� and, while some cannot be modified, most can.
Risk factors that cannot be modified are: age (45 or older for
men; 55 or older for women) and a family history of early Coronary Heart Disease
(a father or brother diagnosed before age 55, or a mother or sister diagnosed
with heart disease before age 65).
Factors that can be modified are: cigarette smoking, high
blood cholesterol, high blood pressure, overweight/obesity, physical inactivity,
and diabetes.
Risk factors do not add their effects in a simple way. Rather, they multiply
each other�s effects. Generally, each risk factor alone doubles a person�s
chance of developing Coronary Heart Disease. Someone who has high blood
cholesterol and high blood pressure, and smokes cigarettes is eight times more
likely to develop Coronary Heart Disease than someone who has no risk factors. So,
it is important to prevent or control risk factors that can be modified.
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Risk factors are behaviors or conditions that increase
the chance of developing a disease. For Coronary Heart Disease, there
are two types of risk factors�those that cannot be modified and those
that can. Most Coronary Heart Disease risk factors can be modified.
Check the lists below:
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| CAN BE MODIFIED: |
CANNOT BE MODIFIED: |
- Cigarette smoking
- High blood pressure
- High blood cholesterol
- Overweight/obesity
- Physical inactivity
- Diabetes
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- Age�45 and older for men; 55 and older for women
- Family history of early Coronary Heart Disease�father or brother
diagnosed before age 55; mother or sister diagnosed before age 65
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Symptoms of Coronary Heart Disease vary. Some persons feel no discomfort,
while others have chest pain or shortness of breath. Sometimes, the first
symptom of Coronary Heart Disease is a heart attack or cardiac arrest (a sudden,
abrupt loss of heart function).
Chest pain also can vary in its occurrence. It happens when the blood flow
to the heart is critically reduced and does not match the demands placed on the
heart. Called angina, the pain can be mild and intermittent, or more pronounced
and steady. It can be severe enough to make normal everyday activities
difficult. The same inadequate blood supply also may cause no symptoms, a
condition called silent ischemia.
Often, particularly in men, angina is felt behind the breastbone and may
radiate up the left arm or neck. It may also be felt in the shoulder, elbows,
jaw, or back. Angina is usually brought on by exercise, lasts 2 to 5 minutes,
does not change with breathing, and is eased by rest.
Women may get a less typical form of angina that feels like shortness of
breath or indigestion, and can linger or occur in a different location than
behind the breastbone. This less typical form may not be brought on by exertion
or be eased by rest. In fact, it may occur only at rest.
A person who has any symptoms should talk with his or her doctor. Without
treatment, the symptoms may return, worsen, become unstable, or progress to a
heart attack.
Those with Coronary Heart Disease should talk with their doctor about the
symptoms of a heart attack (see Box 2) and the appropriate steps to take to get
emergency care. The key to surviving a heart attack is fast action. Learn the
heart attack warning signs and, if you or someone else experiences any of them,
call 9-1-1 fast. Do not wait for more than a few minutes�5 minutes at most.
Fast treatment is critical: Treatments to restore blood flow to the heart are
most effective if given within 1 hour of the start of symptoms. The sooner
treatment is begun, the greater the chance for survival and a full recovery.
Warning signs of a heart attack are: Discomfort or pain in the center of the
chest; discomfort in the arm(s), back, neck, jaw, or stomach; shortness of
breath; and breaking out in a cold sweat, nausea, or light-headedness.
The most common warning sign�chest discomfort�is the same for men and women.
However, women are somewhat more likely than men to have some of the other
common symptoms, particularly shortness of breath, nausea and vomiting, and back
or jaw pain. Also, women tend to be about 10 years older than men when they
have a heart attack and to have other conditions as well, such as diabetes, high
blood pressure, and congestive heart failure. So it is vital that women receive
treatment fast.
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When a heart attack happens, every minute counts. Know the warning signs:
- Chest discomfort. Most heart attacks involve discomfort in the center
of the chest that lasts for more than a few minutes, or goes away and
comes back. The discomfort can feel like uncomfortable pressure,
squeezing, fullness, or pain.
- Discomfort in arm(s), back, neck, jaw, or stomach.
