Angina Management: Is a Stent Always Necessary?

Angina occurs when the coronary arteries that supply blood to the heart become narrowed, leading to a pressing or squeezing pain behind the breastbone. This discomfort typically subsides within a few minutes through rest or medication. However, in some cases, the pain does not resolve easily and may even progress to symptoms resembling a heart attack.

Understanding Angina and Treatment Options

When angina symptoms appear, it's crucial to seek medical attention promptly. The severity of coronary artery narrowing determines the treatment approach. Diagnostic procedures like coronary angiography help doctors assess the extent of blockage and decide whether surgical intervention is necessary.

When Is a Stent Required?

Generally, if the narrowing exceeds 75% or if symptoms are severe and unresponsive to medication, interventional treatment may be recommended. However, not every case of angina or coronary artery narrowing requires a stent. In many instances, balloon angioplasty can be used to widen the artery without placing a stent.

During balloon angioplasty, a small balloon is inflated at the site of the blockage to open the artery and improve blood flow. If the blood flow is restored adequately after this procedure, a stent may not be necessary. In some cases, drug-coated balloons are used to further enhance the effectiveness of the treatment.

What If Balloon Angioplasty Isn't Enough?

If the artery remains narrowed or if blood flow remains compromised after balloon treatment, a stent might be needed to keep the artery open. Once a stent is placed, blood flow improves significantly, which often leads to a reduction or complete relief of angina symptoms.

Ultimately, the goal of treatment is to enable patients to return to a healthy, active lifestyle with minimal risk of cardiac events. Decisions regarding stent placement are made on a case-by-case basis, depending on the patient's condition, the severity of the blockage, and the results of diagnostic tests.