If you're experiencing shortness of breath and chest pain (angina) and your doctor says the cause is due to blockages in your heart arteries, she may recommend angioplasty with stenting.

During an angioplasty procedure, a tiny balloon is inserted in the affected artery or arteries through a catheter that's placed in an artery, typically in the groin. The balloon is then inflated to widen the artery and a small wire mesh tube (stent) is used to prop open the artery. The stent stays in place permanently, holding open the narrowed arteries, improving blood flow to the heart muscle and relieving symptoms.

Stenting procedures are so common, there are more than one million performed each year in the U.S. But is stenting right for you? It depends on whether you have unstable or chronic stable angina, both of which are caused by a narrowing of the arteries. Unstable angina is a serious situation and a warning sign of a heart attack and requires emergency treatment, which usually involves angioplasty with stents.

Chronic stable angina is a form of chest pain that happens when your heart is working hard, for example, during exercise, but the pain goes away when you rest. If you have this type of angina, you may have to decide between angioplasty with stenting or medications as your treatment options. Or, if the blockage is severe, your doctor may recommend coronary bypass surgery in which the blocked arteries are replaced with blood vessels grafted from another part of your body.

Treating Stable Angina

If you have stable angina, you may be able to treat the problem with medications and lifestyle changes alone. Some medications used to treat stable angina include:

  • Aspirin
  • Beta blockers
  • Nitrates
  • Statins
  • Calcium channel blockers
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Ranolazine (Ranexa)

Regardless of the type of angina you have and whether you and your doctor choose angioplasty with stenting or medication to treat the problem, your doctor will also recommend that you make some lifestyle changes, including:

  • Quitting smoking
  • Eating a healthy diet of whole grains and fruits and vegetables
  • Getting physical exercise. Your doctor will help you develop a safe exercise plan that doesn't overly tax your heart
  • Losing weight
  • Treating underlying conditions that can increase your risk of angina, such as diabetes, high blood pressure, and high blood cholesterol
  • Relieving stress

Sources:
mayoclinic.com/health/angina-treatment/HB00091/METHOD=print

americanheart.org/presenter.jhtml?identifier=4721