Harvard Heart Letter

Understanding angioplasty: When you need it and when you may not

Angioplasty can save lives, but it isn't always urgent. For some people, optimal medical therapy makes sense.

Each year, about 600,000 people in the United States undergo an angioplasty to widen a narrowed coronary artery, nearly always with a tiny wire mesh tube (stent) left inside the artery to keep it open. About two-thirds of these procedures are done in people experiencing a potentially life-threatening event—a heart attack or unstable angina, defined as severe, worsening chest pain during exertion or stress, or chest pain that happens at rest.

"Angioplasty is a phenomenal therapy that has greatly enhanced our ability to improve quality of life and reduce mortality in millions of people with cardiovascular disease," says Dr. Kenneth Rosenfield, who heads the vascular medicine section at Harvard-affiliated Massachusetts General Hospital. If you have angina that suddenly worsens, angioplasty and stent placement can restore blood flow to your oxygen-starved heart, easing the pain within about 20 minutes—the average time it takes for the procedure. Once you've recovered, you may find you're able to exercise longer than before. And if you're having a heart attack, the procedure will lower your risk of a having a second heart attack or of dying.

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