Treatments for coronary heart disease

A doctor explaining treatment to patient

BHF Professor David Newby, who leads our Scottish Centre of Regenerative Medicine at the University of Edinburgh, explains treatments for coronary heart disease like angioplasty and bypass surgery, what they involve and how long they last.

Coronary heart disease (CHD) is where the arteries that supply your heart muscle with oxygen-rich blood become narrowed due to a build-up of fatty plaque (atheroma). This can reduce blood flow, resulting in angina symptoms.

Sometimes a piece of plaque breaks off and a blood clot forms around it, blocking blood flow to part of your heart muscle. This is a heart attack.

CHD is a progressive disease and there is currently no way to reverse plaque buildup, but the process can be slowed down by medications and lifestyle changes, and treatment can manage symptoms.

If your plaque build-up is severe or causing symptoms, or if you’ve already had a heart attack, you may be referred for an angioplasty and stent, or coronary artery bypass grafting (CABG).

Coronary artery bypass grafting (CABG)

What does the procedure involve?

This procedure is normally carried out on people with a very severe narrowing in one or more arteries, especially if the narrowing is too tight to accommodate a stent or you have several narrowings in the arteries that supply your heart muscle with blood.

An artery or vein is taken from another part of your body and used to divert blood around the narrowing or blockage.

How quickly will it start to work?

Following successful bypass surgery, around 75 per cent of patients will be free from the symptoms of angina.

Following successful bypass surgery, around 75 per cent of patients will be free from the symptoms of angina, such as chest pain and shortness of breath. However, the benefit may be masked by soreness from the wound for a few weeks after surgery.

How long will it last?

Plaque can build up in your bypass graft, so some people will later require angioplasty and stents, but eating a balanced diet, taking regular exercise and not smoking help to prevent this. You will need to take medications after the procedure, too.

Angioplasty and stents

What does the procedure involve?

A small balloon is inflated in the narrowing to push plaque to the sides of the artery, then the stent is put in to reinforce this.

How quickly does it work?

“This treatment should resolve the symptoms of angina, such as chest pain, straight away,” says BHF Professor David Newby.

“It’s very unusual for a stent to cause any other problems, but in about one in 20 cases, symptoms may return because of in-stent restenosis. This is where the inside of the stent becomes furred up with scar tissue. It usually develops over three to six months.”

How long does it last?

As with other treatments, a stent won’t fix the underlying disease, but it will reduce or resolve your symptoms.

It’s important to make positive lifestyle changes to slow down further plaque build-up.

Professor David Newby
University of Edinburgh

For this reason, it’s important to make positive lifestyle changes to slow down further plaque build-up, as this could mean further stents or even bypass surgery,” says Professor Newby. “Future problems are particularly likely if you continue to smoke.

“Stents can last your whole lifetime and you may not need any further treatment to the narrowed artery. However, if plaque builds up at different places in the stented artery or any other coronary arteries, you may need further stents fitted.

“Recovery time following a stent is usually very short. For a planned procedure, you normally go home the same day. Full recovery depends on the success of the procedure and your pre-operative fitness.”

BHF Professor David NewbyProfessor David Newby

  • BHF Professor of Cardiology, University of Edinburgh
  • Leads the Scottish Centre of Regenerative Medicine (funded by our Mending Broken Hearts Appeal)

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