Patients suffering from coronary artery disease may experience worsening symptoms that require intervention beyond medication to alleviate their discomfort. This is where coronary angioplasty steps in. Patients considering this procedure should know what to expect before, during, and after the procedure, as covered in this article.
What is Coronary Angioplasty?
Coronary angioplasty (also known as percutaneous coronary intervention) is a minimally invasive procedure to widen a narrowed or blocked artery. This is done by inserting a narrow tube (catheter) with a balloon attached into the artery via a small incision in the groin or wrist. Once in place, the balloon is inflated to widen the artery. In the majority of cases, a small wire mesh tube called a coronary stent is placed to help keep the artery open after it has been widened. Depending on the severity of the patient’s conditions, the cardiologist may recommend balloon angioplasty alone (oftentimes with a drug-coated balloon) or more commonly angioplasty with coronary drug-eluting stent placement as part of an individualised treatment plan.
Why is it performed
Coronary angioplasty is performed to widen narrowed arteries caused by blockages. Blockages in the coronary arteries may result in poor blood flow to the heart muscle. These blockages may cause symptoms such as chest pain (angina) and shortness of breath. In emergencies such as a heart attack, angioplasty can quickly restore blood flow to minimise heart damage and potentially save a patient’s life.
When it’s recommended
A cardiologist may recommend an angioplasty for patients who:
- have severely narrowed arteries demonstrated on scans
- experience symptoms of coronary artery disease, such as chest pain or shortness of breath despite being on medications
- are in an emergency situation, such as during a heart attack
Preparing for Coronary Angioplasty
If you are planning for a coronary angioplasty, here are some things to keep in mind when preparing for the procedure.
Your cardiologist will review your full medical history, including any medication allergies. You are encouraged to share any past experience involving the use of X-ray contrast (dye) or iodine compounds, which will be utilised during a coronary angioplasty. Patients who think they may be pregnant should also inform their cardiologist.
Patients may also undergo several preliminary tests, including blood tests, an electrocardiogram (ECG), and additional investigations as needed. You are advised to bring reports of any prior investigations done to be reviewed by your cardiologist.
Based on the above results, your cardiologist will decide if the procedure is suitable. Your care team will then schedule a date for the procedure. You will need to arrange for transport home upon discharge, as you will not be allowed to drive immediately after an angioplasty.
During the Procedure
You will be advised to fast for at least 6 hours before the procedure. You will also be required to remove any dentures, contact lenses, and jewellery before the procedure. Additionally, since catheter insertion may be done through the groin area, shaving may be necessary.
At the start of the procedure, your cardiologist will administer local anaesthesia and sedation medications to ensure comfort. The first step of the procedure is to perform a coronary angiogram. A catheter is inserted through the wrist or groin vessel to reach the heart, and contrast is injected to help the cardiologist visualise the arteries. You are unlikely to feel pain, but you may experience uncomfortable pressure at the insertion site.
The coronary angiography and angioplasty procedure may involve:
- coronary physiology assessment (assessing blood flow in the coronary arteries)
- intracoronary or intravascular imaging (using a special imaging catheter to look from within the coronary artery)
- balloon angioplasty (using small coronary balloons to widen the blockages including the use of drug-coated balloons)
- coronary stenting (placement of the latest drug-eluting stents to keep the arteries open)
- rotational or orbital atherectomy (using special drills to open up very hardened or calcified vessels)
- intravascular lithotripsy (using a special balloon which delivers ultrasonic waves to soften the calcium before implanting the stent)
The entire procedure usually takes 30 minutes to 2 hours to complete, but may vary depending on the complexity of the procedure.
Recovery After Angioplasty
After the procedure, you will be monitored in a hospital ward for recovery. Coronary angioplasty usually requires an overnight stay, but it varies based on the patient’s condition. Your care team will continue to monitor your condition and look out for any potential complications.
Once ready for discharge, your cardiologist will provide further instructions, prescribe medications (e.g., blood thinners), and schedule follow-up appointments.
Long-Term Care and Lifestyle Changes
Upon returning home, you may need some time to recover. This means avoiding strenuous activity, especially activities that involve excessive use of or pressure on the site of catheter insertion.
You are also encouraged to monitor the catheter access site to ensure that no excessive bleeding occurs after the procedure. Significant swelling, pain, or numbness will require consultation with your cardiologist.
Importantly, patients are recommended to make healthy changes to their lifestyle, including a balanced diet, regular exercise, and quitting smoking.
When to Seek Help After the Procedure
The risk of complications following a coronary angioplasty is low. Patients should be mindful of the following complications should they occur and contact their medical team immediately for further checks:
- Chest discomfort or difficulty breathing
- Weakness or episodes of fainting
- Bleeding or swelling at the site where the catheter was inserted
- Pain or tenderness around the catheter insertion area
Still Worried? Speak to A Cardiologist
Going for a procedure can indeed be unnerving. To ensure you are in optimal condition, make sure you speak to the right cardiologist and have all your questions addressed beforehand.
In Singapore, you can turn to Capital Heart Centre, which provides expert cardiovascular care helmed by Dr Joshua Loh, Senior Consultant Cardiologist. Under his care, the friendly team is committed to helping patients achieve optimal heart health. If you are looking for a care team that can promptly address your heart concerns, schedule an appointment at Capital Heart Centre.
References
- Mayo Clinic Staff. Coronary Angioplasty and Stents. Mayo Clinic [Internet]. Available at: https://www.mayoclinic.org/tests-procedures/coronary-angioplasty/about/pac-20384761.
- Coronary Angioplasty and Stent Insertion – Recovery. NHS [Internet]. Available at: https://www.nhs.uk/conditions/coronary-angioplasty/recovery/.
- Ministry of Health Singapore. SD714H – Heart, Primary Percutaneous Coronary Intervention (PCI) for ST-Elevation Myocardial Infarction: Bill Information. Ministry of Health Singapore [Internet]. Published 2026. Available at: https://www.moh.gov.sg/managing-expenses/bills-and-fee-benchmarks/cost-financing/tosp-sd714h-bill-information/.
