Is Balloon Angioplasty Necessary for Heart Failure Patients?

Q: Is Balloon Angioplasty Necessary for Heart Failure Patients?

Teacher Chen： The blood vessels that nourish the heart are called coronary arteries. <br>If these arteries become narrowed or blocked, it can lead to angina, and even myocardial infarction or heart failure. <br>Treatment methods include medication, catheterization for diagnosis,

Is balloon dilation necessary for heart failure?

My friend's family member is a diabetic patient who has not been managing their condition well.
Recently, they have experienced shortness of breath while walking and lower extremity edema, but no chest tightness or pain.
They were referred to a certain hospital for treatment, where it was found that their heart was enlarged, and they mentioned that the ejection fraction (E.F.) was less than 20%.
It was recommended that they undergo balloon angioplasty, which resulted in a bill of over a hundred thousand NT dollars covered by health insurance.
Less than a day after returning home, they were admitted to the intensive care unit due to chest pain, and the doctor diagnosed them with an acute myocardial infarction.
My friend wants to understand: Is balloon angioplasty always necessary for heart failure? Is it urgent to perform it? Is the recent myocardial infarction related to the cardiac catheterization?

Chen Laoshi, 30~39 year old female. Ask Date: 2005/04/04

Dr. Zhong Yuxun reply Cardiology

Teacher Chen: The blood vessels that nourish the heart are called coronary arteries.
If these arteries become narrowed or blocked, it can lead to angina, and even myocardial infarction or heart failure.
Treatment methods include medication, catheterization for diagnosis, and interventional treatments (including balloon angioplasty or stent placement).
There are many causes of heart failure, and various heart diseases can lead to it; treatment should be directed at the underlying cause.
Other issues depend on individual cases and should be addressed by the patient's attending physician.
Dr.
Chung Yu-Hsuan.

Reply Date: 2005/04/04

More Info

Balloon angioplasty, also known as percutaneous coronary intervention (PCI), is a common procedure used to treat coronary artery disease (CAD) by widening narrowed or obstructed blood vessels of the heart. However, whether it is necessary for heart failure patients, particularly those with diabetes and other comorbidities, is a nuanced question that requires careful consideration of individual circumstances.

In the case of your friend's family member, who has diabetes and is experiencing symptoms such as shortness of breath and lower extremity edema, the situation is complex. The reported ejection fraction (EF) of less than 20% indicates severe left ventricular dysfunction, which is a significant concern. A low EF can lead to heart failure, and patients with such a condition often have a higher risk of adverse cardiac events, including heart attacks.

The decision to perform balloon angioplasty in heart failure patients is not automatic. It depends on several factors, including the underlying cause of heart failure, the severity of coronary artery disease, the patient's overall health, and the presence of symptoms. In some cases, if the heart failure is primarily due to ischemic heart disease (where the heart muscle is deprived of oxygen due to narrowed arteries), angioplasty may be indicated to restore blood flow and improve heart function. However, if heart failure is due to non-ischemic causes, such as hypertension or valvular heart disease, angioplasty may not be beneficial.

In your friend's case, the urgency of performing the procedure should be evaluated in light of the patient's overall clinical picture. While balloon angioplasty can provide immediate relief from ischemia and improve symptoms, it is not without risks. The fact that the patient experienced an acute myocardial infarction shortly after the procedure raises concerns about the appropriateness of the intervention and whether it was the right choice given the patient's condition.

It is crucial for healthcare providers to conduct a thorough assessment before proceeding with invasive procedures like balloon angioplasty. This includes evaluating the patient's functional status, the extent of coronary artery disease, and the potential benefits versus risks of the procedure. In some instances, medical management may be sufficient, especially if the patient is stable and asymptomatic.

In summary, balloon angioplasty is not universally necessary for all heart failure patients. Each case should be evaluated individually, considering the patient's specific circumstances, the underlying cause of heart failure, and the potential risks and benefits of the procedure. It is essential for your friend's family member to have a detailed discussion with their cardiologist to understand the rationale behind the treatment plan and explore all available options, including medical management and lifestyle modifications, which can also play a significant role in managing heart failure.

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