- Shortness of breath. Often comes along with chest discomfort. But it
also can occur before chest discomfort.
- Cold sweat, nausea, or light-headedness.
Most heart attacks are not sudden and intense, but start slowly, with
only mild pain or discomfort. It may not be clear what's wrong�even for
those who have had a heart attack before. Signs can change for each attack.
So, when in doubt, check it out. Don't wait more than a few minutes�5 at
most�to call 9-1-1. Fast action can save lives. |
Calling 9-1-1 is the best way to get fast treatment. It is like bringing the
hospital to you. Emergency medical personnel can begin treatment
immediately�even before arrival at the hospital. They also have equipment to
start the heart beating if it stops during the heart attack. And patients who
use the ambulance tend to receive faster treatment on their arrival at the
hospital.
If for some reason, you are having heart attack symptoms and cannot call
9-1-1, have someone else drive you at once to the hospital. Never drive
yourself to the hospital, unless you absolutely have no other choice.
You also can increase your chance of surviving a heart attack by preparing
ahead of time, especially if you have Coronary Heart Disease. Talk with your
doctor about what to do if you experience any warning signs and how to reduce
your heart attack risk. Fill out a heart attack survival plan and keep it in
handy places, such as your wallet or purse. Make sure your family and friends
know about the warning signs and to call 9-1-1 within 5 minutes.
There is no single, simple test for Coronary Heart Disease. Which diagnostic
tests are done depends on a number of factors, especially the severity of the
symptoms and the likelihood that their cause is Coronary Heart Disease. After
taking a careful medical history and doing a physical examination, the doctor
may use some of the following tests to rule out other causes for the symptoms,
and to confirm the presence and check the severity of Coronary Heart Disease:
- Electrocardiogram (ECG or EKG). This is a graphic record of the
electrical activity of the heart as it contracts and relaxes. The ECG can
detect abnormal heartbeats, some areas of damage, inadequate blood flow, and
heart enlargement.
- Stress test. The stress test is used to check for problems that
show up only when the heart is working hard. There are different types of
stress test. One is called the exercise test (also called a treadmill test or
bicycle exercise ECG); another uses a drug instead of exercise to increase
blood flow. The latter is used for persons, such as those with arthritis, who
cannot exercise. In both cases, the blood pressure and heartbeat response are
continuously monitored and periodically recorded. An ECG rate and blood
pressure are taken before, during, and after the test. For an exercise stress
test, breathing and oxygen consumption also may be measured.
Still another type of stress test uses a nuclear scan (see next bullet) to
assess heart muscle contraction or blood flow in the heart.
Stress tests are useful but not 100 percent reliable. False positives
(showing a problem where none exists) and false negatives (showing no problem
when something is wrong) can occur. For instance, gender and race can affect
the measurements of exercise stress tests.
- Nuclear scan. This also is called a thallium stress test. It is
sometimes used to show areas of the heart that lack blood flow and are
damaged, as well as problems with the heart�s pumping action. A small amount
of a radioactive material called thallium is injected into a vein, usually in
the arm. A scanning camera positioned over the heart records whether the
nuclear material is taken up by the heart muscle (healthy areas) or not
(damaged areas). The camera also can evaluate how well the heart muscle pumps
blood. This test can be done during both rest and exercise, enhancing the
usefulness of its results.
- Coronary angiography (or arteriography). This test is used to
detect blockages and narrowed areas inside coronary arteries. A fine tube
(catheter) is threaded through an artery of an arm or leg into position in the
heart vessel. A dye that shows up on x ray is then injected into the blood
vessel, and the vessels and heart are filmed as the heart pumps. The picture
is called an angiogram or arteriogram.
- Ventriculogram. This is a picture of the heart�s main pumping
chamber, the left ventricle. It is taken by following a procedure similar to
the one described for an angiogram. For a ventriculogram, the catheter is
positioned in the left ventricle.
- Intracoronary ultrasound. This uses a catheter that can measure
blood flow. It gives a picture of the coronary arteries that shows the
thickness and character of the artery wall. This lets the doctor assess blood
flow and blockages.
There are three main types of treatment for Coronary Heart Disease:
lifestyle, medication, and, for advanced atherosclerosis, special procedures.
