When Are Stents Used to Treat Blocked Arteries?

On Tuesday former President George W. Bush underwent a heart stent procedure to treat a blocked artery, a procedure performed on about 500,000 patients per year in the U.S. The blockage was found during his annual physical.

While it’s not known what kind of tests Bush underwent, it may have been an exercise stress test, an exercise stress test with an imaging procedure, an echocardiogram or a CT scan of his heart, according to Randolph P. Martin, MD, Medical Director at Piedmont Heart Institute in Atlanta and Sharecare Editorial Advisory Board member. “Most likely a significant blockage, meaning more than 70 to 80 percent, was found in one or more of his coronary arteries,” says Dr. Martin.

Although it wasn’t an emergency procedure, President Bush’s doctors recommended that a stent be used to open the artery, and Bush agreed.

Are You at Risk?
You don’t have to be a former leader of the free world to have heart problems. Over time, your arteries may become damaged and a substance called plaque  — made up of fat, cholesterol, calcium and scar tissue — can build up, stopping or blocking blood flow in the arteries. Several factors increase the risk of plaque forming on your artery walls. Lifestyle choices such as smoking, a diet filled with saturated fats, trans fats and high-cholesterol foods, diabetes, and/or a family history of heart disease all play a role. Eating a healthy diet, losing extra pounds and not smoking are a few of the things that can help stop, slow or sometimes even reverse the blockage of arteries.   

Signs of Blocked Arteries
Even if a test doesn’t turn up blockage, as was the case with President Bush, you may have symptoms that give important clues, says Darria Long Gillespie, MD, MBA, an emergency room physician at Emory University Hospital. Signs to look for include shortness of breath, sudden chest pain or breaking into a cold sweat when doing normal activities. “It’s even more of a concern when you’re not doing anything and these symptoms occur,” she says. “These could be signs of critical blockage.” 

Diagnosis and Treatment
Should you experience any of these symptoms, go to the ER immediately or call 911 for help. Gillespie says that the first thing the ER doctor will do is an EKG. “That will show whether you’re having a heart attack.” 

At the same time a catheterization laboratory team is called, including cardiologists and other specialists, to find the source of the problem if a heart attack is ruled out. That typically means an angioplasty, in which a long catheter with a tiny balloon at the tip is inserted into a blood vessel, usually in the groin. Once the catheter reaches the blockage, the balloon is opened and deflated to stretch open the blocked artery wall.

“Doctors then insert a stent,” says Dr. Martin. “Think of it as a metal scaffolding that props open the artery and re-establishes normal blood flow.”

Crisis averted, you’ll likely be put on what’s called “dual anti-platelet therapy.” “This includes aspirin and another medication that both serves as anticoagulants and inhibits blood from clotting,” says Dr. Martin. You may also be given medication to reduce cholesterol (even if it’s normal) and other cardiac medications.

More ways to improve your heart health:

What to Eat for a Healthy Heart

How to Lower High Cholesterol

Best Ways to Prevent Heart Disease

Why Your Blood Pressure Matters

How Less Stress Helps Your Heart


File under: In the News


Deborah Wilburn

Deborah Wilburn is a senior content producer at Sharecare.