“Can heart blockages be cleared with medicine?”
My brother has been detected with two heart blockages, and the doctors have recommended an angioplasty to be done. Can these blockages be removed with medicines?
8 Answers
Mark Rasak
Cardiologist
Yes, medication can stabilize and even reduce the size of cholesterol plaque. This is a slow process, however, and your brother needs his arteries cleared now. Once opened, then the doctors will place him on the medications to help keep this from happening again.
Angioplasty is recommended when a patient has symptoms or the lesions are hemodynamically significant (usually greater than 80%). Medicines and lifestyle modification take time. But heart disease does regress. So, it depends which vessels and the degree of narrowing. No matter what, he should be on medications EVEN if he needs an angioplasty.
No
If Angioplasty was recommended that usually means that the vessel diameter is/are at least 75 % narrowed.
If the blockages are suspected to be borderline certain tests can be done prior to treatment with angioplasty. These tests may include ultrasound of the blocked artery ( IVUS), or other test (FFR),
If the blockages are significant by any of the above measures then intervention treatment with angioplasty and stent is necessary and knowing to reduce risk of heart attack, death, and other serious events. This is based on evidence from research.
Medications are necessary after stent or surgery,but would not get ride of the blockages .
If the blockages are suspected to be borderline certain tests can be done prior to treatment with angioplasty. These tests may include ultrasound of the blocked artery ( IVUS), or other test (FFR),
If the blockages are significant by any of the above measures then intervention treatment with angioplasty and stent is necessary and knowing to reduce risk of heart attack, death, and other serious events. This is based on evidence from research.
Medications are necessary after stent or surgery,but would not get ride of the blockages .
The straight and easy answer is No. Proven critical obstructive coronary lesions are best treated with balloon/stenting or CABG. Studies have shown early intervention by modifying and reducing risk factors, ie, BP, LDL, DM, body weight, waist circumference, increase activity and manage stress will offer long term CV benefits
Is your brother symptomatic on optimal guideline-directed Medical therapy?
Where are the blockages, i.e. in what arteries?
Did your brother have some sort of objective ischemic evaluation with a stress test done with an imaging modality?
Heart blockages cannot be cleared with medicine and lifestyle alterations alone. However, that does not mean they need to be treated with angioplasty. Is your brother being treated by a board-certified cardiologist who is up to date on the literature regarding this issue. See especially the ORBITA study and the COURAGE study.
Where are the blockages, i.e. in what arteries?
Did your brother have some sort of objective ischemic evaluation with a stress test done with an imaging modality?
Heart blockages cannot be cleared with medicine and lifestyle alterations alone. However, that does not mean they need to be treated with angioplasty. Is your brother being treated by a board-certified cardiologist who is up to date on the literature regarding this issue. See especially the ORBITA study and the COURAGE study.
Unfortunately, there is no magic pill that can dissolve cholesterol plaques. Cholesterol lower medications, like statins, can slow or even stop the progression of those plaques but they are not going to remove them. If he was found to have significant blockages (>70%) and is having symptoms (chest pain, shortness of breath), angioplasty is the way to go.
Julia G. Ansari
Cardiologist
No, angioplasty is the first step followed by stenting. Medications will be needed after to stablize other plaques that are less than 70%, but if the blockage is more than 70% you need angioplasty and stenting, otherwise the muscle can have damage form lack of blood flow