The first two types of treatment also can help prevent the development of
Coronary Heart Disease. A discussion of each type of treatment follows.
Six key steps can help prevent or control Coronary Heart Disease: stop
smoking cigarettes, lower high blood pressure, reduce high blood cholesterol,
lose extra weight, become physically active, and manage diabetes.
Here�s more on each step:
- Cigarette smoking. There is no safe way to smoke. Although
low-tar and low-nicotine cigarettes may somewhat reduce the risk for lung
cancer, they do not lessen the risk for Coronary Heart Disease. In fact,
smoking accelerates atherosclerosis. It also increases the risk for stroke.
The risk for Coronary Heart Disease increases along with the number of
cigarettes smoked daily. Quitting sharply lowers the risk, even in the first
year and no matter what a person�s age. Quitting also reduces the risk for a
second heart attack in those who have already had one.
The U.S. Food and Drug Administration has approved five medications that can
help persons stop smoking and lessen the urge to smoke. These are: Bupropion
SR (available only by prescription), which has no nicotine and reduces the
craving for cigarettes; nicotine supplements, which include gum (available
over the counter); a nicotine patch (available both over the counter and by
prescription); a nicotine inhaler (available only by prescription); and a
nicotine nasal spray (available only by prescription).
For more about how to stop smoking, check the Virtual Office of the U.S.
Surgeon General at www.surgeongeneral.gov/tobacco.
- High blood pressure. Also known as hypertension, high blood
pressure usually has no symptoms. Once developed, it typically lasts a
lifetime. If uncontrolled, it can lead to heart and kidney diseases, and
stroke.
Blood pressure is given as two numbers�the systolic pressure over the
diastolic pressure�and both are important. A measurement of 140/90 mmHg
(millimeters of mercury) or above is called high blood pressure�but if either
number is high, that too is hypertension. A healthy blood pressure is around
120/80.
Lifestyle steps often can prevent or control high blood pressure: lose excess
weight, become physically active, follow a healthy eating plan, including
foods lower in salt and sodium, and limit alcohol intake. Some of these steps
are the same as those needed to reduce the risk for Coronary Heart Disease and
are discussed later.
A key ingredient of healthy eating is choosing foods lower in salt (sodium
chloride) and other forms of sodium. Most Americans should consume no more
than 2,400 milligrams of sodium (which equals about 6 grams of salt, or about
1 teaspoon) in a day. This is the amount listed as a Daily Value on the
Nutrition Facts label on food items. Recent research shows that it�s even
better to consume no more than 1,500 milligrams of sodium (which equals about
4 grams of salt, or about 2/3 teaspoon) in a day. This includes ALL salt�that
in processed foods or added in cooking or at the table.
An overall eating plan also should be low in saturated fat and cholesterol,
and moderate in total fat. It also should include plenty of fruits and
vegetables�most are naturally low in salt and calories.
One such healthy eating plan has been shown to reduce elevated blood pressure.
It�s called the DASH diet. DASH stands for Dietary Approaches to Stop
Hypertension. The eating plan emphasizes fruits, vegetables, and lowfat dairy
products. It is reduced in red meat, sweets, and sugar-containing drinks. It
is rich in potassium, calcium, magnesium, fiber, and protein. See �For More
Information� on page 8 to find out how to get more details about the DASH
Diet.
Those who consume alcoholic beverages should do so in moderation. Alcoholic
beverages supply calories but few nutrients. They are harmful when consumed
in excess, and some persons should not drink at all. Furthermore, drinking
alcoholic beverages increases the risk of some serious health problems. For
example, even one drink a day can slightly raise the risk of breast cancer.
While drinking alcoholic beverages in moderation may lower the risk of
Coronary Heart Disease� mainly among men over age 45 and women over age
55�there are other factors that reduce the risk of heart disease. These
include a healthy diet, physical activity, avoidance of smoking, and
maintenance of a healthy weight.
Moderate drinking is defined as no more than two drinks a day for men and no
more than one drink a day for women. One drink equals 1.5 ounces of 80-proof
whiskey, or 5 ounces of wine, or 12 ounces of beer (regular or light).
