We don't want to admit that we have something physically wrong. We may, therefore, wait too long to get the proper care when we get sick. Coronary artery disease is the number one killer in our country. Don't wait, if you think that you may have a heart problem! Coronary arteries carry oxygenated blood to nourish the heart muscle. If these arteries are too narrow, the blood can't flow properly to the heart muscle. This may cause damage which may result in poor pumping action of the heart. The National Heart, Lung and Blood Institute lists symptoms of impending heart attack as:

o Chest discomfort: Most heart attacks involve discomfort in the center of the chest (angina) that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness or pain.

o Discomfort in other areas of the upper body: This may include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

o Shortness of breath: This often comes along with chest discomfort.

o Other symptoms: This may include breaking out in a cold sweat, or experiencing nausea or light-headedness.

(Visit web site www.nhlbi.nih.gov/actintime/haws/haws.htm for more information.)

The treatment for angina may include medications and lifestyle changes. If the artery(ies) is (are) too blocked, the treatment options are coronary artery bypass grafting or angioplasty with stent insertion. Although coronary artery bypass surgery may be the best option, more angioplasties with coronary stents inserted are performed, because it is a less invasive procedure.

Coronary artery bypass surgery entails cutting open the chest and grafting veins from other places in the body (such as arms, chest, or legs) around the blocked artery. The surgery is major and requires a 5-8 day in-patient hospital stay, an extended rehabilitation time, and time for several incisions to heal. Possible complications after surgery are more numerous than with angioplasty as well. (Comments by E. Murat Tuzcu, M.D., a Cleveland Clinic Heart Center interventional cardiologist are available at the web site: www.webmd.com/content/chat_transcripts/2/110128.htm ).

Angioplasty requires only local anesthesia and mild sedation. During an angioplasty procedure, a wire is inserted into the arm or a groin artery and threaded to the blockage. A catheter with a deflated balloon is advanced over the wire. The baloon is then inflated in the artery to push open the blockage. A stent may be inserted to keep the artery open. The recovery period is shorter than bypass surgery. Angioplasty is preferred if the blockage is small, if it can be reached by catheter, if you don't have heart failure, and if the artery affected is not the main artery supplying blood to the left side of the heart.

Your cardiologist, with your input, will select the best treatment for your condition based on:
o The blockage's severity and location
o Your other medical conditions
o Your surgical risk for bypass

If you experience the symptoms listed in this article, do not wait. Call your doctor immediately! With prompt treatment, recovery is shorter. Please call your parish nurses at 314-837-1090, ext. 107 if you have further questions about this article.