Heart Patient Guide

Treatment of coronary artery disease aims at 4 targets :

      (i) To decrease the rate of progression of coronary artery disease and other manifestations of atherosclerosis. This is achieved by modifying the risk factors and changing the life-style (see “ Prevention of Coronary Artery Disease”). Some drugs are also used to reduce stickiness of blood and reduce fat levels in blood.

      (ii) To reduce work – load and oxygen consumption of the heart. Drugs are used for this purpose.

      (iii) Treatment of associated conditions like diabetes, high blood pressure and obesity.

      (iv) Increase the blood supply to the heart muscles.

There are 3 ways by which blood supply to the heart muscles can be increased :

(a) Angioplasty - In angioplasty, a balloon catheter is passed into the diseased coronary artery across the blockage and the balloon is inflated. This opens up the diseased vessel. Sometimes, a metallic scafolding (stent) is inserted to prevent recurrence of blockage. However, angioplasty is suitable only in a limited number of patients with localized and less extensive coronary artery disease.

(b) Coronary Artery Bypass Grafting (CABG) : As the name implies, in CABG a new route is created for flow of blood to the heart muscles, and thus bypassing the obstruction. This is one of the most commonly performed operation in present times.

(c) Trans Myocardial Revascularization (TMR) : In TMR, with help of Laser machine, multiple small channels are made in the heart muscles. This increases the blood supply to the heart muscles. However, this procedure is suitable only in few patients. TMR can be done in isolation or in combination with CABG.