Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein. You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Get the Compare Your Your Quiz Your Summary This decision aid is for people who: This decision aid may also be helpful if you are scheduled to have an angiogram. Depending on what that test finds, an angioplasty can sometimes be done at the same time. Angioplasty is a procedure to restore blood flow in narrowed coronary arteries. During angioplasty, the doctor puts a thin, flexible tube called a catheter into an artery in your groin or arm. The doctor guides the tube into the narrowed coronary artery. Dye is put into the catheter to make the artery show up on an X-ray. This helps the doctor see narrow parts that limit blood flow. The doctor uses the catheter to put a small balloon into the narrowed part of the artery. The doctor expands the balloon for a short time. This widens the artery to allow blood to flow more easily. The doctor may put a small, expandable tube called a stent in the artery to keep it open. Before the procedure, you may get medicine that relaxes you or puts you in a light sleep. The area where the catheter is put in will be numb. You may feel a brief sting or pinch from the numbing medicine. Most people do not have pain when the catheter is in the blood vessel. You will probably feel some warmth when the dye is put in. The procedure can take a few hours. This includes the time to get ready for the procedure and the time to recover after it. You may go home the same day. Or you may stay at least 1 night in the hospital. After you leave the hospital, you will avoid strenuous activity and not lift anything heavy until your doctor says it is okay. This may be for several days. It's important to continue medical therapy. This includes having a heart-healthy lifestyle and taking medicines to prevent a heart attack and stroke. If you get a stent, you may take aspirin plus another medicine to prevent blood clots. How long you will take the medicines depends on the type of stent you have. If your stent is coated with medicine to prevent clots, you may take both medicines for at least 6 months. If your stent is bare metal, you may take both medicines for at least 1 month. After that, you will likely keep taking one of the medicines. If you have a high risk of bleeding, your doctor may shorten the time you take these medicines. You can work with your doctor to decide how long you will take both of these medicines. You may still need medicine such as nitroglycerin when you have angina symptoms. But you may not need to take it as often. To have a heart-healthy lifestyle, be active, eat healthy foods, stay at a healthy weight, manage other health problems, and don't smoke. Medical therapy includes taking medicines and having a heart-healthy lifestyle. Medical therapy is important for all people who have coronary artery disease. Whatever choice you make about angioplasty, medical therapy will give you the best chance of keeping coronary artery disease from getting worse. It can help you prevent a heart attack and live longer. And it also can help relieve angina symptoms. You take medicines to prevent a heart attack. These include aspirin and medicines to lower blood pressure and cholesterol. You also take medicine to relieve angina symptoms. Examples of angina medicines include nitroglycerin, beta-blockers, and calcium channel blockers. A heart-healthy lifestyle includes eating a healthy diet, not smoking, staying at a healthy weight, and getting daily exercise. Your doctor may ask you to: After angioplasty, a cardiac rehab program can help you make lifestyle changes if you need to. Talk to your doctor about whether rehab is right for you. Cardiac rehab includes supervised exercise. It also includes help with diet and lifestyle changes and emotional support. You may have had tests such as an exercise stress test or a coronary angiogram to see if you have narrowing of your heart arteries. If you do have narrowing, you may decide to have angioplasty because you want relief from angina symptoms. Angioplasty can improve symptoms for people who have stable angina. (Stable angina means that you can usually predict when your symptoms will happen. You probably know what things cause your angina. For example, you know how much activity usually causes your angina. You also know how to relieve your symptoms.) Your doctor may suggest angioplasty if:footnote 7 It's important to talk with your doctor about your symptoms. Do they limit your daily activities and make it hard to enjoy your life? Do you have angina during light physical activity, such as walking a couple of blocks or up stairs? Also, if you are taking medicine for angina, let your doctor know if it doesn't control your symptoms enough. Your doctor may do some other tests to make sure that angioplasty is a good choice for you. For example, your doctor may check: You don't have to decide right away whether to have angioplasty. You could decide later to have it. Angioplasty can improve your angina symptoms. It can also improve your quality of life. If your symptoms happen a lot, you are more likely to have a better quality of life after the procedure.footnote 10 Angioplasty might not relieve all of your symptoms. But you might not need to take angina medicines anymore. Or you might not need to take as much. There are some things that angioplasty can't do. In people who have stable angina:footnote 2 It may be hard to understand why angioplasty does not lower your risk of a heart attack or help you live longer. It's because of how coronary artery disease and plaque happen in your arteries. Even if you get a stent, you still may have other places in your arteries where a heart attack can happen. During the procedure, your doctor finds and treats the places where plaque narrows the artery and limits blood flow. But smaller plaques can build up in other places in your arteries. They don't limit blood flow much or cause symptoms. But if one ruptures, it can cause a heart attack. This type of plaque is treated with medicines and a heart-healthy lifestyle. Angioplasty has some risks. They include: Your doctor can help you know your chance of problems from the procedure. Several things, including age and health, can raise your risk of problems. For example, older people or those with heart failure or kidney disease have a higher risk of problems. The risks of problems where the catheter was placed include: Over time, there is a chance that blood vessels with stents can close. There also is a chance that you'll need to decide whether or not to have another angioplasty or a bypass surgery. Radiation: There is always a slight risk of damage to cells or tissues from being exposed to any radiation. This includes the low levels of X-ray used for this procedure. But the risk of damage from the X-rays is usually very low compared with the possible benefits of the procedure. *These numbers are based on one research study.footnote 13Another study showed a similar trend in symptom relief after angioplasty.footnote 10footnote 9(Evidence quality: moderate.) Both medical therapy alone (heart-healthy lifestyle and taking medicines) and angioplasty plus medical therapy can relieve angina. Angioplasty improves angina sooner. But over time, both treatments may work about the same to ease symptoms and improve quality of life.footnote 13footnote 10 Take 100 people who had angioplasty in one study:footnote 13 Doctors usually recommend that you try medical therapy first. This may include changing the dose of medicines or trying new medicines. Medical therapy doesn't always work to relieve symptoms. But it does help to prevent a heart attack. You may decide later to have angioplasty if you still have symptoms that keep you from doing your activities. Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it. Another thing to understand is that the evidence can't predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98. The following numbers about risks come from problems seen in patients in hospitals. Take 100 people who have angioplasty. They have the following risks: *Based on rates of complications from patients. Compare What is usually involved? What are the benefits? What are the risks and side effects? These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. My chest pain bothers me sometimes. My doctor and I talked about it, and we decided that I could change my dose or maybe try another angina medicine. And I could take better care of myself. At my age, any procedure has extra risks, so I want to try the other stuff first. Rodrigo, age 75 I love to take hikes with my daughter and grandchildren. And I love to travel. But I can't walk very far, because my chest hurts. Even though I have been taking my medicines and trying to eat well and exercise, my pain is still there. My doctor and I agreed that angioplasty may be a good choice for me. Margie, age 62 I have some angina symptoms, but they don't bother me very often. I mostly want to lower my risk of a heart attack. And angioplasty won't do that. So I'm going to try to keep eating better, being active, and taking my medicines. Susan, age 56 I've had angina for a while now. I usually take nitroglycerin for it, along with my other medicines. But lately I've had more pain when I do chores around the house or play golf. My doctor said angioplasty might be an option because I have a couple of narrowed arteries. So I'm going to have it. I'll still have to watch what I eat, get some exercise, and take my medicines. Frank, age 60 Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to choose angioplasty Reasons to choose medical therapy I have angina symptoms that keep me from doing my activities and enjoying my life. My angina doesn't keep me from my activities and from enjoying my life. I would rather take less medicine for angina. I don't mind taking medicine for angina. I'm not worried about the risks of angioplasty. I'm worried about the risks of angioplasty. My other important reasons: My other important reasons: Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Angioplasty Medical therapy Check the facts Decide what's next Certainty 1. How sure do you feel right now about your decision? Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. This decision aid is for people who: This decision aid may also be helpful if you are scheduled to have an angiogram. Depending on what that test finds, an angioplasty can sometimes be done at the same time. Angioplasty is a procedure to restore blood flow in narrowed coronary arteries. During angioplasty, the doctor puts a thin, flexible tube called a catheter into an artery in your groin or arm. The doctor guides the tube into the narrowed coronary artery. Dye is put into the catheter to make the artery show up on an X-ray. This helps the doctor see narrow parts that limit blood flow. The doctor uses the catheter to put a small balloon into the narrowed part of the artery. The doctor expands the balloon for a short time. This widens the artery to allow blood to flow more easily. The doctor may put a small, expandable tube called a stent in the artery to keep it open. Before the procedure, you may get medicine that relaxes you or puts you in a light sleep. The area where the catheter is put in will be numb. You may feel a brief sting or pinch from the numbing medicine. Most people do not have pain when the catheter is in the blood vessel. You will probably feel some warmth when the dye is put in. The procedure can take a few hours. This includes the time to get ready for the procedure and the time to recover after it. You may go home the same day. Or you may stay at least 1 night in the hospital. After you leave the hospital, you will avoid strenuous activity and not lift anything heavy until your doctor says it is okay. This may be for several days. It's important to continue medical therapy. This includes having a heart-healthy lifestyle and taking medicines to prevent a heart attack and stroke. If you get a stent, you may take aspirin plus another medicine to prevent blood clots. How long you will take the medicines depends on the type of stent you have. If your stent is coated with medicine to prevent clots, you may take both medicines for at least 6 months. If your stent is bare metal, you may take both medicines for at least 1 month. After that, you will likely keep taking one of the medicines. If you have a high risk of bleeding, your doctor may shorten the time you take these medicines. You can work with your doctor to decide how long you will take both of these medicines. You may still need medicine such as nitroglycerin when you have angina symptoms. But you may not need to take it as often. To have a heart-healthy lifestyle, be active, eat healthy foods, stay at a healthy weight, manage other health problems, and don't smoke. Medical therapy includes taking medicines and having a heart-healthy lifestyle. Medical therapy is important for all people who have coronary artery disease. Whatever choice you make about angioplasty, medical therapy will give you the best chance of keeping coronary artery disease from getting worse. It can help you prevent a heart attack and live longer. And it also can help relieve angina symptoms. You take medicines to prevent a heart attack. These include aspirin and medicines to lower blood pressure and cholesterol. You also take medicine to relieve angina symptoms. Examples of angina medicines include nitroglycerin, beta-blockers, and calcium channel blockers. A heart-healthy lifestyle includes eating a healthy diet, not smoking, staying at a healthy weight, and getting daily exercise. Your doctor may ask you to: After angioplasty, a cardiac rehab program can help you make lifestyle changes if you need to. Talk to your doctor about whether rehab is right for you. Cardiac rehab includes supervised exercise. It also includes help with diet and lifestyle changes and emotional support. You may have had tests such as an exercise stress test or a coronary angiogram to see if you have narrowing of your heart arteries. If you do have narrowing, you may decide to have angioplasty because you want relief from angina symptoms. Angioplasty can improve symptoms for people who have stable angina. (Stable angina means that you can usually predict when your symptoms will happen. You probably know what things cause your angina. For example, you know how much activity usually causes your angina. You also know how to relieve your symptoms.) Your doctor may suggest angioplasty if:7 It's important to talk with your doctor about your symptoms. Do they limit your daily activities and make it hard to enjoy your life? Do you have angina during light physical activity, such as walking a couple of blocks or up stairs? Also, if you are taking medicine for angina, let your doctor know if it doesn't control your symptoms enough. Your doctor may do some other tests to make sure that angioplasty is a good choice for you. For example, your doctor may check: You don't have to decide right away whether to have angioplasty. You could decide later to have it. Angioplasty can improve your angina symptoms. It can also improve your quality of life. If your symptoms happen a lot, you are more likely to have a better quality of life after the procedure.10 Angioplasty might not relieve all of your symptoms. But you might not need to take angina medicines anymore. Or you might not need to take as much. There are some things that angioplasty can't do. In people who have stable angina:2 It may be hard to understand why angioplasty does not lower your risk of a heart attack or help you live longer. It's because of how coronary artery disease and plaque happen in your arteries. Even if you get a stent, you still may have other places in your arteries where a heart attack can happen. During the procedure, your doctor finds and treats the places where plaque narrows the artery and limits blood flow. But smaller plaques can build up in other places in your arteries. They don't limit blood flow much or cause symptoms. But if one ruptures, it can cause a heart attack. This type of plaque is treated with medicines and a heart-healthy lifestyle. Angioplasty has some risks. They include: Your doctor can help you know your chance of problems from the procedure. Several things, including age and health, can raise your risk of problems. For example, older people or those with heart failure or kidney disease have a higher risk of problems. The risks of problems where the catheter was placed include: Over time, there is a chance that blood vessels with stents can close. There also is a chance that you'll need to decide whether or not to have another angioplasty or a bypass surgery. Radiation: There is always a slight risk of damage to cells or tissues from being exposed to any radiation. This includes the low levels of X-ray used for this procedure. But the risk of damage from the X-rays is usually very low compared with the possible benefits of the procedure. *These numbers are based on one research study.13Another study showed a similar trend in symptom relief after angioplasty.109(Evidence quality: moderate.) Both medical therapy alone (heart-healthy lifestyle and taking medicines) and angioplasty plus medical therapy can relieve angina. Angioplasty improves angina sooner. But over time, both treatments may work about the same to ease symptoms and improve quality of life.1310 Take 100 people who had angioplasty in one study:13 Doctors usually recommend that you try medical therapy first. This may include changing the dose of medicines or trying new medicines. Medical therapy doesn't always work to relieve symptoms. But it does help to prevent a heart attack. You may decide later to have angioplasty if you still have symptoms that keep you from doing your activities. Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it. Another thing to understand is that the evidence can't predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98. The following numbers about risks come from problems seen in patients in hospitals. Take 100 people who have angioplasty. They have the following risks: *Based on rates of complications from patients. These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. "My chest pain bothers me sometimes. My doctor and I talked about it, and we decided that I could change my dose or maybe try another angina medicine. And I could take better care of myself. At my age, any procedure has extra risks, so I want to try the other stuff first." — Rodrigo, age 75 "I love to take hikes with my daughter and grandchildren. And I love to travel. But I can't walk very far, because my chest hurts. Even though I have been taking my medicines and trying to eat well and exercise, my pain is still there. My doctor and I agreed that angioplasty may be a good choice for me." — Margie, age 62 "I have some angina symptoms, but they don't bother me very often. I mostly want to lower my risk of a heart attack. And angioplasty won't do that. So I'm going to try to keep eating better, being active, and taking my medicines." — Susan, age 56 "I've had angina for a while now. I usually take nitroglycerin for it, along with my other medicines. But lately I've had more pain when I do chores around the house or play golf. My doctor said angioplasty might be an option because I have a couple of narrowed arteries. So I'm going to have it. I'll still have to watch what I eat, get some exercise, and take my medicines." — Frank, age 60 Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to choose angioplasty Reasons to choose medical therapy I have angina symptoms that keep me from doing my activities and enjoying my life. My angina doesn't keep me from my activities and from enjoying my life. I would rather take less medicine for angina. I don't mind taking medicine for angina. I'm not worried about the risks of angioplasty. I'm worried about the risks of angioplasty. My other important reasons: My other important reasons: Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Angioplasty Medical therapy 1.
Do you still have to take medicines for your heart if you have angioplasty? 2.
If you keep trying medical therapy now, can you still have angioplasty later? 3.
Does angioplasty have serious risks? 1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? 1.
How sure do you feel right now about your decision? 2.
Check what you need to do before you make this decision. Current as of: July 31, 2024 Author: Ignite Healthwise, LLC Staff Clinical Review Board This information does not replace the advice of a doctor. Ignite Healthwise, LLC disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content. To learn more about Ignite Healthwise, LLC, visit webmdignite.com. © 2024 Ignite Healthwise, LLC. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Ignite Healthwise, LLC.Coronary Artery Disease: Should I Have Angioplasty for Stable Angina?
