stent

Angioplasty is a procedure to improve blood flow in coronary arteries that have become narrow or blocked. Your coronary arteries supply oxygen-rich blood to the heart. If you have coronary artery disease, a sticky material called plaque builds up in the coronary arteries. Plaque is made of cholesterol, calcium, and other substances in your blood. Over time, it can narrow your arteries or fully block them. When this happens, some parts of your heart don't get enough blood.

Angioplasty widens the blocked part of the artery so more blood can get through. It is also called percutaneous coronary intervention (PCI).

Doctors use angioplasty to:

• Reduce chest pain from blockages in the coronary arteries. This type of pain is called angina. There are different types of angina. Angioplasty treats certain types.
• Limit damage to the heart during or right after a heart attack. In this case, angioplasty is an emergency treatment.

Angioplasty does not cure coronary artery disease. To help prevent more plaque blockages, you'll need to take any prescribed medicines, eat healthy foods, and get regular exercise.

Most people have angioplasties in a hospital in a special room called a cardiac catheterization, or cath, lab. You will be awake and lying down. You'll get medicine to help you relax through an intravenous (IV) line. This is a small tube that goes into a vein in your hand or arm.

Angioplasty is done through a blood vessel in your arm, wrist, or groin. Your doctor will:

• Make a small opening in that area to insert a thin tube (a catheter) into a blood vessel.
• Thread the tube through the vessel to your heart, using x-rays as a guide.
• Inject contrast dye inside your arteries. The dye highlights your heart and blood vessels in the x-rays.
• Replace the first tube with another one that has a small, deflated balloon on the end.
• Guide the balloon inside the blockage and inflate it to push the plaque flat against the artery wall. This makes the artery wider and improves blood flow.
• Sometimes put a small, mesh tube into the artery to help keep it open. The tube is called a stent. Some stents have a coating of medicine that helps prevent blood clots from forming.

If you had an angioplasty for chest pain, you'll go to a recovery room for a few hours. You may stay in the hospital overnight. Your doctor will probably prescribe medicines to prevent blood clots. Most people can return to their usual activities after a week.

If you had an emergency angioplasty for a heart attack, you'll need to stay in the hospital for about a few more days.

Angioplasty is very safe. You may get a bruise, feel sore, or have some bleeding where the tubes were inserted. More serious problems don't happen very often, but they are possible. They can include serious bleeding, blood clots, and narrowing of the artery again.

NIH: National Heart, Lung, and Blood Institute

Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women.

CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This buildup is called atherosclerosis. As it grows, less blood can flow through the arteries. As a result, the heart muscle can't get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts' blood supply, causing permanent heart damage.

Over time, CAD can also weaken the heart muscle and contribute to heart failure and arrhythmias. Heart failure means the heart can't pump blood well to the rest of the body. Arrhythmias are changes in the normal beating rhythm of the heart.

NIH: National Heart, Lung, and Blood Institute

Your carotid arteries are two large blood vessels in your neck. They supply your brain and head with blood. If you have carotid artery disease, the arteries become narrow or blocked, usually because of atherosclerosis. Atherosclerosis is the buildup of plaque, which is made up of fat, cholesterol, calcium, and other substances found in the blood.

Carotid artery disease is serious because it can block the blood flow to your brain, causing a stroke. Too much plaque in the artery can cause a blockage. You can also have a blockage when a piece of plaque or a blood clot breaks off the wall of an artery. The plaque or clot can travel through the bloodstream and get stuck in one of your brain's smaller arteries.

Carotid artery disease often does not cause symptoms until the blockage or narrowing is severe. One sign may be a bruit (whooshing sound) that your doctor hears when listening to your artery with a stethoscope. Another sign is a transient ischemic attack (TIA), a "mini-stroke." A TIA is like a stroke, but it only lasts a few minutes, and the symptoms usually go away within an hour. Stroke is another sign.

Imaging tests can confirm whether you have carotid artery disease.

Treatments may include:

• Healthy lifestyle changes
• Medicines
• Carotid endarterectomy, surgery to remove the plaque
• Angioplasty, a procedure to place a balloon and stent into the artery to open it and hold it open

NIH: National Heart, Lung, and Blood Institute

Lung cancer is cancer that forms in tissues of the lung, usually in the cells that line the air passages. It is the leading cause of cancer death in both men and women.

There are two main types: small cell lung cancer and non-small cell lung cancer. These two types grow differently and are treated differently. Non-small cell lung cancer is the more common type.

