A Cardiologist Talks About a Procedure to Treat Coronary Artery Disease

WORDS DR TIMOTHY JAMES WATSON

FEATURED EXPERT
DR TIMOTHY JAMES WATSON
Consultant Cardiologist
Pantai Hospital Batu Pahat
PERCUTANEOUS CORONARY INTERVENTION

Percutaneous coronary intervention (PCI for short) is a mechanical solution for obstructive coronary artery disease.

An overview of coronary artery disease. Click image for a larger, clearer version.

This solution essentially pushing the plaques to the side of the vessel to restore blood flow to the heart.

Stents and balloons are used to widen the blood vessel affected by plaque that blocks blood flow. Click the image for a larger, clearer version.

Firstly, this helps to relieve symptoms and, in unstable patients, saves lives.

Nonetheless, it doesn’t reverse the atherosclerotic process.

However, the advent of newer technologies such as drug-eluting balloons likely help with positive remodeling of the artery, such as enlargement without needing a stent.

ATTACHING A FINE ULTRASOUND CAMERA TO PCI CAN IMPROVE OUTCOME

During the coronary angiogram, a fine ultrasound camera is inserted into the angiogram catheter and fed into the heart blood vessel.

The ultrasound camera is then slowly withdrawn whilst taking a series of pictures from inside the blood vessel.

The doctor can then use these pictures to get live data of the plaque and size of the blood vessel to help make treatment decisions.

This procedure, called intravascular ultrasound-guided percutaneous coronary intervention (IVUS-guided PCI), has been repeatedly shown to improve outcomes and is highly recommended in many cases.

The IVUS procedure takes only 5 minutes or so and the patient will be unaware of what is going on.

PREPARING FOR A PERCUTANEOUS CORONARY INTERVENTION

Percutaneous coronary intervention is generally a straightforward and fairly low-risk procedure.

  • Of course, feelings of anxiety are natural. So, it is best to come to the hospital with a friend or family to accompany you.
  • Eat all your medications as normal, especially the blood thinning medication.
  • For the diabetes medication, your doctor may ask you to withhold one or two doses before/after the procedure.
  • Prolonged fasting is generally not required pre-procedure. A few hours should be ample.
AFTER THE PROCEDURE

In the majority of cases recovery from PCI is very rapid.

There may be some discomfort or bruising at the puncture site, but this should quickly resolve within a few days to a week.

Thereafter most patients will be back to normal very quickly.

Can Stress Cause Heart Diseases in Young Adults? A Cardiologist Explains

WORDS LIM TECK CHOON

FEATURED EXPERT
DR TIMOTHY JAMES WATSON
Consultant Cardiologist
Pantai Hospital Batu Pahat
HOW COMMON IS HEART DISEASE AMONG YOUNG ADULTS? 
Dr Timothy:

Heart disease is common. In general, the risk factors are:

  • Male gender
  • Advancing age
  • Smoking
  • Diabetes
  • High blood pressure or hypertension
  • High levels of fats in the blood or hyperlipidaemia
  • Family history
  • Physical inactivity.

Young people that develop heart disease often are significantly overweight, or they have smoking or uncontrolled diabetes from young as major risk factors.

HOW ABOUT FATAL HEART DISEASE?
Dr Timothy:

Fatal heart disease is rare in otherwise apparently fit young people.

Nonetheless, we all know of people that have heart attacks or those who even collapse at a young age.

In many cases there is an underlying driving factor, such as smoking, or an underlying heart muscle defect such as hypertrophic cardiomyopathy

CAN STRESS INCREASE A YOUNG ADULT’S RISK OF HEART DISEASE?
Dr Timothy:

Stress may also play a role, but this is hard to define. Stress is a very personal matter.

For example, some people thrive in stressful environments, while others struggle. How this translates into cardiac risk is not clear-cut, especially as there is no universal definition or measurement scale for stress.

WHAT IS YOUR ADVICE TO YOUNGER ADULTS WHEN IT COMES TO STRESS MANAGEMENT?
Dr Timothy:

We all feel stressed. Sometimes it can be a motivating factor, but sometimes it can be overwhelming and daunting.

It is important to be comfortable and happy in life. Find things you enjoy.

Work hard but don’t do things to excess. This includes overworking, overeating, etc.

Find a job you enjoy. After all, you will spend a significant amount of your time at work.

Find time to relax yourself and keep your body fit and healthy. A simple evening walk may be enough. Jogging or cycling with your family may be even better.