What to know about heart stents

There is a good chance you know someone (or yourself) that has had a heart stent.  Every year, around two million Americans get coronary heart stents inserted into narrowed or blocked arteries.  This makes heart stents a common surgery performed across the country. However, in 2013, The American Medical Association issued a report stating that stents were one of the most overused medical interventions in the U.S.

What is the purpose of a heart stent?

When an artery feeding the heart muscle becomes narrowed by a buildup of fatty deposits called plaque, blood flow will be reduced. Symptoms of narrowed arteries could be chest pain, shortness of breath, a cold sweat, and lightheadedness – however it is possible to have narrowing in your arteries with no symptoms.  Another subtle feature can be noticeable changes in your endurance. You might notice trouble walking up a hill but a month later you feel a bit short of breath or lightheaded after walking on a flat surface.

The danger of blocked arteries is increased risk of a heart attack or a stroke. This is why a stent can be lifesaving for many people. By opening up the blocked artery and restoring blood flow, the stent can stop damage to your heart muscle and reduce your chance of having a heart attack or even death.  

Do not ignore the symptoms of narrowed arteries - they could be red flags of poor blood flow in one of your coronary arteries.  Anyone having any of these symptoms should see their primary care physician right away.

When it is discovered that you have an artery significantly blocked, a doctor may recommend placing a stent to help keep a coronary artery open.  The goal is to prevent plaque from building again in the artery, thus reducing the risk of a heart attack.

How do stents open a narrowed artery?

The stent itself is a tiny wire mesh tube that is inserted into the clogged artery with a balloon catheter.  In order to open an artery that is narrowed, a procedure called a percutaneous coronary intervention (PCI) or angioplasty.  The catheter (a balloon-tipped tube) is inserted into an artery and moved to the point of the blockage. Then the balloon is inflated which compresses the plaque and opens the narrowed area.  Once the opening in the vessel has been widened, the balloon is deflated and the catheter is withdrawn and the stent expands and locks in place. Once the stent is in place, it will hold the artery open allowing blood to flow more freely.

Once the stent is in place, it will hold the artery open which improves blood flow to the heart muscle and relieve symptoms you may have been having such as chest pain.

How will a doctor know if I have blocked or narrowed arteries?

To check for blockage, your doctor will review your symptoms, perform a physical exam, and likely order an electrocardiogram. Further testing may be required, such as a standard treadmill test, a stress echocardiogram, or a more advanced heart imaging test.

Are heart stents always the best solution for blocked arteries?

There has been some debate regarding stents after a groundbreaking study in a 2017 article in The Lancet concluded that people who took heart medications to relieve symptoms of stable angina had similar relief of symptoms and quality of life compared to people who received stents.

This study is not the only one that has also supported these findings.  Stents may not prevent heart attacks any better than optimal medical treatment.

Like any procedure a doctor may recommend, do your homework.  Before considering a stent procedure, discuss with your doctor if you could try focusing on lifestyle changes such as quitting smoking, eating a healthier diet, and engaging in exercise. 

Besides lifestyle interventions, medications may also be necessary. Taking aspirin can be used to prevent clots; beta blockers to slow heart rate and blood pressure; and statins to lower cholesterol levels.

Some people may still require a stent. Stents have helped numerous individuals to prevent having a heart attack, extending the length and quality of their life.  Each individual will need to be evaluated as to what the best approach is for them – whether it is receiving a stent or making lifestyle changes along with medications that focus on prevention.