Lung cancer can affect anyone, but there are certain factors that raise your risk of getting it:

• Smoking. This is the most important risk factor for lung cancer. Tobacco smoking causes about 9 out of 10 cases of lung cancer in men and about 8 out of 10 cases of lung cancer in women. The earlier in life you start smoking, the longer you smoke, and the more cigarettes you smoke per day, the greater your risk of lung cancer. The risk is also greater if you smoke a lot and drink alcohol every day or take beta carotene supplements. If you have quit smoking, your risk will be lower than if you had kept smoking. But you will still have a higher risk than people who never smoked.
• Secondhand smoke, which is the combination of smoke that comes from a cigarette and smoke breathed out by a smoker. When you inhale it, you are exposed to the same cancer-causing agents as smokers, although in smaller amounts.
• Family history of lung cancer
• Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot, or tar in the workplace
• Being exposed to radiation, such as from
  • Radiation therapy to the breast or chest
  • Radon in the home or workplace
  • Certain imaging tests such as CT scans
• HIV infection
• Air pollution

Sometimes lung cancer does not cause any signs or symptoms. It may be found during a chest x-ray done for another condition.

If you do have symptoms, they may include:

• Chest pain or discomfort
• A cough that doesn't go away or gets worse over time
• Trouble breathing
• Wheezing
• Blood in sputum (mucus coughed up from the lungs)
• Hoarseness
• Loss of appetite
• Weight loss for no known reason
• Fatigue
• Trouble swallowing
• Swelling in the face and/or veins in the neck

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A family history
• A physical exam
• Certain imaging tests, such as a chest x-ray or chest CT scans
• Lab tests, including tests of your blood and sputum
• A biopsy of the lung

If you do have lung cancer, your provider will do other tests to find out how far it has spread through the lungs, lymph nodes, and the rest of the body. This is called staging. Knowing the type and stage of lung cancer you have helps your provider decide what kind of treatment you need.

For most patients with lung cancer, current treatments do not cure the cancer.

Your treatment will depend on which type of lung cancer you have, how far it has spread, your overall health, and other factors. You may get more than one type of treatment.

The treatments for small cell lung cancer include:

• Surgery
• Chemotherapy
• Radiation therapy
• Immunotherapy
• Laser therapy, which uses a laser beam to kill cancer cells
• Endoscopic stent placement. An endoscope is a thin, tube-like instrument used to look at tissues inside the body. It may be used to put in a device called a stent. The stent helps to open an airway that has been blocked by abnormal tissue.

The treatments for non-small cell lung cancer include:

• Surgery
• Radiation therapy
• Chemotherapy
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
• Immunotherapy
• Laser therapy
• Photodynamic therapy (PDT), which uses a medicine and a certain type of laser light to kill cancer cells
• Cryosurgery, which uses an instrument to freeze and destroy abnormal tissue
• Electrocautery, a treatment that uses a probe or needle heated by an electric current to destroy abnormal tissue

Avoiding the risk factors may help to prevent lung cancer:

• Quitting smoking. If you don't smoke, don't start.
• Lower your exposure to hazardous substances at work
• Lower your exposure to radon. Radon tests can show whether your home has high levels of radon. You can buy a test kit yourself or hire a professional to do the test.

NIH: National Cancer Institute

Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside of your heart. The cause of PAD is atherosclerosis. This happens when plaque builds up on the walls of the arteries that supply blood to the arms and legs. Plaque is a substance made up of fat and cholesterol. It causes the arteries to narrow or become blocked. This can reduce or stop blood flow, usually to the legs. If severe enough, blocked blood flow can cause tissue death and can sometimes lead to amputation of the foot or leg.

The main risk factor for PAD is smoking. Other risk factors include older age and diseases like diabetes, high blood cholesterol, high blood pressure, heart disease, and stroke.

Many people who have PAD don't have any symptoms. If you have symptoms, they may include:

• Pain, numbness, achiness, or heaviness in the leg muscles. This happens when walking or climbing stairs.
• Weak or absent pulses in the legs or feet
• Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all
• A pale or bluish color to the skin
• A lower temperature in one leg than the other leg
• Poor nail growth on the toes and decreased hair growth on the legs
• Erectile dysfunction, especially among men who have diabetes

PAD can increase your risk of heart attack, stroke, and transient ischemic attack.

