After angioplasty or athrerctomy, a stent may be placed in the artery to improve upon the result. Stent becomes a part of body in about four weeks.

When we need PTCA?
Coronary angiography is simply a dye test showing the details of the narrowed coronary arteries. Your coronary anatomy and symptomatic status will guide a cardiologist to decide whether you need PTCA or a Coronary Artery Bypass Graft (CABG) surgery.

How is PTCA different from bypass surgery?
In bypass surgery, blood vessels from the chest or leg are grafted to the coronary artery beyond its most diseased segment. This lets the blood detour past the narrowing to reach the heart. In PTCA, however, the obstructed part of the coronary artery is widened rather than bypassed. Both operations achieve almost the same result.

Can everyone who has chest pain have PTCA?
No; whether you are a candidate for this procedure depends on a number of variables. The number of arteries showing blockages, number of segments blocked, type of blockage (focal or diffuse), diameter of vessels and functioning of you heart muscle etc. Only a doctor who is familiar with your case can determine the best form of treatment for you out of medication, PTCA or bypass.

Will anyone ever need to have another PTCA?
It is possible especially for those who do not take care of diet, exercise regimen, lifestyle etc. The dilated part of the coronary artery may be re-narrowed in 15 to 20 percent of the subjects who have had PTCA earlier. If this happens to you, your doctor will advise you if the procedure should be repeated.

What are the risks involved?
Angioplasty has many of the same risks as coronary angiographies. An additional risk is that in less than 1 percent of cases - the artery being treated may close off suddenly in the initial few days after angioplasty. Very rarely you may need an urgent bypass surgery.

Is it painful?
No, it is not very painful. About an hour before the procedure you will be given a sedative to help you relax. You may feel some chest heaviness when the balloon is inflated because blood flow in the artery is temporarily blocked. After the procedure, the place where catheter was inserted may be a little sore.

What should we do if need it?
You will come to the centre one or two days before the procedure for some tests. These may include an electrocardiogram (ECG), blood and urine tests and a chest x-ray.

When patients can do their normal activity?
You will be discharged after one or two days if you are feeling well and have no angina. Your doctor or his/her team doctor will talk to you about any guidelines you may have to follow and when you should come to follow-up visits.

You can go back to your normal activities after getting home. You will most likely be able to work within 2 weeks. Try not to overdo it first. Consult with your doctor before you start exercising or doing heavy work.

Check with the doctor within six months initially and then once every year. These visits help monitor your medication. Your doctor may suggest you to exercise tests and see your progress.

Immediately talk to a doctor if you have pain, swelling, redness, bleeding, or drainage at the insertion site, severe pain, coldness, or a bluish colour in the arm or leg into which the catheters were inserted or blood in your urine or black or tarry stools.

Do we need to change our lifestyle?
Your doctor may refer you to a cardiac rehabilitation or lifestyle management programme. This programme can provide guidance, classes, and support groups to help you:

Get into exercise habit

Quit smoking

Lose weight

Lower your cholesterol

Lower your blood pressure

Control diabetes

Reduce stress

Cope better with change

The writer is an Assistant Professor of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka.