What is coronary angioplasty?

Savannah cardiologist Dr. Roy Flood explains this minimally-invasive heart procedure, also called percutaneous coronary intervention

If you have shortness of breath, chest discomfort and often feel tired or sweaty, your doctor may discover a blocked artery in your heart.

Yes, it can be very serious, but it’s also very common. What’s also common is a minimally-invasive procedure to open up blocked arteries that has most people feeling better the same day.

It’s called percutaneous coronary intervention (PCI), also known as coronary angioplasty. St. Joseph’s/Candler is one of the best in the region performing this procedure, being recognized five times with the Chest Pain Center Accreditation with Primary PCI.

What is PCI/angioplasty and stent placement?

Angioplasty is a minimally-invasive procedure using balloons and stents to open blocked arteries, explains Dr. Roy Flood, cardiologist with St. Joseph’s/Candler Physician Network – Cardiology at SouthCoast.

“It’s a very small balloon that goes into the artery, and we expand it and that stretches the artery to help us re-establish blood flow through that area,” says Dr. Flood, who performs this procedure multiple times a week at The Heart Hospital at St. Joseph’s Hospital.

Once that is complete, or sometimes simultaneously, a metal tube – called a stent – is placed in that blocked area and expanded as well. The stent stays within the walls of the artery and establishes good blood flow through the blockage so a patient’s symptoms improve and the heart muscle is protected, Dr. Flood says.

The balloon and stent enter the body through a catheter either via the radial artery (located at your wrist) or the femoral artery (located near your groin). More so, patients and doctors decide to use the radial artery because it usually causes less bleeding and enhances mobility quicker, Dr. Flood says; however, both methods are safe.

Patients are under sedation during the procedure. They are able to talk to the doctor, but many typically have little or no memory of the procedure, Dr. Flood says. A local anesthetic is used, similar to what you may get at the dentist when a tooth is pulled. There is little to no pain involved with a PCI, Dr. Flood adds.

More good news is almost all patients go home the same day. Patients are asked to come in a few hours before the procedure and then stay two to four hours afterwards to monitor their vitals as the anesthesia wears off.

“Once the medication wears off, people often say, ‘I’m not getting that chest discomfort when I walk to my car,’ or ‘I can do more without feeling short of breath.’ It really can be a dramatic difference,” Dr. Flood says. “The heart is no longer starving.”

However, that doesn’t mean you can go back to fast food every day and no exercise. Once you have been diagnosed and treated, your outlook is very good, Dr. Flood says, but he encourages all his patients to stay on top of their health because another blocked artery can happen again.

“The truth of the matter is once you are a patient you should always be in the mindset of knowing your cholesterol, taking whatever medications you need to take and follow up by staying in contact with your heart healthy team,” Dr. Flood says. “It can definitely happen again, and we don’t want it to happen again.”

So who may need this procedure?

PCI can help relieve symptoms of coronary artery disease or reduce heart damage during or after a heart attack. Not everyone is an ideal candidate for coronary angioplasty. Some may still need a different procedure or open surgery, Dr. Flood says.

Coronary artery disease is caused by plaque buildup in the wall of the arteries that supply blood to the heart. It can cause:

• Chest pain and tightness
• Weakness/light-headedness
• Nausea
• Sweats
• Pain or discomfort in the arms or shoulder
• Shortness of breath
• Fatigue

If you experience any of these symptoms, you should see your doctor right away. These can be precursors to a heart attack. Through a series of tests, such as a stress test or echocardiogram, and imaging, your doctor can determine if you have a blockage of any of the heart’s arteries. If found early, your doctor may recommend PCI and potentially prevent a heart attack.

People with certain conditions, such as diabetes, high cholesterol and those with a family history of heart disease, should particularly pay attention to these symptoms as they are at high-risk of heart disease.

“I think the most important thing for your heart is to try not to engage in behaviors that you know are going to worsen your cardiac risks – bad diet, lack of exercise, smoking,” Dr. Flood says. “As important as those things are is having a knowledge of your own personal health issues. If your parents have a history of cardiac disease; if you have a problem with your cholesterol; if you’re hypertensive; if you are diabetic – one needs to know these things because the more those factors involve you, the more likely you’re going to have a problem.”

About the Chest Pain Center Accreditation

St. Joseph’s Hospital was once again awarded Chest Pain Accreditation with Primary PCI in December based on rigorous onsite evaluation of the staff’s ability to evaluate, diagnose and treat patients who have acute coronary syndrome. The American College of Cardiology awards this designation to hospitals that have demonstrated expertise and commitment in treating patients with chest pain.

This is the fifth time St. Joseph’s/Candler has achieved this accreditation, making us one of the very few health systems in the nation to do so and the first in the region. While St. Joseph’s Hospital officially received the accreditation, it recognizes the advanced cardiac treatment St. Joseph’s/Candler provides across the health system.

“The accreditation recognizes the outstanding job that our entire cardiovascular group is doing,” Dr. Flood says. “It means that we are leaders in the ability to diagnose, quickly recognize and mobilize the right people at the right time for the right procedure. I am really proud of our team.”