Factors That Affect the Choice of Treatment in Coronary Artery Disease

Treatment of coronary artery disease depends on a number of things, along with your personal preferences and general health status.

Think about the following when you make decisions about your treatment.

How severe is the chest pain or discomfort (angina), and will it respond to medicine?

• In most cases, mild, ongoing, stable angina can be controlled using medicine alone.
• Ongoing, stable angina that does not respond well to medicine is considered severe and may require further evaluation and treatment.
• Unstable angina means that a heart attack may soon occur and that angioplasty or surgery may be needed.

Heart tests

Before considering treatments, your doctor will use tests to check how your heart is working.

Your doctor might check:

• How your heart responds to increased oxygen demand (exercise stress test).
• How effectively your heart pumps blood (ejection fraction).
• If a normal amount of blood is reaching the heart muscle (cardiac perfusion scan).

What are your personal choices about treatment?

Another important consideration is your personal choice. People who can get information from their doctors about the risks and benefits of their treatment options are able to make better decisions.

Some people may feel intimidated or afraid to question their doctor. But it's very important to understand not only why your doctor is recommending a certain treatment but also the risks and benefits of that treatment.

Other things that affect the decision include:

• Age. Older people, especially those with other long-term health problems, are at increased risk for surgical complications.
• Health status. People with other lifelong health conditions (such as diabetes or lung or kidney disease), those who have impaired mental function, and those whose nutritional status is poor also have a higher risk of surgical complications.