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Published on Mar 30, 2019
Heart disease is incurable disease, no treatment strategy is there, which completely cure the heart disease but it can be controlled.
The treatments which are available for coronary artery disease are medical management, EECP, Angioplasty and Bypass Surgery.
Genetic predisposition and some cardiac risk factors like Diabetes, hypertension, poor life style and personal habits put together increase the tendency of forming the blockage in coronary artery.
This is the most common question asked by the patients, mostly after they have undergone bypass surgery or angioplasty. Their expectation is to know whether the disease is now cured or not. The simple fact remain is, coronary heart disease is an incurable disease, no treatment strategy is there which completely cure coronary heart disease. All the treatment strategy which is available for your coronary artery disease, which includes medical management, EECP, bypass surgery or angioplasty all can only improve your symptoms and relieve your exertional angina. So that the patient able to walk more distance. So all they offer is quality of life improvement, none of the treatment is curative treatment.
We call all this treatment as palliative treatment. When it is invasive treatment its is called as invasively palliative and when it is non-invasive treatment it is called non-invasively palliative. Why is my heart disease cannot be cured? If you have a block in a coronary artery the blood beyond the blocked artery is stopped, so that blood is not sufficiently flowing across the blocked artery. When there is insufficient blood flow across the blocked artery either you get ischemia or called chest pain or heart attack. When you offered with bypass surgery, angioplasty or EECP, the strategy is to improve the blood supply across the blocked arteries. Once the blocked arteries are bypassed by increasing blood flow across the lesion then your symptoms improves remarkably. Now it is clear all the treatment strategy here have only focused to improve the blood supply but it does not cure the blocks. The block is present in the same spot we have just Bypassed the block. So what is heart disease or coronary artery disease? It is a disease of formation of the block. So a patient who has coronary artery disease have a higher tendency of forming the blocks. So why certain people have a higher tendency of forming a block. Why certain people do not have a higher tendency of forming a block?
It is because of the genetic predisposition. Genetically they have been subjected to form more block in the coronary artery, this we call as high tendency to form the block. We only temporarily bypass the blockage so they are all called temporary solutions and not a permanent solution for why you have the tendency to form blocks. Now let us take Bypass surgery and angioplasty. Once the graft is put the graft is not going to be life long graft maybe after 5-8 years or in many conditions, the grafts are blocked in patients even before 5 years. If it good one it can be open or patent up to 10years. Once the grafts are blocked again the patients get chest pain and they have to redo the Bypass surgery. Similar in angioplasty they stent the vessel but many times the stent can close even within 5 years or 8 years or 10years for some people it may close within 6 months. Once the stent is closed again they have to repeat the procedure. So the procedure or treatment is offered to your heart disease are repeated again and again because the simple reason is they have not cured your heart disease. They only give a temporary solution for blockage.
So why do I get blockage again and again? number one it is because of genetic predisposition and No-2, most of the patient with heart disease have diabetes, hypertension, hypercholesteremia, and either they have a poor lifestyle, poor walking distance, and smoking. All these put together it increases their tendency for forming the blockage. The only solution for you to prevent the blockage from, occurring, again and again, is to improve your quality of life and have complete control over your risk factors.
Just doing expensive interventional procedures you may not able to cure your coronary artery disease. Now EECP is the simplest option here as a palliative treatment to improve your quality of life. So I would suggest every patient should have an EECP before attempting to go for the highly invasive procedure which is only palliative treatment. So it is very clear that the treatment strategy for coronary artery disease are only palliative and only provide temporary relief and not at all the curative treatment.