Treatments
Forms of Treatment
If coronary artery disease is left untreated, those suffering can continue to experience unpleasant if not painful symptoms. Likewise, the possibility that the disease will cause other life–threatening conditions increases. Therefore, it is necessary to treat coronary artery disease in order to alleviate the discomfort caused by symptoms and minimize the possibility that a more serious condition will result.
There are a number of different types of treatment, depending on the severity of your condition. They range from lifestyle changes and daily medications to invasive and non–invasive surgeries. Below is a breakdown of some of the more common treatment procedures.
Medications
A number of medications are available in both prescription and over–the–counter form to help alleviate the symptoms and prevent problems as a result of coronary artery disease. For example, niacin is a medication used to help lower cholesterol levels that, when too high, cause plaque build–up in the arteries. Certain types of diuretics are available to help lower high blood pressure that may be causing the heart to work harder than necessary. Likewise, thrombolytics are available to help dissolve blood clots that may be forming as a result of clogged arteries.
These are just a few examples of the types of medications available to help alleviate symptoms and prevent future concerns. For more information, visit the FDA’s Heart Health Web site and click on the Treatment link.
Devices
Much like medications, there are a number of devices available to help a coronary artery disease patient live a normal life with his or her disease. Among them are a pacemaker and a coronary stent.
Pacemakers. The heart possesses its own natural pacemaker; however, when the heart falls into an abnormal rhythm as a result of coronary artery disease, an artificial pacemaker can be used to regulate the rhythm, providing internal monitoring and stimulation when necessary. Weighing no more than an ounce, a pacemaker is implanted permanently inside the chest cavity, just below the collarbone. It is battery operated and designed to monitor the heart’s rhythm. When it senses an irregular rhythm or an arrhythmia, the pacemaker will deliver an electrical stimulus to help the heart beat more normally. The procedure to implant a pacemaker take approximately two hours.
Types of pacemakers. There a several types of pacemakers, depending on one’s specific condition:
- Rate–responsive: This pacemaker can be programmed to increase or decrease your heart rate to match the activity being performed. That is, it will adjust from a walking heart rate to a jogging or cycling one.
- Single–chambered: This pacemaker is connected to the heart in only one location, either the right atrium or right ventricle.
- Dual–chambered: This pacemaker is connected to the heart in two locations: the right atrium and the right ventricle.
- Cardiac resynchronization therapy: This pacemaker is connected to the heart in three different places, including the right atrium, the right ventricle, and through the heart’s veins to the left ventricle.
Possible Interference. It is necessary to be aware of your surroundings once you have a pacemaker implanted. Be aware of equipment that generates magnetic fields as well as medical devices and industrial motors. Likewise, an MRI or Magnetic Resonance Imaging test or radiation therapy may also interfere with the pacemaker. And household devices including cellular phones when held too close to the pacemaker might interfere with its effectiveness. Be sure to alert all doctors, dentists, etc. of your pacemaker and always wear a medical alert bracelet or carry a medial I.D. card in your wallet or purse.
Stents. A stent is a small, lattice shaped metal tube that is inserted into an artery to help hold it open so blood and oxygen can flow through it. The stent procedure is a common one that is used to reopen narrowed arteries that result from coronary artery disease. A stent is inserted in the clogged artery by way of a main artery in either the groin or the arm. Once it reaches the clogged artery, the stent is inflated in a balloon–like fashion, opening the artery and allowing blood to flow effectively through. A variation on the traditional stent is a drug–eluting stent which contains a time–released drug used to reduce the risk that the artery will become clogged again. This procedure takes approximately 30 minutes to two hours and the patient is usually awake for the process.
Coronary Artery Bypass Surgery
Occasionally, bypass surgery must be done to repair the damage coronary artery disease has caused to the heart. This procedure is usually reserved for those who have exhausted all other options for maintaining heart health, including lifestyle changes and medications. In short, coronary artery bypass surgery is a procedure that is performed to restore to the heart the blood supply that may have been blocked due to coronary artery disease. In this procedure, a surgeon will take a portion of blood vessels from other healthy areas of the body (for instance, a leg or an arm) and replaced the corroded artery in the heart with the healthy vessels, allowing blood and oxygen to flow freely once again.
Because this is an invasive procedure, you will be restricted in terms of activity and diet before the surgery. You will also undergo a number of tests, including x–rays, blood tests, an EKG, an angiogram and a urine test. You also may not be able to take some of your prescription medications before the surgery.
The surgery typically can last up to six hours and requires that patients be hospitalized for seven to 10 days, one to two of which will be spent in intensive care. During your hospital stay, you should also expect extensive monitoring of your heart and blood pressure to ensure that your heart functions properly once the new blood vessel(s) are in place.
After surgery, it may take from six to 12 weeks to recover fully from the procedure. Also, it is imperative that you make lifestyle changes to avoid reversing the effects or defeating the purpose of the surgery. You will be expected to
- take all prescribed medications;
- to attend all scheduled doctor’s appointments;
- to monitor and control both your blood pressure and your diabetes;
- to stop smoking or not to start smoking;
- to be active; and
- to maintain a healthy weight.
Types of Bypass Surgeries
Conventional Bypass Surgery. In this conventional method, an incision is made down the center of the chest alongside the breast bone that is long enough to expose the heart when the ribcage is spread. The heart is then stopped and a heart–lung machine is used to mimic the heart’s function within the patient. The clogged arteries are then replaced.
Off Pump or Beating–Heart Bypass Surgery. In this variation, the surgery is performed while the heart is still beating.
Minimally Invasive Bypass Surgery. Limited to specific conditions only, this surgery involves a surgeon placing several small incisions in the chest, exposing the heart. Removal of a rib may be required with this procedure.