Those who drink alcoholic beverages should be aware that they may affect
medications taken. They should check about this with their doctor or
pharmacist.
- High blood cholesterol. Cholesterol is a soft, waxy substance
involved in normal cell function. Normally, the body makes all the
cholesterol it needs. Excess saturated fat and cholesterol in the diet cause
the fatty buildup in blood vessels, which contributes to atherosclerosis.
Cholesterol travels through the blood in packages called lipoproteins. There
are two main types of lipoprotein that affect the risk for Coronary Heart
Disease: low-density lipoprotein (LDL), also called the �bad� cholesterol,
which causes deposits in blood vessels; and high-density lipoprotein (HDL),
also called the �good� cholesterol, which helps remove cholesterol from the
blood. It�s important to have a low level of LDL and a high level of HDL.
Healthy adults age 20 and older should have a lipoprotein analysis once every
5 years to measure their levels of total cholesterol, LDL, HDL, and
triglycerides, another fatty substance in the blood.
To help prevent or control high blood cholesterol, follow a healthy eating
plan such as that mentioned previously, become physically active, and lose
excess weight. Those who already have Coronary Heart Disease should be
especially careful to control their cholesterol and may need to follow an
eating plan more restricted in saturated fat and cholesterol.
- Overweight/obesity. About 65 percent of American adults are
overweight or obese. Being overweight or obese increases the risk not only
for heart disease, but also for other conditions, including stroke,
gallbladder disease, arthritis, and breast, colon, and other cancers.
Overweight and obesity are determined by two key measures�body mass index, or
BMI, and waist circumference. BMI relates height to weight. A normal BMI is
18.5-24.9; an overweight BMI is 25-29.9; and an obese BMI is 30 and over.
(See Box 3 for how to calculate BMI.) For waist circumference, heart
disease risk increases if it is greater than 35 inches for women or greater
than 40 inches for men.
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| Here is a shortcut way to calculate your BMI: |
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Example: A person who is 5 feet 5 inches tall and
weighs 180 lbs. |
| 1 |
Multiply your weight in pounds by 703 |
180 x 703 |
= |
126,540 |
| 2 |
Divide the answer in step 1 by height in inches |
126,540/65 |
= |
1,946 |
| 3 |
Divide the answer in step 2 by height in inches to
get your BMI |
1,946/65 |
= |
29.9 |
= |
BMI |
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Those who are overweight or obese should aim for a healthy weight in order to
reduce Coronary Heart Disease risk. Even a small weight loss�just 10 percent
of current weight�will help to lower Coronary Heart Disease risk and that of
the other conditions too. Those who cannot lose should at least try not to
gain more weight.
There are no quick fixes to lose weight. To be successful, weight loss must
be viewed as a change of lifestyle and not as a temporary effort to drop
pounds quickly. Otherwise, the weight will probably be regained. Do not try
to lose more than 1/2 to 2 pounds a week.
To lose weight, follow a heart-healthy eating plan. Eat a variety of
nutritious foods in moderate amounts. Choose foods that are lower in calories
and fat. It�s also important to become physically active. This helps use
calories and, so, aids weight loss. It also helps keep the weight off for
life.
- Physical activity. Physical activity is one of the best ways to
help prevent and control Coronary Heart Disease. It can lower LDL and raise
HDL. It also lowers blood pressure for those who are overweight.
To become physically active, do 30 minutes of a moderate activity on most and,
preferably, all days. Examples of moderate activities are brisk walking and
dancing. If 30 minutes is too much time, break it up into periods of at least
10 minutes each. Those who have been inactive should start slowly. Begin at
a lower level of physical activity and slowly increase the time and intensity
of the effort.
Those with Coronary Heart Disease or who have a high risk for it should check
with their doctor before starting a physical activity program. Others who
should consult a doctor first include those with chronic health problems, men
over age 40, and women over age 50. The doctor can give advice on how
rigorous the exercise should be.
Those who have had a heart attack benefit greatly from physical activity.
Many hospitals have a cardiac rehabilitation program. The doctor can offer
advice about a suitable program.
