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Is an angioplasty or taking medication better for treating heart disease?

Cardiology

I've read online that angioplasties are unnecessary, and medication can work just as well.

DOCTOR’S ANSWER (2)

Treating heart disease usually begins with lifestyle changes and/or medications that help improve blood flow to your heart muscle.

However, your angiogram will clearly show the blockage in your coronary arteries. I always make sure to explain ALL available treatment options to my patients.

The treatment that's best for you depends on:

  1. How bad your heart disease and symptoms are
  2. Location and severity of the heart vessel blockages
  3. Any other medical conditions that you may have
  4. Your ability to take long-term blood thinning tablets
  5. Your lifestyle
  6. Your preferred treatment 

I emphasized the last point, because at the end of the day, our job as doctors is simply to give you the best advice on all your available treatment options.

Indeed, an angioplasty may NOT be the best treatment in the following situations:

  • You've got many narrowed areas in several different heart vessels 
  • There is a very tight blockage in your heart vessel
  • The catheter cannot reach a blockage because of a tight corner

This is why I always tell my patients that it's important they take the time to understand all their treatment options.  


Dr Julian Tan
MBBS, FRCP, FSCAI, FESC, FAPSIC, MMed, MRCP, ACSM, FAMS (Cardiology)

THE HEART SPECIALIST CLINIC
3 MT ELIZABETH
MOUNT ELIZABETH MEDICAL CENTRE
Singapore 228510

826 views 16 Oct 2018

Medications vs angioplasty, which is better?

I would like to get 1 important message through first: angioplasty is not a cure and one still needs medication even after angioplasty.

Deciding on the options depends on a few factors. 

1) is the patient symptomatic? angioplasty is better than medication in controlling symptom.

2) is the artery blockage prognostically important? ie. will it affect how long one lives. If one has prognostically important coronary artery disease, then revacularisation (eg. angioplasty or bypass) is preferred.

3) is there contra-indication to angioplasty? Angioplasty is an invasive procedure and carries small but important risks. Angioplasty may not be suitable for some patients because of various factors.

4) patient's preference. A cardiologist should outline all the treatment options, their pros and cons, and allow patient to make the final decision. In the process, the cardiologist should indicate his or her preferred option and the reasoning behind it.


Dr Lee Chee Wan
MBBS, MRCP, MMed, FAMS

Cardiac Centre International

Cardiac Centre International

Mount Elizabeth Medical Centre
#07-04, 3 Mount Elizabeth
Singapore 228510


607 views 17 Nov 2018
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Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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