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Apr 2017

Follow Your Heart. Ask Your Doctor About Alternatives to Heart Stenting

We cannot stress enough there is no one size fits all approach to health care and the treatment of diseases. A recent study on the use of stents to treat coronary artery disease stresses the importance of properly diagnosing each individual and administering the right treatment.

We previously discussed the use of stents to treat coronary artery disease, and how it is possible medication and lifestyle changes alone may be enough to treat it.

Traditional stents are mesh-like tubes, and they are placed in the clogged artery of the heart. The stent holds the artery open, which allows blood to flow more freely, hopefully preventing a heart attack.

Recently, physician researchers at Thomas Jefferson University reported stents may be used unnecessarily due to the misdiagnosis of fixed atherosclerotic blockage versus coronary artery spasm.

A coronary artery spasm (also known as a coronary artery contraction) occurs when muscles in the heart’s arteries suddenly tighten, which prevents blood flow to the heart. These spasms are usually brief and temporary but may lead to a heart attack.

Atherosclerotic blockage is when plaque builds up in the heart’s arteries, which can lead to heart attack or stroke.

So as you can see, these are two different types of coronary artery disease that may lead to the same outcome of a heart attack, but this does not mean they should be treated the same.

The study revealed people may be misdiagnosed as having atheroscleotic blockage when they really just have a coronary artery spasm. As a result, they unnecessarily receive a stent when all they actually needed was medication.

The study took six patients with coronary artery disease. Prior to placing stents, cardiologists gave the patients nitroglycerin. Nitroglycerin is a drug used to control congestive heart failure associated with heart attack. The drug works by relaxing and widening blood vessels.

In the study, once all six patients received the nitroglycerin their blockages cleared, which means they had coronary artery spasms (not a fixed blockage), which does not require the use of a stent. What’s also interesting about this study is the patients, both male and female, were between the ages of 46 to 57, which is considered young to be having coronary artery disease. The researchers said if the person is under the age of 60 and only a single heart vessel is affected this is a red flag he or she may have a spasm as opposed to a fixed blockage.

If you were in the patient’s’ position, wouldn’t it be such a relief to know you didn’t have to place a foreign object in your heart?!

The study says, “[c]ardiovascular guidelines on cardiac catheterization and coronary intervention with stents go to great lengths emphasizing the importance of antiplatelet (blood thinning) medications to prevent blood clots in the stents. On the other hand, they fail to mention any role for intracoronary nitroglycerin during cardiac catheterization or before angioplasty with stenting.”

This is why it is important to know your options as a patient. Stents are very popular. You may have heard about very famous people that received stents. Bill Clinton had two stents put in is heart in 2010 (he also had quadruple coronary artery bypass surgery in 2004), and former President George W. Bush received a stent in 2013.

“Like Clinton and Bush, one million Americans undergo stent procedures every year, sometimes without even a night in the hospital,” according to an article from the American Bar Association.”

Earlier this year, Spanish actor Antonio Banderas, 56, suffered a heart attack and received three stents!

Of course we cannot determine ourselves whether we should receive a stent, but we can always question why millions of Americans are undergoing stent procedures every year.

Part of being proactive about your health is being somewhat of an investigator. Always ask your doctor whether there are alternatives, especially if the treatment involves putting a foreign object in your body.

Enjoy your healthy life!

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