- Diabetes. Diabetes mellitus affects more than 17 million
Americans. It damages blood vessels, including the coronary arteries of the
heart. Up to 75 percent of those with diabetes develop heart and blood vessel
diseases. Diabetes also can lead to stroke, kidney failure, and other
problems.
Diabetes occurs when the body is not able to use sugar as it should for growth
and energy. The body gets sugar when it changes food into glucose (a form of
sugar). A hormone made in the pancreas and called insulin is needed for the
glucose to be taken up and used by the body. In diabetes, the body cannot
make use of the glucose in the blood because either the pancreas cannot make
enough insulin or the insulin that is available is not effective.
Symptoms of diabetes include: increased thirst and urination (including at
night), weight loss, and blurred vision, hunger, fatigue, frequent infections,
and slow healing of wounds or sores.
There are two main types of diabetes�type 1 and type 2. Type 1 usually
appears suddenly and most commonly in those under age 30. Type 2 diabetes
occurs gradually and most often in those over age 40. Up to 95 percent of
those with diabetes have type 2.
You�re more likely to develop type 2 if you are overweight or obese,
especially with extra weight around the middle, over age 40, or have high
blood pressure or a family history of diabetes. Diabetes is particularly
prevalent among African Americans, Asians, and American Indians.
Because of the link with heart disease, it�s important for those with diabetes
to prevent or control heart disease and its risk factors (see Box 1).
Fortunately, new research shows that the same steps that reduce the risk of
Coronary Heart Disease also lower the chance of developing type 2 diabetes.
And, for those who already have diabetes, those steps, along with taking any
prescribed medication, also can delay or prevent the development of
complications of diabetes, such as eye or kidney disease and nerve damage.
According to the research, a 7 percent loss of body weight and 150 minutes of
moderate physical activity a week can reduce the chance of developing diabetes
by 58 percent in those who are at high risk. The lifestyle changes cut the
risk of developing type 2 diabetes regardless of age, ethnicity, gender, or
weight.
Steps that reduce the risk of developing diabetes�as well as Coronary Heart
Disease�are to:
- Follow a healthy eating plan, which is low in saturated fat and
cholesterol, and moderate in total fat.
- Aim for a healthy weight.
- Be physically active each day�30 minutes of moderate physical activity
on most and, preferably, all days of the week.
- Not smoke.
- Prevent or control high blood pressure.
- Prevent or control high blood cholesterol.
Those who already have diabetes can delay its progression, or prevent or
slow the development of heart, blood vessel, and other complications by
following the steps given above as well as to:
- Eat meals and snacks at around the same times each day.
- Check with the doctor about the best physical activities.
- Take prescribed medicine for diabetes at the same times each day.
- Check blood sugar every day. Each time blood sugar is checked, the
number should be written in a record book. The doctor should be called if
the numbers are too high or too low for 2 to 3 days.
- Check the feet every day for cuts, sores, bumps, or red spots.
- Brush and floss teeth and gums every day.
- Take any prescribed medication for other conditions, such as Coronary
Heart Disease.
- For those who have Coronary Heart Disease, check with the doctor about
whether or not to take aspirin each day.
Sometimes, in addition to making lifestyle changes, medications may be needed
to prevent or control Coronary Heart Disease. For instance, medications may be
used to control a risk factor such as high blood pressure or high blood
cholesterol and so help prevent the development of Coronary Heart Disease. Or,
medication may be used to relieve the chest pain of Coronary Heart Disease.
If prescribed, medications must be taken as directed. Drugs can have side
effects. If side effects occur, they should be reported to the doctor. Often,
a change in the dose or type of a medication, or the use of a combination of
drugs, can stop the side effect. Prescription monitoring may also help your doctor know more about drug use and better anticipate unwanted side effects.
Drugs used to treat Coronary Heart Disease and its risk factors include:
- Aspirin�helps to lower the risk of a heart attack for those who
have already had one. It also helps to keep arteries open in those who have
had a previous heart bypass or other artery-opening procedure such as coronary
angioplasty (see next section).
Because of its risks, aspirin is not approved by the Food and Drug
Administration for the prevention of heart attacks in healthy persons. It may
be harmful for some persons, especially those with no risk of heart disease.