Doctors diagnose PAD with a physical exam and heart and imaging tests. Treatments include lifestyle changes, medicines, and sometimes surgery. Lifestyle changes include dietary changes, exercise, and efforts to lower high cholesterol levels and high blood pressure.

NIH: National Heart, Lung, and Blood Institute

Angina is chest pain or discomfort you feel when there is not enough blood flow to your heart muscle. Your heart muscle needs the oxygen that the blood carries. Angina may feel like pressure or a squeezing pain in your chest. It may feel like indigestion. You may also feel pain in your shoulders, arms, neck, jaw, or back.

Angina is a symptom of coronary artery disease (CAD), the most common heart disease. CAD happens when a sticky substance called plaque builds up in the arteries that supply blood to the heart, reducing blood flow.

There are three types of angina:

• Stable angina is the most common type. It happens when the heart is working harder than usual. Stable angina has a regular pattern. Rest and medicines usually help.
• Unstable angina is the most dangerous. It does not follow a pattern and can happen without physical exertion. It does not go away with rest or medicine. It is a sign that you could have a heart attack soon.
• Variant angina is rare. It happens when you are resting. Medicines can help.

Not all chest pain or discomfort is angina. If you have chest pain, you should see your health care provider.

NIH: National Heart, Lung, and Blood Institute

Atherosclerosis is a condition in which plaque builds up inside your arteries. Plaque is a sticky substance made up of cholesterol, fat, blood cells, calcium, and other substances found in the blood. Over time, plaque hardens and causes your arteries to narrow. That limits the flow of oxygen-rich blood to your body.

Some people may confuse atherosclerosis and arteriosclerosis, but they are not the same thing:

• Arteriosclerosis is hardening of the arteries, which means that the arteries thicken and become less flexible. It can have several different causes.
• Atherosclerosis, which develops from plaque buildup, is a common type of arteriosclerosis.

Atherosclerosis can affect most of the arteries in the body. It has different names, based on which arteries are affected:

• Coronary artery disease (CAD) is plaque buildup in the arteries of your heart.
• Peripheral artery disease (PAD) is plaque buildup in the arteries that carry blood away from the heart to other parts of the body. It most often affects the arteries of your legs, but it can also affect the arteries of your arms or pelvis.
• Carotid artery disease is plaque buildup in the neck arteries. It reduces blood flow to the brain.
• Renal artery stenosis is plaque buildup in the arteries that supply blood to your kidneys.
• Vertebral artery disease is plaque buildup in the arteries that supply blood to the back of your brain.
• Mesenteric artery ischemia is plaque buildup in the arteries that supply your intestines with blood.

Plaque often starts to build up during childhood and gets worse with age. The exact cause is unknown, but researchers believe that this buildup happens when there is damage to the arteries. This damage may be caused by unhealthy lifestyle habits, medical conditions, and your genes.

You may be more likely to develop atherosclerosis if you:

• Have certain medical conditions, including:
  • High blood pressure
  • High blood cholesterol
  • Diabetes
  • Metabolic syndrome
  • Inflammatory diseases such as rheumatoid arthritis and psoriasis
• Have a family history of high blood cholesterol
• Eat a lot of foods high in saturated fats
• Smoke or chew tobacco
• Are older - the risk increases after age 45 men and age 55 in women

In the early stages, atherosclerosis often does not cause any symptoms. You may first notice some symptoms at times when your body needs more oxygen. For example, this could be when you are having physical or emotional stress.

Your symptoms will depend on which arteries are affected and how much blood flow is blocked:

• With coronary artery disease, the symptoms may include angina (a type of chest pain), palpitations (racing or pounding heart), and shortness of breath.
• With carotid artery disease, you may have a bruit. This is a whooshing sound that your health care provider hears when using a stethoscope. You could also have a transient ischemic attack (TIA), sometimes called a mini-stroke.
• With peripheral artery disease, you may have pain, aching, heaviness, or cramping in the legs when walking or climbing stairs.
• With vertebral artery disease, you may have problems with thinking and memory, weakness or numbness on one side of the body or face, and vision trouble. You could also have a transient ischemic attack.
• With mesenteric artery ischemia, the symptoms can include severe pain after meals, weight loss, and diarrhea.

For men, erectile dysfunction (ED) is an early warning sign that you may be at higher risk for atherosclerosis and its complications. If you have ED, talk with your provider about your risk of plaque buildup.

