Coronary Heart Disease  
    Treatement
A block of less than 66% does not need any invasive treatment. What the patient has to do is to change his life style and remain under surveillance. If the site of block is critical like left main artery or left anterior descending artery, the lifestyle modification has to be vigorous with a closer surveillance.

A block more than 66% in these arteries [left main and left anterior descending] with or without symptoms, or in any other arteries with symptoms, needs to be taken care of by invasive treatment.

A block of more than 66% without any symptoms in a vessel or two other than left main and left anterior descending locations needs vigorous lifestyle modification with a close surveillance.

Three or more such blocks at any location with or without symptoms need invasive treatment.

CORONARY HEART DISEASE- WHICH INVASIVE TREATMENT?

Having angioplasty with a stent implantation is exchanging one disease with another. The reason is stent is a foreign body in circulation and without blood thinners will get blocked thus stent implantation means life long risk of complications of bleeding like paralysis. Following is the comparison between the bypass surgery and the angioplasty with the so-called best [Medicated] stent.

Criteria Bypass surgery with the
best method		 Angioplasty by the best method
Benefit at the end of 10 years 85% 0%
Risk Less. Same for any number of blocks More. Risk is added with number of blocks.
Cost Less More
Lifelong medication Not needed Mandatory
Hospital stay 3 days 2 days

CORONARY HEART DISEASE- OPTION OF "NO" TREATMENT

Patient with multiple blocks can survive without any intervention but the whole life is associated with high risk of death and complications. Also the quality of the life is very poor in the sense that he will have to have a lot of limitations on his performance. If he is willing to accept this he can go ahead with his choice of not having any kind of intervention.

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