Patients must be assessed carefully to make sure the benefits of taking
aspirin outweigh the risks. Each person should talk to his or her doctor
about whether or not to take aspirin.
Aspirin also is given to patients who arrive at a hospital emergency
department with a suspected heart attack.
- Digitalis�helps the heart contract better and is used when the
heart�s pumping function has been weakened; it also slows some fast heart
rhythms.
- ACE (angiotensin converting enzyme) inhibitor�stops production of a
chemical produced by the body that makes blood vessels narrow. It is used for
high blood pressure and damaged heart muscle. It also can prevent kidney
damage in some patients with diabetes.
- Beta blocker�slows the heart and makes it beat with less force,
lowering blood pressure and making the heart work less hard. It is used for
high blood pressure, chest pain, and to prevent a repeat heart attack.
- Nitrate (including nitroglycerine)�relaxes blood vessels and stops
chest pain/angina.
- Calcium-channel blocker�relaxes blood vessels, and is used for high
blood pressure and chest pain/angina.
- Diuretic�decreases fluid in the body and is used for high blood
pressure. Diuretics are sometimes referred to as �water pills.�
- Blood cholesterol-lowering agents�decrease LDL levels in the blood.
Some can increase HDL.
- Thrombolytic agents�also called �clot-busting drugs,� they are
given during a heart attack to dissolve a blood clot in a coronary artery in
order to restore blood flow. They must be given immediately after heart
attack symptoms begin. To be most effective, they need to be given within 1
hour of the start of heart attack symptoms.
Advanced atherosclerosis may require a special procedure to open an artery
and improve blood flow. This is usually done to ease severe chest pain, or to
clear major or multiple blockages in blood vessels.
Two commonly used procedures are coronary angioplasty and coronary artery
bypass graft operation:
- Coronary angioplasty, or balloon angioplasty. In this
procedure, a fine tube, or catheter, is threaded through an artery into the
narrowed heart vessel. The catheter has a tiny balloon at its tip. The
balloon is repeatedly inflated and deflated to open and stretch the artery,
improving blood flow. The balloon is then deflated, and the catheter is
removed.
Doctors often insert a stent during the angioplasty. A wire mesh tube, the
stent is used to keep an artery open after an angioplasty. The stent stays in
the artery permanently.
Angioplasty is not surgery. It is done while the patient is awake and may
last 1 to 2 hours.
In about a third of those who have an angioplasty, the blood vessel becomes
narrowed or blocked again within 6 months. Vessels that reclose may be opened
again with another angioplasty or a coronary artery bypass graft. An artery
with a stent also can reclose.
- Coronary artery bypass graft operation. Also known as �bypass
surgery,� the procedure uses a piece of vein taken from the leg, or of an
artery taken from the chest or wrist. This piece is attached to the heart
artery above and below the narrowed area, thus making a bypass around the
blockage. Sometimes, more than one bypass is needed.
Bypass surgery may be needed due to various reasons, such as an angioplasty
that did not sufficiently widen the blood vessel, or blockages that cannot be
reached by, or are too long or hard for, angioplasty. In certain cases,
bypass surgery may be preferred to angioplasty. For instance, it may be used
for persons who have both Coronary Heart Disease and diabetes.
A bypass also can close again. This happens in about 10 percent of bypass
surgeries, usually after 10 or more years.
Other procedures also may be used to open coronary arteries:
- Atherectomy. A specially equipped catheter is threaded through an
artery to a blockage, where thin strips of plaque are shaved off and removed.
Balloon angioplasty or insertion of a stent may be done as well.
- Laser angioplasty. A catheter with a laser tip is inserted into an
artery to burn, vaporize, or break down plaque. The procedure may be used
alone or along with balloon angioplasty.
It is important to understand that these procedures relieve the symptoms of
Coronary Heart Disease but do not cure the disease. Lifestyle changes must
still be followed and any necessary medications must continue to be taken
The National Heart, Lung, and Blood Institute (NHLBI) has more information
about Coronary Heart Disease, its risk factors, the DASH diet, and related
topics. To get materials, contact:
NHLBI Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
phone (301) 592-8573
fax (301) 592-8563
TTY (240) 629-3255
Many materials are available free online at
www.nhlbi.nih.gov.
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