Myocardial infarction, or heart attack, and angina, which is also called chest pain, are caused by the inability of oxygen and nutrients to reach the heart muscle. Under normal circumstances the coronary arteries carry oxygen-rich blood, providing the nutrients which enable the heart to do its work. The development of coronary artery disease is caused by atherosclerosis or the development of plaque within the artery, which then causes the coronary arteries to become blocked. These blockages interrupt the normal flow of blood through the coronary arterial system. Severe reduction of blood flow causes the pain known as angina. Lack of blood flow to the heart is called ischemia.
Conventional treatment of coronary artery disease includes medication, bypass surgery and angioplasty. The goal for treatment by medication is based on reducing or modifying the demand for oxygen by the heart muscle. The basis for treatment by surgery is to bring a new oxygen-rich blood supply to the heart by means of a coronary artery bypass; the blood is rerouted to a point beyond the blockage in the artery. Coronary artery bypass requires open heart surgery. Angioplasty improves the blood flow in the native artery by dilating or enlarging the artery at the point of the blockage. A balloon is inflated inside the artery, and the pressure of the balloon flattens the plaque against the arterial wall. Angioplasty is performed by catheterization techniques.
There are many patients who respond very well to these forms of treatment. However, there are also those who do not respond to these conventional forms of treatment or those who are not candidates for traditional procedures such as coronary artery bypass or angioplasty. For these patients, Transmyocardial Laser Revascularization of the heart may be an alternative.
Heart and Lung Institute N124 W16862 Lovers Lane Germantown, WI 53022