Question

1. A myocardial infarction (heart attack) occurs when a coronary artery is suddenly blocked, usually due to the rupture of a cholesterol plaque. Which coronary artery do you think would have the biggest effect on heart function when blocked? How are blockages of the coronary arteries treated medically? How are they treated surgically?

Answer 1

LAD (left anterior descending) artery is the most important artery. It functions to supply blood to whole of front wall of the heart. If LAD is 100% blocked, it leads to ‘widowmaker’ heart attack or ‘chronic total obstruction’.

Medical treatment for blockage of coronary artery would include drugs like cholesterol-modifying medicines (decrease the cholesterol deposited on coronary arteries), aspirin (blood thinner to reduce blood clots), beta blockers (decrease blood pressure, thus reducing the demand for oxygen in heart), ranolazine (helps with chest pain) etc.

Surgical removal of heart blockage would include angioplasty and stent replacement (a balloon is targeted surgically to the narrow artery and inflated to compress the deposits on artery walls, while a stent is left in the artery to keep them open) and coronary artery bypass surgery (a graft is made to bypass the blocked artery for flow of blood in the heart).