Featuring Dr. Milan Gupta, MD, FRCPC, Cardiologist

Duration: 2 minutes, 39 seconds

Once a patient is found to have coronary disease or blocked arteries supplying the heart, we have to decide on the best treatment option.

And treatment options generally boil down to one of three: either medical therapy alone; medications, diet and exercise; or bypass surgery or stent treatment, which avoids the need for surgery.

Once it's been decided that a patient's coronary arteries need to be dealt with – meaning that medical therapy alone won't be enough – the options are bypass versus stenting.

Sometimes the arteries are blocked in such a manner – too many arteries blocked, too severe blockages, that stents are not an option. And in certain types of patients, bypass surgery is a better option.

However, often we can get away without surgery. We can insert stents done in the absence of any operation, often as a day procedure or an overnight procedure that allows us to effectively open up very tight blockages and improve blood flow to the heart muscle.

It's very important to understand what advantages putting a stent in offers to a patient. If a patient is in a setting of an acute heart attack, putting a stent in can be lifesaving. Many patients will receive stents even if they haven't had a heart attack because they have been found to have badly blocked arteries and perhaps they are suffering from symptoms like chest pain with exercise or shortness of breath – whereas stents in that setting will improve quality of life, but may not necessarily reduce the risk for heart attack.

Regardless of the situation in which a stent is being put in, it's important to remember that stents are not a cure. They fix an acute problem, but the underlying disease process, the narrowing of the arteries, will continue unless the patient receives the appropriate medical treatment and follows the appropriate lifestyle advice – healthy diet, exercise, controlling body weight.

Not everyone with heart disease needs a stent; not everyone with heart disease needs bypass surgery; but some people do.

If you have more questions or you have concerns about how your heart disease should be treated, it's important to have that discussion with your cardiologist and with your family physician.

Presenter: Dr. Milan Gupta, Cardiologist, Brampton, ON

Local Practitioners: Cardiologist