Cardiac Catheterizations - Done Without Reason

Coronary angiograms are injections of dye into the arteries of the heart to visualize blockages. Access to these arteries is obtained through the femoral artery, located in the groin. Well over a million of these procedures are performed every year in the United States.

The purpose of the angiogram is to locate blockages in the coronary arteries that may be relieved by balloon angioplasty or stent placement, or establish a need for bypass surgery.

Amazingly, a study in JAMA (October 15, 2008, pp 1765-73) reveals that the majority of patients with stable angina do NOT have stress testing performed prior to angiography. In other words, they have no increase in chest pain, yet are subjected to an expensive, invasive procedure without proper testing to indicate that they really need it.

This report suggests that angiograms are largely being performed for financial gain rather than for patient benefit. It has already been demonstrated that stent placement provides no benefit to survival beyond that of optimal medical therapy. Stents should be inserted for the relief of cardiac pain that has progressed to the point that the patient cannot manage the activities of daily living, or cannot exercise enough to maintain conditioning. Clearly, that is not what is happening.

Coronary angiograms are not always safe procedures. They may result in heart attacks or strokes, dangerous bleeding at needle insertion sites, occlusion of leg arteries, or infection. They require the addition of potent blood thinners to keep the stents open, exposing patients to the risk of bleeding. In addition, stents often provide only temporary benefit. Angina may recur weeks or months after the stent is inserted.

Before you, a family member or a friend submits to cardiac catheterization, inquire why it is necessary, and verify that a stress test has been performed that indicates a need for it.

Our practice works with a non-invasive, extremely safe treatment that relieves chest pain in the majority of patients with angina. It is called exte
al counterpulsation therapy, and uses leg compression to dilate coronary arteries and create collateral circulation. Contact us for more information.

Allan Sosin, MD
www.iprogressivemed.com

(*The information contained in this article is provided for educational purposes only and is not intended to diagnose, treat or cure any illness or condition. These recommendations have not been reviewed by the U.S. Food and Drug Administration (FDA). No content contained in this article is a substitute for professional medical advice, diagnosis or treatment. Never increase, reduce or discontinue any medication or treatment without first consulting your doctor. If you are seeking the advice of a medical professional and wish to make an appointment with one of our doctors, please call our office at (949) 600-5100. Unsolicited e-mail may not be answered and is not a substitute for obtaining medical advice in person from a qualified health professional. If you have a medical emergency, contact your personal physician or local medical emergency service immediately.)