Coronary Artery Disease: Should I Have Angioplasty for Stable Angina?
1
Facts2
Options3
Feelings4
Decision5
Yourself6
Get the facts
Your options
Key points to remember
What is angioplasty?
Treatment after angioplasty
What is medical therapy for stable angina?
Medicines
Heart-healthy lifestyle
Why might you have angioplasty?
What are the benefits of angioplasty?
What are the risks of angioplasty?
What do numbers tell us about benefits and risks of angioplasty?
Benefits
After 3 months After 2 years After 3 years Angioplasty plus medical therapy 53 out of 100 59 out of 100 59 out of 100 Medical therapy 42 out of 100 53 out of 100 56 out of 100 Understanding the evidence
Risks
Possible problems from the procedure How many people had this problem Damage to the blood vessel where catheter is put infootnote 11, footnote 4 About 1 to 4out of 100 Bleeding problem during the procedurefootnote 8 About 1 or 2 out of 100 Emergency bypass surgeryfootnote 6 Fewer than 1 out of 100 people (4 out of 1,000) Strokefootnote 1 Fewer than 1 out of 100 (2 out of 1,000) Death in the hospitalfootnote 12 Fewer than 1 out of 100 (1 out of 1,000) Compare your options
Personal stories about deciding to have angioplasty for stable angina
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?
Your Summary
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
Author Ignite Healthwise, LLC Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.Coronary Artery Disease: Should I Have Angioplasty for Stable Angina?
1. Get the Facts
Your options
Key points to remember
What is angioplasty?
Treatment after angioplasty
What is medical therapy for stable angina?
Medicines
Heart-healthy lifestyle
Why might you have angioplasty?
What are the benefits of angioplasty?
What are the risks of angioplasty?
What do numbers tell us about benefits and risks of angioplasty?
Benefits
After 3 months After 2 years After 3 years Angioplasty plus medical therapy 53 out of 100 59 out of 100 59 out of 100 Medical therapy 42 out of 100 53 out of 100 56 out of 100 Understanding the evidence
Risks
Possible problems from the procedure How many people had this problem Damage to the blood vessel where catheter is put infootnote 11, footnote 4 About 1 to 4out of 100 Bleeding problem during the procedurefootnote 8 About 1 or 2 out of 100 Emergency bypass surgeryfootnote 6 Fewer than 1 out of 100 people (4 out of 1,000) Strokefootnote 1 Fewer than 1 out of 100 (2 out of 1,000) Death in the hospitalfootnote 12 Fewer than 1 out of 100 (1 out of 1,000) 2. Compare your options
Have angioplasty, along with taking medicines and having a healthy lifestyle Take medicines and have a heart-healthy lifestyle (medical therapy) What is usually involved? What are the benefits? What are the risks and side effects? Personal stories
Personal stories about deciding to have angioplasty for stable angina
3. What matters most to you?
4. Where are you leaning now?
5. What else do you need to make your decision?
Check the facts
Decide what's next
Certainty
By Ignite Healthwise, LLC Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
FAQs
Have angioplasty, along with taking medicines and having a healthy lifestyle Have angioplasty, along with taking medicines and having a healthy lifestyle
Take medicines and have a heart-healthy lifestyle (medical therapy) Take medicines and have a heart-healthy lifestyle (medical therapy)
More important
Equally important
More important
More important
Equally important
More important
More important
Equally important
More important
More important
Equally important
More important
Leaning toward
Undecided
Leaning toward
Not sure at all
Somewhat sure
Very sure
Credits
References
Citations
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
FAQs
More important
Equally important
More important
More important
Equally important
More important
More important
Equally important
More important
More important
Equally important
More important
Leaning toward
Undecided
Leaning toward
You're right. If you choose angioplasty, you will still need to take medicines to reduce your risk of a heart attack or stroke.
You're right. If you decide to try medical therapy now, you can still have angioplasty later if your angina symptoms bother you too much.
You're right. Angioplasty carries the risk of heart attack, stroke, and death. Your chances of having a serious problem increase with age.
Not sure at all
Somewhat sure
Very sure
Credits
References
Citations