How stenting may save your life

MANILA, Philippines - Coronary artery disease (CAD) is the most common cause of cardiovascular (CVD) deaths (45 percent of all CVD deaths), accounting for 7.2 million deaths per year, or 12 percent of all deaths worldwide.

CAD develops when major blood vessels that supply the heart with blood, oxygen and nutrients become diseased or narrowed with cholesterol-containing deposits (plaque), causing the heart to receive less blood. A complete blockage can cause a heart attack.

Heart attacks can go unnoticed because CAD develops over decades, it can go virtually unnoticed until you have a heart attack. But there’s plenty you can do to prevent and treat coronary artery disease. Start by knowing the symptoms and treatment. 

When should you have yourself checked. If your coronary arteries become narrowed, they cannot supply enough oxygen-rich blood to your heart. At first, you may not feel any symptoms but as the plaque continues to build you may feel symptoms, including:

ʉۢChest pain (angina). Pressure or tightness in your chest, as if someone were standing on your chest triggered by physical or emotional stress. It typically goes away within minutes after stopping the stressful activity. In some people, especially women, this pain may be fleeting or sharp and noticed in the abdomen, back or arm.

• Shortness of breath. If your heart cannot pump enough blood to meet your body’s needs, you may develop shortness of breath or extreme fatigue with exertion.

• Heart attack. Occurs if the coronary artery becomes completely blocked. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating.

Women are somewhat more likely than men to experience less typical signs and symptoms of a heart attack, including nausea and back or jaw pain. Sometimes a heart attack occurs without any apparent signs or symptoms.

Support your heart

Lifestyle changes and therapeutic treatment may lower the risk of CAD. However, certain medical procedures may be needed as the disease progresses.

You have two options for medical procedure — coronary bypass surgery and balloon angioplasty and stent placement.

Balloon angioplasty and stent placement is a non-invasive procedure since it involves no major incision. In this procedure, a thin, long, balloon-tipped tube is inserted into the artery and moved to the site of the blockage, where it will be inflated to make room for blood to flow (as the plaque is pushed against the wall).

The balloon is deflated afterwards and removed from the body once the procedure is successful.

However, due to a lack of support at the blockage site once the balloon is gone, the artery may resume its previous shape or it may even rupture (in a process called restenosis).

To support the arterial wall and prevent collapse or rupture of the artery, stents or metallic mesh are inserted in the artery. They even made it more effective by coating the stents with drugs (called drug-eluting stents) which prevent scar tissue from growing into the artery.

Drug-eluting stents also lower the probability of a second procedure. These stents usually have three layers of coating to increase effectiveness: a polymer that keeps the drug on the stent, the drug itself, and a final layer of polymer on top for a controlled release.

Future of stenting

The Philippine Heart Association (PHA) recently held its 44th Annual Convention and Scientific Meeting where new updates on stenting were discussed. This medical organization is considered as the utmost authority on stenting in the Philippines, having introduced cardiology and interventional cardiology as a medicine sub-specialty in the country.

Some of the studies presented included one that showed stenting as an effective and less invasive means of managing hypogastric artery aneurysms. Another demonstrated the dramatic improvement of symptoms related to a rare cyanotic heart defect, after a patient underwent atrial stenting.

“The modality of balloon angioplasty and stenting has revolutionized the practice of cardiology locally and globally, providing patients with an effective life-saving strategy that allows those with heart disease to return to functional lifestyles quickly,” said Dr. Saturnino Javier, immediate past president of PHA.

For more information on CAD and stenting, contact FAME at 345-2120, 345-2124 or 0917-8787406 or e-mail at [email protected]  to know how these procedures work, and how these may save your life.