• Treating Stable Angina with Angioplasty & Stenting

    If you have stable angina, the first steps of treatment will likely be taking medications and changing your habits to include a healthier diet and more physical activity. For some people with stable angina, this strategy is enough to manage the symptoms and get them back to the activities they enjoy. If these treatments don’t work, the care team may consider an angiogram or other tests and perhaps an angioplasty and stenting procedure.
    Heart arteries that are blocked or narrowed by with the build-up of fatty materials (called plaque) or with blood clots can cause stable angina or unstable angina. Both of these conditions can be treated with angioplasty and stenting. Unstable angina is a serious condition that often leads to a heart attack. Both unstable angina and heart attack require immediate medical treatment. Stable angina, on the other hand, is not an emergency but it can cause uncomfortable, even painful symptoms that may interfere with your daily activities and make it difficult for you to be active.

    Symptoms of Stable Angina

    The most common symptoms of stable angina include the following:
    • Pain, pressure or a tightness in the chest, arms, neck, jaw, shoulders or back
    • Difficulty breathing or trouble catching your breath (especially common for people with diabetes)
    • Nausea
    • Lightheadedness
    • Weakness
    • Anxiety

    Although stable and unstable angina have similar symptoms, they differ in terms of severity and when the symptoms occur. If you are having any of the symptoms listed above for the first time, if the symptoms just started in the last couple of weeks, or if you are experiencing a change in your usual pattern of angina, you could be having a heart attack and should call 911. For people who have stable angina, the pain or discomfort usually occurs with a predictable, reliable amount of exercise or stress, such as when they exert themselves or feel stressed. Stable angina symptoms typically stop when you stop what you are doing.

    Angioplasty & Stenting Can Improve Quality of Life

    Angioplasty and stenting is an option for some patients who have stable angina that does not respond to medications and lifestyle changes. In an angioplasty procedure, a tiny balloon is used to push aside the material that is blocking blood from flowing to the artery. The lack of blood flow to the heart muscle is what causes the pain and other symptoms of angina. After the balloon widens the open space in the artery, a tiny mesh tube called a stent is implanted in the artery to help prevent the artery from becoming re-blocked.

    Although angioplasty and stenting is probably best known for treating heart attacks, patients with stable angina can also benefit from angioplasty. But the benefits are not as clear-cut in patients with stable angina, so it is very important to work closely with your doctor to make sure you are comfortable with your treatment choices.

    In 2012, to help patients and their physicians better understand when angioplasty and stenting are most beneficial to patients with stable angina, the Society for Cardiovascular Angiography and Interventions (SCAI; the medical society hosting SecondsCount) sponsored a survey and conducted a comprehensive review of research on quality of life following angioplasty and stenting.

    The Survey

    According to the results of the survey of more than 460 adult heart patients in the United States, four out of five (81 percent) said their lives had changed for the better following angioplasty. Respondents also reported a nearly two-fold reduction in symptoms such as chest discomfort and shortness of breath.

    The heart patients surveyed also reported improvement in quality of life in every one of 10 categories of the survey including their ability to perform basic physical activity, opportunities for socializing, sex life, ability to do chores and run errands, participate in hobbies, feel financially secure and improve relationships with spouses/significant others, family and friends.

    The survey also found:
    • Angioplasty patients were able to return to work nearly three times faster than heart surgery patients.
    • Patients who underwent angioplasty required less care post-procedure and felt they were less of a burden to family and friends: 16 percent of angioplasty patients said they felt like a burden to family and friends, doubling to 34 percent for heart surgery patients.

    The Research

    SCAI’s comprehensive review of research on quality of life following angioplasty and stenting, published in 2012 in the medical journal Catheterization and Cardiovascular Interventions, underscored many of the same findings, including the ability of angioplasty and stenting to:
    • Enhance heart disease patients’ ability to exercise;
    • Relieve angina or chest pain more effectively than medications in patients with stable angina; and
    • More effectively enhance quality of life shortly after the procedure when compared to heart bypass surgery, because patients are able to return to work sooner.

    Is Angioplasty Right for You?

    In addition to clarifying some of the benefits experienced by patients with stable heart disease treated with angioplasty and stenting, SCAI’s analysis also provided guidance to healthcare providers about helping their patients make the best treatment decisions. When you talk to your doctor about your condition and how to treat it, you should expect the following:

    • Information about Each Treatment Option: Before You Agree to a Treatment or Procedure, your doctor should present treatment options and the risks and benefits of each, as well as what the quality of life associated with each option.
    • An Explanation of How Each Treatment Option Compares to the Others: Angioplasty and stenting, heart bypass surgery and medications all have short- and long-term advantages and disadvantages. You should be fully informed of the trade-offs to consider when choosing among your treatment options.
    • An Open and Honest Discussion About Your Personal Needs and Preferences: Your preferences and quality of life should be taken into consideration in all aspects of your care, from diagnosis to recovery and resuming your daily activities.

    Explore Your Options

    Because stable angina is not life-threatening in the same way as a heart attack, some people decide the benefits of angioplasty and stenting do not outweigh the risks. And you can certainly opt to try a more conservative approach first by making lifestyle changes and taking medications to see if they help your angina before you pursue angioplasty and stenting.

    You might be surprised at how much better you feel if you are careful to eat right, exercise, relax, maintain a healthy weight, manage your cholesterol, quit smoking and treat your diabetes, high blood pressure and high cholesterol. Many people find this appealing because it is a less expensive approach and it doesn’t involve recovery from a procedure.

    But talk with your doctor. Be honest about how you feel and describe your symptoms in great detail so he or she can help you make the decision that’s best for you. Whether you decide to treat your angina with angioplasty and stenting is really a personal decision made with the advice of your doctor, with careful consideration to your lifestyle, how active you want to be, your tolerance for symptoms and medication side effects and other factors that make your situation unique.

    Click here for more information about the risks and benefits of angioplasty and stenting.