$Unique_ID{BRK02086}
$Pretitle{}
$Title{Concerns about and Arguments for Angioplasty and Angiography}
$Subject{angina attacks angioplasty angiography arteries coronary artery
disease heart muscles angina pectoris x-ray test catheter by-pass operation
aorta hospital hospitalization hospitalizations}
$Volume{}
$Log{
The Heart's Blood Supply*0008901.scf}

Copyright (c) 1993  Tribune Media Services, Inc.


Concerns about and Arguments for Angioplasty and Angiography


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QUESTION:  I am a 66 year old male, and have been suffering from angina
attacks for the last 3 years.  I have been admitted to hospitals on 4
occasions, treated and then released.  During my last hospitalization, my
doctor started to talk about things like angioplasty and angiography.  I have
read all about the dangers of those tests, and became frightened by the
direction things were taking, so I signed myself out of the hospital "against
medical advice".  I want no part of surgery.  I know that there must be
medicines that can take care of angina, and I think my doctor should have
offered me that option.  Do you think you can help me, and offer me some words
of advice?

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ANSWER:  This is one of the many times I wish I could have a "sit down"
conversation with a reader, but the feelings and sentiments expressed in this
question are so important, that I am going to try and provide a full
explanation here.  I'll try to do it as clearly as possible, using only the
information you provided me with.
     Angina for 3 years with 4 hospitalizations clearly speak of coronary
artery disease.  The arteries that supply your heart with blood are clogged,
if not completely plugged up, and your heart muscles are not getting enough
blood, with its oxygen supply, to function properly.  When heart muscles do
not get sufficient oxygen they let you know it, with the chest pain we call
"angina pectoris".  While it is true that this condition can be treated with
medications, in many cases quite successfully, it is also apparent that this
is not so in your case.  And so, with you in the hospital (again), and things
not getting better, your doctor started to discuss some logical "next steps"
with you.
     "Angiography" is a special kind of x-ray test.  A catheter (a hollow
tube) is placed in an artery of your groin or elbow and guided up into the
main artery of the body, the aorta.  When it reaches the location where the
arteries to the heart branch off, a liquid that is opaque to x-rays (often
called a "dye") is injected through the catheter, and then carried by the
blood stream through the coronary arteries, which makes them readily visible
on the x-ray.  The doctors can spot the areas that are blocked or narrowed,
and develop a treatment strategy to overcome the problem.
     One of the possible treatments is called "angioplasty".  It is a
technique that also uses catheters, in this case one which has a balloon at
the tip.  It is passed along (while the doctor observes the progress on a TV
monitor) until it sits in the area of the narrowed section of the artery.
Then the balloon is inflated, which opens the artery, and permits blood flow
to return to more normal levels.
     If your arteries are completely blocked, a by-pass operation may be
suggested instead.
     It is understandable that your anxieties make you fearful about such
procedures.  However, your history also provokes fear in me, for repeated
episodes of angina maybe but a prelude to a total heart attack and its
unpredictable outcome.  It is clear to me that you need more information, and
more communication with your physician.  Perhaps a second opinion will help in
these circumstances.  One thing is certain.  You gain nothing by running
(unless it is in a prescribed exercise program) and everything to gain by
following a logical path of tests and treatment that can reverse the painful
situation that currently limits your life.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.