Coronary Angioplasty: Procedure, Recovery, Cost, Risk & Complication

Coronary Angioplasty, also known as percutaneous coronary intervention is a procedure that is used for opening clogged arteries of the heart. It involves inserting and then inflating a small balloon in the area where the artery is clogged to help widen it.

Coronary angioplasty can improve the symptoms of a blocked artery, like shortness of breath and chest pain. It is also used in case of a heart attack for opening the blocked artery quickly, thus reducing the amount of damage to the heart.

One may need a coronary angioplasty in the following conditions:

• Treating a heart disease called atherosclerosis, a condition where there is a slow build-up of fatty plaques in the blood vessels of the heart, which can lead to a coronary heart disease. It is suggested as a treatment option when the prescribed medicines or changes in your lifestyle are not enough for improving the condition of the heart.
• As an emergency treatment for a patient who suffered a heart attack
• Angina (chest pain caused due to reduction of the blood flow to the heart), or other symptoms. Angina may be treated with medications, but in severe cases, angioplasty is required for restoring the blood supply to your heart.

Pre Procedure

There are certain pre-procedure guidelines that need to be followed before an angioplasty is carried out:

• First and foremost, the doctor conducts a physical exam and reviews your medical history.
• Coronary angiogram, an imaging test is conducted for seeing if the blockages can be treated by angioplasty.
• Generally, you have to stop eating or drinking anything 6-8 hours before the procedure has been scheduled.
• Routine tests like blood tests, electrocardiogram, and X-ray of the chest will be conducted.
• Make adjustments in your current prescribed medicines before going to angioplasty. Your doctor will guide you in this matter. If there are any approved medicines, make sure you take it with very little sips of water.

During Procedure

The procedure of angioplasty involves the following steps:

• A local anaesthesia will be administered for numbing the area where the catheter is inserted.
• A small cut is made in the skin for accessing an artery after numbing the area.
• A thin guide wire with the catheter is inserted in the artery so that it reaches the blockage in the heart
• Through the catheter, a small amount of dye is injected for the doctor to look at the blockages in an X-ray image.
• A small balloon that is located at the end of the catheter is inflated so that the blocked artery can be widened. Once the artery has been stretched, the balloon will be deflated and removed. This process can be repeated more than once, in cases of several blockages.

Post Procedure

If you had undergone a non-emergency angioplasty, you will be kept in supervision for a day while your heart will be monitored and your medicines will be adjusted. You are more likely to resume your normal activities within a week after the procedure. The stay at the hospital and the recovery period will be longer if you had undergone angioplasty for a heart attack.

Once you are back home, ensure to drink a lot of water and other fluids for washing out the dye that has been used in the procedure. Avoid lifting heavy objects and doing strenuous exercises for a day or two.

Seek medical help in case of:

• Bleeding or swelling in the area where the catheter had been inserted
• Pain or discomfort in that area
• Redness, fever or other signs of infection
• A feeling of faintness or weakness
• Shortness of breath or chest pain

The risks and complications associated with coronary angioplasty are:

• Restenosis, which is the narrowing of a blood vessel, restricting the flow of blood
• Blood clots, which can lead to closing of the arteries, resulting in a heart attack
• Bleeding in the leg or arm where the catheter was inserted. In case of serious bleeding, a blood transfusion or surgical procedure may be required.
• A rare risk of angioplasty is a damage of the coronary artery, which may be ruptured or torn during the procedure.
• Heart attack or a stroke (very rare)
• Problems of the kidney due to the dye used in the procedure
• Abnormal rhythms of the heart, where it can beat either too quickly or too slowly during the procedure

It is very important that you follow your medication schedule after angioplasty. Discontinuation of medicines before time can lead to the blockage of the treated artery, causing a heart attack. Simple changes in your lifestyle like having a healthy diet, quitting smoking, lowering your cholesterol levels, controlling conditions like blood pressure and diabetes, losing weight if obese and exercising regularly can reduce your risk of having any problems in the future.

Coronary angioplasty may cost approximately Rs. 50,000 – Rs. 89,850.