Treatment of Coronary Artery Disease

How to treat Coronary Artery disease?

Hello. This is Dr. Rohit Sane, Medical Director of Madhavbaug. I've done my MBBS, I've done my fellowship in Cardiac Rehabitilation from Apollo Hospital. Today we'll be talking about blockages and the available treatment options on this disorder. Normally we call this as blockages but the medical term for this is atherosclerosis or else coronary artery disease. Now whenever a blockage has been identified in you coronary artery the search for n number of treatment options begins. We need to understand what all treatment options are available for treating a blockage coronary artery. Now, as all of us know there are many invasive options in which we can invade the coronary artery with angioplasty or else we can open the whole thorasic cavity with bypass surgery. Or else there are non invasive therapies also.

Now we need to understand what to take as a decision when a coronary artery has been blocked. What will lead to our decision are typical simple parameters that we need to assess. Consider that I've been diagnosed with a coronary artery blockage. The next thing I'm supposed to do is to perform a stress thallium. Angiography helps me to diagnose whether I've a blockage in my coronary artery or not. Now once I've been diagnosed with a coronary artery the next thing I'm supposed to do is to undergo a stress thallium. Now, the question arises why. Stress thallium will give you two inferences, the first one whether this blockage has resulted into any damage in your coronary artery or not. And second whether this blockage is really blocking your blood supply to your heart muscles or not. Based on these two parameters we can take the next option whether to go for invasive therapy or whether to go for non invasive therapy.

Talking about non invasive therapy can the blood supply to the myocardium be increased with it? Yes. there are n number of invasive therapies which can help you to increase blood supply to the heart muscle. The only thing that decides whether to go for invasive or non invasive therapy would be some type of stress thallium or a normal stress test. A simple stress test where in you have to walk for about 15mins on a modified Bruss's protocol or else 9mins on Bruss's protocol with a typical ECG which is monitored by the doctor. If at all you get this stress tolerance test, whether it be thallium or a normal stress test, if you get your stress tolerance test done, based on this report we'll be able to take a decision whether to go for invasive or whether to go for non invasive therapy.

So, a simple parameter which is called as MET value, which is nothing else but the exercise tolerance capacity of your heart muscle. As your MET value is a clear indicator of your exercise tolerance capacity of your heart muscle, this will help us to decide whether to go for invasive or whether to go for non invasive treatment options. Thus, if at all a coronary blockage is identified in your heart with angiography the next thing you got to do is get a stress tolerance test done which will help you to take a good decision in the future.

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