Atherosclerosis can cause other health problems, or complications. For example, if a plaque bursts, a blood clot may form. The clot could block the artery completely or travel to another part of the body. Other possible complications can vary, depending on which arteries are affected. For example, blockages in different parts of the body can lead to complications such as a heart attack, stroke, vascular dementia, or limb loss.

To find out if you have atherosclerosis, your provider:

• Will ask about your medical and family health history
• Will ask about your lifestyle and risk factors for plaque buildup in the arteries
• Will do a physical exam, which will include listening to your heart and the blood flow in your arteries
• Will likely order tests, such as blood tests and heart health tests

If you have atherosclerosis, your provider will work with you to create a treatment plan that works for you. Your plan will depend on which arteries are affected, how much the blood flow is blocked, and what other medical conditions you have. Possible treatments may include:

• Heart-healthy lifestyle changes.
• Medicines to:
  • Manage your risk factors.
  • Treat atherosclerosis or its complications.
  • Treat any medical conditions you have that can worsen plaque buildup.
• Procedures or surgeries to treat diseases or complications that were caused by plaque buildup. The specific type of procedure or surgery will depend on which arteries are affected.
• Cardiac rehabilitation, if you have had certain complications from atherosclerosis.

There are steps you can take to try to prevent atherosclerosis:

• Choose heart-healthy foods, such fruits, vegetables, and whole grains. Limit foods that are high in saturated fats, salt, and added sugars.
• Do regular physical activity. But before you start an exercise program, ask your provider what level of physical activity is right for you.
• Aim for a healthy weight.
• Limit how much alcohol you drink. Drinking less is better for health than drinking more. Men should limit their intake to 2 drinks or less in a day. Women should drink 1 drink or less per day.
• Manage stress.
• If you smoke, quit smoking.
• Avoid secondhand smoke.
• Get enough good-quality sleep.

NIH: National Heart, Lung, and Blood Institute

Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly becomes blocked. Without the blood coming in, the heart can't get oxygen. If not treated quickly, the heart muscle begins to die. But if you do get quick treatment, you may be able to prevent or limit damage to the heart muscle. That's why it's important to know the symptoms of a heart attack and call 911 if you or someone else is having them. You should call, even if you are not sure that it is a heart attack.

The most common symptoms in men and women are:

• Chest discomfort. It is often in center or left side of the chest. It usually lasts more than a few minutes. It may go away and come back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion.
• Shortness of breath. Sometimes this is your only symptom. You may get it before or during the chest discomfort. It can happen when you are resting or doing a little bit of physical activity.
• Discomfort in the upper body. You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach.

You may also have other symptoms, such as nausea, vomiting, dizziness, and lightheadedness. You may break out in a cold sweat. Sometimes women will have different symptoms then men. For example, they are more likely to feel tired for no reason.

The most common cause of heart attacks is coronary artery disease (CAD). With CAD, there is a buildup of cholesterol and other material, called plaque, on their inner walls or the arteries. This is atherosclerosis. It can build up for years. Eventually an area of plaque can rupture (break open). A blood clot can form around the plaque and block the artery.

A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery.

At the hospital, health care providers make a diagnosis based on your symptoms, blood tests, and different heart health tests. Treatments may include medicines and medical procedures such as coronary angioplasty. After a heart attack, cardiac rehabilitation and lifestyle changes can help you recover.

NIH: National Heart, Lung, and Blood Institute

A transient ischemic attack (TIA) is a stroke that lasts only a few minutes. It happens when the blood supply to part of the brain is briefly blocked. Symptoms of a TIA are like other stroke symptoms, but do not last as long. They happen suddenly, and include:

• Numbness or weakness, especially on one side of the body
• Confusion or trouble speaking or understanding speech
• Trouble seeing in one or both eyes
• Difficulty walking
• Dizziness
• Loss of balance or coordination

Most symptoms of a TIA disappear within an hour, although they may last for up to 24 hours. Because you cannot tell if these symptoms are from a TIA or a stroke, you should go to the hospital right away.

TIAs are often a warning sign for future strokes. Taking medicine, such as blood thinners, may reduce your risk of a stroke. Your doctor might also recommend surgery. You can also help lower your risk by having a healthy lifestyle. This includes not smoking, not drinking too much, eating a healthy diet, and exercising. It is also important to control other health problems, such as high blood pressure and cholesterol.

NIH: National Institute of Neurological Disorders and Stroke