People who arrive at the hospital a day or more after experiencing a heart attack might expect to receive an artery-opening angioplasty. But they shouldn’t, according to guidelines issued in 2007 based on evidence that angioplasty was no more beneficial than medical treatment in such cases.

Yet today, doctors still perform as many angioplasties on people showing up “late” after a heart attack as they did before the guidelines were published, according to the lead feature in the December 2011 Harvard Heart Letter.

Among the possible reasons why practice hasn’t changed in this regard:

• Doctors may be unaware of — or disagree with — the no-angioplasty approach in this scenario
• Doctors may have concerns about being sued if they don’t intervene aggressively or meet patient expectations of a dramatic response

Time — in terms of minutes and hours, not days — is truly of the essence when it comes to seeking help for a heart attack. The same Heart Letter article cites a study of people who received an angioplasty within 12 hours of having a heart attack. Among them, every hour of delay between the onset of symptoms and the angioplasty boosted the risk of heart failure by 4% over the next three years.

The bottom line: if you think you are having a heart attack, call 911. If the symptoms turn out to be something else, no real harm is done. Better to risk the mild embarrassment of a false alarm than to increase the odds of developing a difficult-to-manage condition like heart failure.

Read the full-length article: "Angioplasty a day after a heart attack not worth it"