Let's simply learn about PCI (Percutaneous Coronary Intervention), a treatment used to open a blockage in the heart.

Has a doctor ever told you or a friend of yours that they have a 'heart block'? Perhaps you yourself feel a tightness in your chest, a pain, and difficulty breathing when you climb stairs or exert yourself a little? Today we are going to talk about the treatment that doctors call 'Angioplasty' or 'PCI'. Don't be scared when you hear this name, this is not as big or invasive a surgery as you might think. Let's talk about everything simply.

What is PCI? Simply put...

Simply put, Percutaneous Coronary Intervention (PCI) is a procedure that removes a blockage in the arteries that carry blood to the heart (we call these the coronary arteries) and allows blood flow to resume. Think of it like a water pipe that has a blockage in it and is not flowing properly. PCI is like removing the blockage and cleaning the pipe again.

Many people know this treatment as angioplasty . You may have heard of it before. It involves threading a thin tube (catheter) through a vein in your arm or leg to the narrowed artery in your heart, and then inflating a small balloon at the end of the tube to widen the narrowed area.

Many of the new stents have a drug in them that reduces the risk of the artery getting blocked again. We call these 'drug-eluting stents'. This results in even better results.

Who needs this treatment?

Over time, things like oil and cholesterol build up in our blood vessels, forming a thick layer. It's like rust building up inside an old water pipe. In medicine, we call this layer 'plaque. ' The condition in which these plaques build up in the arteries, narrowing and thickening the walls, is called atherosclerosis .

This causes the veins to narrow and the heart does not receive the required amount of blood. This is when:

• When you exert yourself a little, climb stairs, or walk quickly, you feel a pain or tightness in your chest . This is called angina .
• It's getting hard to breathe, I'm feeling like I'm going crazy.

For people with these symptoms, PCI treatment is performed to remove the block and restore blood flow.

Also, PCI is a major life-saving treatment for someone who has had a heart attack . A heart attack is when a blood vessel is completely blocked, cutting off blood flow to a part of the heart. Then, the blockage needs to be opened as quickly as possible and blood can be sent. PCI can do that quickly and greatly reduce the damage to the heart.

Are there any cases where PCI treatment should not be performed?

Your cardiologist will decide whether you need this, whether you can manage it with medication alone, or whether you need a major surgery called a coronary artery bypass graft (CABG). This is different for each person.

When making that decision, the doctor specifically considers these factors:

• How many of your veins are blocked, how severe the blockage is, and where they are located.
• Apart from heart disease, do you have any other illnesses like diabetes or kidney disease?
• How is the pumping action of your heart muscle, things like your age.

Therefore, the doctor will explain to you which treatment is most suitable for you.

What should you do before treatment?

Unless it's a sudden heart attack, your doctor will give you some advice on how to prepare for this.

• Eating and drinking: You will usually be asked to stop eating and drinking 6-8 hours before treatment.
• Medication: The most important thing is that if you are taking blood thinners or any other medication, you should tell your doctor. They may ask you to stop taking them a few days before your treatment. Otherwise, you may experience increased bleeding during the treatment. You should do this exactly as your doctor tells you. Never stop or change your medication on your own.

What happens during treatment?

Don't be scared when you hear this, it's not as big a deal as you think. This is done by a doctor who has received special training in treating heart diseases (Interventional Cardiologist). You will be given a light anesthetic to keep you relaxed and calm. So you won't feel any pain, but you will be awake. You will hear what the doctor says.

Here are the simple steps of the treatment:

The whole process can take anywhere from 30 minutes to about two hours, depending on the nature of the blockage in your veins.

What happens after treatment?

After PCI, you will be kept in a recovery area for a few hours to monitor your heart rate and blood pressure. There may be some bruising or soreness where the catheter was inserted. This is normal and will subside in a few days. In most cases, you will be able to go home the same night or the next morning.

What are the benefits and risks of this treatment?

Like any treatment, this one has benefits and small risks.

Main advantages

• Quick recovery: Since this is not a major surgery, you can recover and return to normal life more quickly than with bypass surgery.
• Symptom relief: Things like chest pain (angina) and shortness of breath on exertion (dyspnea) are greatly reduced.
• Saving lives: This can save lives by minimizing damage to the heart during a heart attack.

Possible risks

Although PCI is a very safe procedure , there are a few rare complications that can occur.

• Bleeding or infection at the site of insertion of the tube.
• Blood clots forming inside the stent (medication is given to prevent this).
• The treated vein becomes blocked again over time.
• Kidney damage (especially in people with pre-existing kidney disease).
• Very rarely, a stroke occurs.

How long does it take to recover and what should I be concerned about?

You can usually return to your normal activities within a week. However, if you have a job that requires heavy lifting or physical exertion, it may take a while before you can return to work. Talk to your doctor about this.

This is the most important thing:

After the treatment, your doctor will prescribe you anticoagulants (such as Clopidogrel, Prasugrel, Ticagrelor). It is important to take these medications exactly as prescribed, without missing a single day. These medications prevent blood clots from forming inside the stent. Therefore, follow your doctor's instructions exactly.

What time should I see the doctor again?

If you experience any of the following symptoms after going home after treatment, inform your doctor immediately or go to the nearest hospital's Emergency Department (ETU).

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