Angioplasty is not a permanent cure: continuing care for coronary heart disease

The original article identifies heart disease as a major cause of death in Hong Kong. It cites 2020 figures of 6,561 heart-disease deaths and approximately 3,937 coronary heart disease deaths, described as 58.8% of the total and about 10.8 deaths per day. These figures are retained as reported in the source.

Coronary arteries supply oxygen and nutrients to the heart muscle. Fat or cholesterol deposits can narrow, block or harden these vessels, reducing blood supply and damaging the heart. Controllable risk factors include smoking, high-fat food, inactivity, hypertension, high cholesterol, obesity and stress. Age, sex and family history cannot be changed. Men, people with diabetes and older adults are highlighted as higher-risk groups.

Symptoms and assessment Cardiologist Dr. Mui Chan Yu described angina as chest pain, tightness or pressure, often more noticeable during exertion. Pain may spread to one or both arms, the neck, jaw, shoulders or back. Breathlessness, nausea, dizziness, cold sweats, vomiting or weakness may also occur. Improvement with rest does not mean the warning should be ignored.

Doctors may use exercise ECG or stress echocardiography to assess symptoms and changes in electrical activity or heart function, or consider cardiac CT, MRI, nuclear imaging and coronary angiography. Untreated disease can lead to more frequent or severe angina, dangerous arrhythmias, shock, heart failure or sudden death.

Angioplasty The original article describes angioplasty as a common option, with around 70% or greater narrowing prompting consideration. A catheter is introduced through the wrist or groin, usually under local anaesthesia, with sedation when needed. X-rays and contrast help locate narrowing; a balloon opens it and a stent supports the vessel. Not every patient is suitable: doctors assess the balance between medication, angioplasty and bypass surgery.

Follow-up remains necessary The article cites a 20–50% risk of renewed narrowing and describes dual antiplatelet therapy for six to twelve months together with cholesterol-lowering medication in many cases. Antiplatelet medicines may cause stomach discomfort, bruising or bleeding. Seek medical advice about symptoms and never stop them independently, as clotting and a heart attack may result.

Reducing recurrence The doctor advised stopping smoking and alcohol, managing weight, glucose, blood pressure and cholesterol, and choosing a diet lower in salt, oil, sugar, cholesterol and trans fat and higher in fibre. Examples include beans and nuts containing plant sterols and oily fish such as salmon. The article suggests regular aerobic activity four or five times a week for about 30 minutes, alongside stress reduction and emotional wellbeing.

Take medicines as prescribed and attend regular follow-up and blood tests. Ask your doctor about their benefits and side effects. Original reference: Centre for Health Protection, https://www.chp.gov.hk/tc/healthtopics/content/25/57.html