Coronary Artery Disease

Treatment

Mayo Clinic doctors with training in heart disease (cardiologists) treat people who have all stages of coronary artery disease (CAD). Cardiologists with training in diagnostic and treatment procedures done through tubes (catheters) placed in the leg or wrist (interventional cardiologists) and heart surgeons at Mayo Clinic regularly perform several thousand angioplasty, stent placement and coronary bypass operations each year.

Doctors tailor treatment for coronary artery disease depending on the cause and severity of your CAD. Treatment may include catheter-assisted procedures, surgery, medications and lifestyle changes.

• Catheter-assisted and surgical procedures. Your doctor may recommend one or more of these surgeries to open blocked arteries:

• Coronary angioplasty and stents. In an angioplasty, your doctor guides a long, thin tube (catheter) through the arteries to your heart. Your doctor inflates a small balloon at the end of the catheter inside your blocked coronary artery. The balloon reduces narrowing in the artery and allows blood to flow more freely. Your doctor often will insert a small metal wire tube (stent) in the coronary artery to permanently open it. Sometimes stents may be coated with a drug to reduce the risk of the blockage coming back. Some people who may be considered too high risk for open heart surgery may be candidates for stent placement.
• Magnetic-assisted intervention. Cutting-edge technologies including magnetically assisted procedures now allow doctors to treat blockages that previously required open-heart surgery. Computer-controlled magnets in the surgical room are used to precisely guide devices used for complex angioplasty and stent procedures.
• Coronary artery bypass surgery. Coronary artery bypass surgery creates a detour around a blocked coronary artery using a new blood vessel (graft).
• Minimally invasive heart surgery. Heart surgeons at Mayo Clinic routinely perform minimally invasive heart procedures using smaller incisions, including robot-assisted surgery. Minimally invasive heart surgery may result in shorter hospital stays and faster recovery for people after major operations.

• Medications. Medications can help prevent progression of CAD and improve blood flow to your heart. Your doctor may prescribe these medications:

• Aspirin. Aspirin thins your blood and reduces the tendency for blood to clot within a narrowed coronary artery.
• Nitroglycerin. Nitroglycerin relieves chest pain (angina) by slightly relaxing or dilating narrowed blood vessels, which improves blood flow to your heart.
• Beta-blockers. Beta-blockers slow your heart rate and reduce your blood pressure.
• Cholesterol-lowering medications. Cholesterol-lowering medications can reduce the formation of blockages in your heart arteries.
• ACE inhibitors (angiotensin-converting enzyme inhibitors). ACE inhibitors lower your blood pressure and may improve heart function after heart attacks.
• Calcium channel blockers. These medications dilate your coronary arteries and reduce high blood pressure. They also may relieve angina.
• Omega-3 fatty acids and vitamins. These supplements may reduce heart disease risk factors such as high cholesterol.

• Healthy lifestyle programs. Adopting a healthy lifestyle can prevent or slow development of coronary artery disease. Mayo Clinic offers many services to help you change unhealthy habits, including:

• Heart disease risk management. Mayo Clinic doctors help you assess your risk of future heart disease and give you an individualized plan to reduce your risk of heart disease through the rest of your life.
• Heart-healthy diet and nutrition. Counselors advise you and your family about healthy diets and nutrition to reduce the risk of another heart attack.
• Regular exercise and physical activity. If you have had coronary artery disease or a heart attack, doctors and medical specialists help you develop regular exercise habits.
• Smoking cessation assistance. Mayo Clinic smoking cessation programs help you quit using tobacco, which is a leading cause of coronary artery disease.

• Cardiac rehabilitation programs. Mayo Clinic's cardiac rehabilitation program focuses on exercise training and lifestyle changes that help you become and stay healthy.

Read more about angioplasty and stents at MayoClinic.com.