New Delhi: Dr B M Hegde, cardiologist and former vice chancellor of Manipal University, has questioned some cardiologists’ propensity to indiscriminately prescribe angioplasty.
“The only area where angioplasty has a proven track record is during an acute heart attack and during such times also, the procedure has to be done within minutes. Rest of the time, it is done just to make money by frightening patients and their relatives saying that there are blocks in the coronary arteries (vessels that supply blood to your heart),” Dr Hegde writes in an article, titled Dogmas of Modern Medicine, and published in The New Indian Express.
“Almost every human being, including children, have one, two or, even three vessel blocks. This was shown in the post-mortem angiograms done on 205 young American soldiers shot dead in Vietnam and Korean wars,” writes Dr Hegde. “So almost all our angioplasties are unnecessary. The blocks in fact do not usually critically restrict blood flow to the heart muscle.”
Dr Hegde adds, “If the doctor studies the FFR (Flow Fraction Ratio) across a block, almost 90 per cent of the so-called critical blocks become benign to be left alone. To my knowledge, no hospital in India does the FFR although they do sundry tests for money. In essence, the only indication for an angioplasty is immediately after a heart attack— if the vessel blocked is the one causing the attack. Treatment is better. Asymptomatic patients have no indication for an angioplasty at all.”