Coronary artery disease: Common myths and facts related to this disease

CABG creates a new route for blood flow using a piece of blood vessel (graft) from the patient’s body. The graft links the aorta with the diseased artery, bypassing the obstruction. (Image: Canva)

One of the major reasons for opting for coronary artery bypass grafting (CABG) is coronary artery disease. CAD is the leading cause of heart attacks and can also result in angina. It is a condition where the major blood supply to the heart is disrupted because the coronary arteries, which supply blood to the heart, become clogged with fat deposits and other substances. Risk factors for CAD include gender, age, genetics, high blood pressure, smoking, diabetes, increased blood fat levels, lack of exercise, and obesity.

CAD can also be managed by increasing the blood supply to the heart muscles, says Dr. Shiv Choudhary, executive director of adult cardiothoracic & vascular surgery at Fortis Escorts Heart institute, Okhla road, New Delhi.

Following are the two main procedures

Angioplasty: This minimally invasive procedure uses a tiny balloon to force plaque against artery walls, restoring blood flow.

Coronary artery bypass grafting: CABG creates a new route for blood flow using a piece of blood vessel (graft) from the patient’s body. The graft links the aorta with the diseased artery, bypassing the obstruction. The graft may be an artery or a vein, with arterial grafts being regarded as superior because they remain patent for a longer period.

Though CABG is one of the most common operations globally, there are several misconceptions about it, says Dr. Choudhary. The common myths, according to him, include:

Myth: All heart blocks require CABG

Fact: In consultation with the patient, a heart team of a cardiac surgeon and cardiologist decide the best treatment option for the patient. This decision is primarily based on the number and location of blocks, the condition of coronary arteries and heart muscles, age, and the general condition of the patient.

Myth: CABG is required only in older patients

Fact: Traditionally, especially in Western populations, elderly patients (>60 years) require CABG. However, younger patients (35-60 years) may also need CABG. In India, the average age of patients undergoing CABG is much lower than that of Western patients.

Myth: Coronary artery bypass grafting (CABG) is a risky surgery

Fact: CABG is one of the safest operations. The risk of complications generally depends on age, general health, smoking history, specific medical conditions, and heart function. Less than 5% of patients may develop any form of complications.

Myth: CABG is a painful procedure

Fact: Though CABG is a major surgical procedure, the availability of good pain-relieving drugs and proper respiratory training can reduce pain to tolerable discomfort.

Myth: CABG is a cure for coronary artery disease

Fact: CABG, known to prolong lifespan by relieving symptoms, is neither a cure nor an inhibitor of the disease. A patient may redevelop symptoms, either due to involvement of the grafts in the disease process or due to progression of the disease. Vein grafts are particularly susceptible to involvement in the disease process. About 50% of vein grafts may be blocked within 10 years.

Myth: One cannot lead a normal life after CABG

Fact: CABG improves the performance of the heart. After wound healing, most patients can lead a normal and fulfilling life. With better surgical and rehabilitation techniques, most patients enjoy an active life without any restrictions.

Myth: CABG is a quick fix and lifestyle modification is not required after it

Fact: CABG is not a quick fix it only acts as a palliation against the disease. Lifestyle changes are equally important after CABG.