Coronary heart disease and stents

Written in association with: Dr Oliver Guttmann
Published: | Updated: 12/04/2023
Edited by: Robert Smith

Coronary heart disease is one of the UK's leading causes of death and the most common cause of premature death. In the UK, one in seven men and one in twelve women die from coronary heart disease, according to the British Heart Foundation.

We recently sat and spoke with one of our expert cardiologists, Dr Oliver Guttman, to find out how this disease can be treated.

hearthealth

 

What is coronary heart disease?

Coronary arteries (blood vessels around the heart) supply the heart with blood and oxygen. They are crucial in keeping the heart healthy.

In some people, the arteries can become narrowed because of fat deposition (atheroma) that is built up in the blood vessel wall. This is commonly known as atherosclerosis, which leads to coronary artery disease.

coronary arteries

 

If the blood vessels become narrow to the point that there is not enough blood and therefore not enough oxygen reaching your heart, you may complain of discomfort in the chest. This is called angina and typically occurs when you are exerting yourself, it can eventually lead to a heart attack.

The initial treatment for this is certain medicines to control the angina symptoms. In some people, medication is not enough to control the symptoms and you may need to have treatment to improve the blood supply of your heart.
 

There are two main types of treatment:

Coronary angiogram with angioplasty with a stent. A coronary angiogram, also called a cardiac catheterisation, allows the doctor to see the blood vessels around the heart and see where the narrowing is.

Many patients, who undergo an angiogram, will go on to have an angioplasty. An angiogram involves squashing the atheroma against the walls of the blood vessels, making the inside of the vessel wider.
 

What does an angiogram procedure involve?

You are asked not to eat or drink a few hours before the procedure. The angiogram takes place in a special room called the catheter lab. You then meet the team consisting of the doctor performing the procedure, a nurse, a lab technician and a radiographer. You're then asked to lie on a table and an X-ray machine will move around your chest.

A small tube will be inserted into your wrist or your groin after you receive a local anaesthetic and some medication to relax you.

Equipment can then be passed into the blood vessels around your heart under X-ray guidance. This consists of tubes called catheters through which the doctors can insert tiny wires and balloons into your heart to treat the narrowing. Once the narrowing has been ballooned, a stent is placed to keep the blood vessels open.

The procedure usually takes about an hour and most patients will have the procedure as a day case and go home on the same day.
 

What are stents?

A stent is a small metal mesh tube which is inserted into the heart arteries to act as a scaffold to keep them open.
 

Are there any alternative treatments to stents and are they as effective?

In some circumstances, stent treatment might not be sufficient or optimal treatment. In that case, your cardiologist might advise you to have a coronary artery bypass graft surgery. This is open-heart surgery performed by a cardiothoracic surgeon and involves bypassing the narrowing of the coronary arteries. This surgery is very effective.
 

What are the benefits of stents?

Stents keep the blood vessels open and therefore reduce the symptoms of angina.
 

Can stents be removed once placed in the body?

Once a stent has been implanted it cannot be removed and will be part of your body.
 

Are stents safe?

Stents are very safe, but there are risks associated with the procedure. A small number of people have complications. These can include needing emergency bypass surgery. There is also a low risk of having a heart attack or a stroke or die during the procedure. The risk of a serious complication for a coronary angiogram is 1 in every 1000 people.

Sometimes the blood vessel with the stent can become narrow again. This is called in-stent restenosis. To reduce the risk of this happening your cardiologist generally uses a drug eluting stent. Following a stent procedure, you will have to take blood-thinning medication.
 

How long does it take to recover from a stent implantation?

When you get home, you have to keep an eye on the area where the catheter was inserted for a few days. You might have some bruising and tenderness. Most people find that they are back to normal after a few days. It is advisable to increase your activity gradually. If you had a stent to treat a heart attack, the recovery might take slightly longer.
 

If you're concerned about your cardiovascular health or think treatment for coronary heart disease may be necessary, we recommend booking an appointment with a leading-expert in cardiology, such as Dr Guttmann, via their Top Doctors profile.

By Dr Oliver Guttmann
Cardiology

​Dr Oliver Guttmann is the Consultant Cardiologist for Inherited and Inflammatory Cardiovascular Diseases and Interventional Cardiology at St Bartholomew’s Hospital, the Wellington Hospital and Golders Green Outpatients and Diagnostics Centre, all located in London. He is also an Honorary Associate Professor at University College London.

Dr Guttmann sees patients related to all areas of adult cardiology (high blood pressure, high cholesterol and palpitations) for which he has a special interest in chest pain/angina management and coronary intervention, including  angiography and stenting. Dr Guttmann also specialises in inherited cardiac conditions, especially hypertrophic cardiomyopathy and the management of myocarditis.

Dr Guttmann studied medicine at Cambridge University and University College London. Following this, he was awarded both his membership of the Royal College of Physicians and Dr.med qualification from the Ludwig-Maximilians-University in Munich, Germany in 2008.

His research in atrial fibrillation and stroke in hypertrophic cardiomyopathy, which was funded by the British Heart Foundation, gained him his MD (Res) degree from the University College London in 2016. Dr Guttmann completed his cardiology training at the London Chest Hospital, Heart Hospital and Barts Heart Centre in 2017.

He publishes routinely in peer-reviewed journals and book chapters and has written medical articles on inherited inflammatory heart muscle disease, risk stratification in cardiomyopathy and outcomes after percutaneous coronary intervention. He is the Clinical Lead of the Coronary Care Unit at Barts Heart Centre and is a member of the British Cardiovascular Intervention Society and the Working Group on Pericardial and Myocardial Disease of the European Society of Cardiology.

View Profile

Overall assessment of their patients


  • Related procedures
  • Heart attack
    Arrhythmia
    Hypertension (high blood pressure)
    Pericarditis
    Heart failure
    Injury valves
    Heart murmur
    Echocardiogram
    Electrocardiogram
    Ambulatory electrocardiogram (Holter)
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.