Coronary angioplasty is carried out as a planned procedure, or as a form of emergency treatment.
Planned coronary angioplasty
Coronary angioplasty is not suitable for everyone with angina. Initially, your GP will refer you to a heart specialist, called a cardiologist, for some tests. The tests that you will usually have include:
- blood tests,
- an electrocardiogram (ECG) - an electrical recording of your heart to measure how well it is working, and
- a coronary angiogram.A coronary angiogram is used to find the blockages in your coronary arteries.
A catheter (thin, flexible tube) is gently inserted into your coronary artery and a special dye is injected which shows up on X-ray pictures to highlight any blockages. The specialist will use the test results to determine the most suitable form of treatment for you. About three in every 10 people who have a coronary angiogram go on to have a coronary angioplasty.
If there are too many narrow sections in your arteries, or if there are lots of branches coming off the arteries, that are also blocked, a coronary angioplasty may not be possible. In such cases, alternative operations, such as a coronary artery bypass, may be considered (see below).
Emergency coronary angioplasty
Coronary angioplasty may sometimes be used to treat people who have acute coronary syndrome, such as a heart attack, or unstable angina. If you have unstable angina, you will experience chest pain even while you are resting. Emergency coronary angioplasty and planned coronary angioplasty use the same procedure, although if you have acute coronary syndrome, you may require additional medication when the angioplasty is carried out.
Coronary artery bypass
A coronary artery bypass is a procedure that allows the blood flowing through your coronary artery, to bypass (get round) the part of the artery that is blocked. To do this, an artery from another area of your body, usually your chest wall, or a vein from your leg, is taken and one end is grafted (attached) below the blockage and the other end above the blockage.
A coronary angioplasty may be a suitable procedure if you have previously had a coronary artery bypass. If the 'grafted' blood vessels become blocked, a coronary angioplasty may be used to widen them. For more information about coronary artery bypass, see the separate encyclopaedia topic.