If you have a life-threatening coronary artery blockage and you are a good candidate to have angioplasty with stent rather than the more invasive coronary artery bypass grafting (CABG), it will be recommended that you have the procedure immediately.
If you don’t need emergency treatment, and you have the opportunity to discuss options with your doctor, he or she can explain the factors that go into recommending angioplasty with stent for you. These include:
- Your general health and medical history
- The full extent and severity of your coronary heart disease (CHD)
- How well or poorly your heart is working
- Your test results
- All your symptoms and what, if anything, makes them better or worse
- The effects of any medications you may have taken to relieve your symptoms, including whether they worked or not
- Any other health problems in the past or present, like stroke, heart attack, peripheral artery disease (PAD), heart valve disease, diabetes or kidney disease
Tests Used to Determine the Need for Coronary Artery Angioplasty With Stent
Electrocardiogram (ECG, EKG)
To look for evidence of heart disease or heart problems, like:
- A heart attack that is happening now
- Signs of a previous heart attack
- Heartbeat irregularities
- Heart defects
How it’s done: Electrodes are placed on your arms, legs and chest. The electrodes send your heart signals to the ECG machine, which records and prints them out for analysis.
To detect any weakness in the walls of your heart that may be disrupting its ability to pump normally, like a heart attack or lack of oxygen to the heart.
How it’s done:A wand-like device sends ultrasound waves at your heart, producing video images of your heart in motion.
There are three types of stress tests that may be done to assess your heart function:
- Exercise stress test with ECG: Typically used for people whose heart symptoms occur mainly during exercise; ECG is done while you exercise on a treadmill or stationary bicycle.
- Nuclear stress test with ECG and imaging: To measure flow of blood to your heart muscle both at rest and during exercise; ECG is done before and while you exercise on a treadmill or stationary bicycle. For imaging, trace amounts of a radioactive material are injected into your bloodstream, using special cameras to identify areas of reduced blood flow in your heart.
- Exercise stress test with echocardiograms: To detect any weakness in the walls of your heart that may be disrupting its ability to pump normally; echocardiograms are done before and after you exercise on a treadmill or stationary bicycle.
To show if your heart:
- Has one or more defects
- Is enlarged
- Has calcium buildup that may be affecting heart function
The x-ray may also show fluid in your lungs, which can occur as the result of a heart attack.
- Certain enzymes found only when the heart has been damaged
- Heart-specific antibodies linked to heart failure
Coronary angiogram (also called cardiac catheterization)
To learn if the main arteries to your heart are blocked or narrowed by fatty plaque buildup and to evaluate heart problems in people with:
- Symptoms of CHD, such as chest pain
- New or worsening chest pain
- Pain in the chest, neck, jaw or arm
- Heart failure
- Congenital heart disease or defect
- A heart valve problem requiring surgical repair
- A chest injury
- Other blood vessel problems
- Upcoming surgery and a high risk that a heart-related problem will occur during the operation
How it’s done:
- A long, thin tube is used to inject liquid dye into your bloodstream to make tissues more visible on x-ray.
- As the dye fills the arteries of your heart, the x-ray machine takes a series of images that let your doctor see any areas of blood flow blockage.
Computed tomography (CT) angiogram
To check for narrowed or blocked arteries in your heart
How it’s done:
- Before the test, you’ll be given medication to slow your heart rate so the CT images of your beating heart will be clear instead of blurred. Dye is injected to make coronary artery blockage or narrowing more visible.
- You will lie on your back on a long table that will carry you through a short tunnel while the CT scanner takes high-resolution, stop-action-like images of your beating heart.