Cardiologist: Arterial plaque can be prevented

On Saturday, the Prime Minister underwent an angiogram and angioplasty at West Shore Medical Hospital after experiencing some “discomfort” on Friday.

The medical history of Dr Rowley, 71, has shown evidence of arterial plaque. The discovery was made in 2016 when he had tests in the US for prostate cancer.

The fact that he had both procedures in one day yesterday indicates that the condition was severe, according to a doctor, who spoke on the condition of anonymity.

Rowley would have had to be given a local anaesthesic, where the skin is numbed, and sedated for the angioplasty procedure.

What is arterial plaque and how dangerous is it?

It is classed as a lifestyle disease, according to cardiologist Dr Lana Boodoo, and is caused by the build-up of the fatty substance cholesterol in an artery.

Boodoo explained, “It is something we all get as we get older, so it is almost inevitable. In the vast majority of people, as early as the age of 30 it is identifiable.

“It becomes problematic and symptomatic if the plaque occupies a large volume of artery, causing a restriction of blood flow. If it ruptures, it causes a heart attack.”

Boodoo said most adults have arterial plaque. Conditions such as diabetes, hypertension, high cholesterol, obesity; and lifestyle choices such as smoking and poor diet are some of the causes.

“Stress is also a factor. It is a very common condition and can be a precursor to a heart attack or stroke. “When the flow to the arteries is limited, the heart has to work harder because it does not get its arterial supply. That manifests as angina or chest discomfort on exertion.”

Angina is a type of chest pain caused by reduced blood flow to the heart.

Tell-tale signs of the disease, she said, included shortness of breath, chest discomfort on exertion, reduced exercise capacity, and dizziness.

“It is generally chest discomfort which can radiate down the arms, jaws, back.”

Boodoo added that people also needed to pay attention to their family history, which was also a good indicator of the disease.

If the condition persists, she said treatment includes medication to control things like hypertension and diabetes, and lifestyle changes are explored. Treatment for a severe condition would entail surgery.

“Diagnostic testing is first done, such as stress testing. If this is positive, a coronary angiography – a dye test of the coronary arteries – is performed. This would outline the nature and pattern of the blockages present.

“This would then determine if an angioplasty or open-heart surgery is needed, or nothing at all.”

Angiograms and angioplasty

Angiography, or an angiogram, involves inserting a long catheter – an narrow tube – into an artery in the arm, upper thigh, or groin. Contrast dye is then injected into the catheter and x-ray images of the blood vessels are taken.

The contrast dye makes blood vessels more visible on the x-ray so that blockages or narrowings can be seen.

Angioplasty involves the permanent insertion of a stent, a short wire-mesh tube, into the artery. This stretches open the blocked artery to allow the blood to flow.

Boodoo added that medication is available to stabilise and prevent further growth of arterial plaque, but in most cases, the artery needs to be cleared by the other methods.

She called for people to get regular check-ups and to make lifestyle changes if needed.