Choosing a treatment may seem like a decision that your doctor should make. But you can take part in this important choice if:

• You have mild heart disease. This means that you do not have too much narrowing of the arteries that send blood and oxygen to your heart (coronary arteries). It also means that your risk of having a heart attack is not too high.
• You have stable angina. This is chest pain or discomfort that occurs only with emotional or physical stress and goes away when you rest or after you take nitroglycerin.

Your doctor can tell you if you meet these conditions.

You will want to talk to your doctor about angioplasty before you have a coronary angiogram (also called cardiac catheterization). During that test, you will not be able to take part in the decision about angioplasty, because you will be sleepy from medicines. So before the test, talk with your doctor about what the test might show and what the doctor's options are in each case. You can tell the doctor in advance what you would prefer, based on the test results.

During angioplasty , the doctor puts a thin, flexible tube called a catheter into an artery in your groin or arm. The doctor guides the tube into the narrowed artery. He or she inflates a small balloon at the end of the tube. This widens the artery to allow blood to flow. The doctor may put a small wire-mesh tube called a stent in the artery to keep it open.

After angioplasty, you will need to follow a heart-healthy diet and get plenty of exercise. You will also need to quit smoking if you smoke. Taking your medicines is also important.

Angioplasty has some rare but serious risks. They are:

• The need for emergency open-chest surgery during the procedure.
• Heart attack.
• Stroke.
• Death.

Keep in mind that the chances of having a serious problem with this procedure are higher if you are older than 70.

Most people recover from angioplasty fairly quickly. They usually go home after an overnight stay in the hospital. They can return to normal activities within a few days.

Medical therapy includes making lifestyle changes and taking medicines. Lifestyle changes play a big role in helping you live longer. They include eating a healthy diet, not smoking, and getting daily exercise. Changing your habits may not be easy, but it could keep your heart disease from getting worse. It could even reverse some of the damage.

Your doctor will ask you to:

• Stop smoking. Quitting smoking can greatly lower your chance of having a heart attack and dying.
• Exercise almost every day. The American Heart Association suggests that you exercise for at least 30 minutes on all or most days of the week.
• Eat a heart-healthy diet. This includes lots of fruits and vegetables, whole grains, and lean protein. Try to eat fish at least 2 times a week.
• Know your numbers. Keep track of your blood pressure and cholesterol, and take your medicines to keep your numbers in a healthy range.
• Stay at a healthy weight.
• Keep your blood sugar in a target range if you have diabetes.

Whatever choice you make about angioplasty, making these lifestyle changes will give you the best chance of keeping heart disease from getting worse. These changes are important for all people who have heart disease.

Taking medicines every day is another key part of medical therapy. You may need to take:

• Medicines to improve cholesterol, such as statins.
• Beta-blockers to keep your heart from working too hard. The medicine slows the heart rate and lowers blood pressure. It can help relieve chest pain and may prevent it.
• ACE inhibitors to lower blood pressure and the risk of heart attack.
• Aspirin or other medicines to reduce the risk of blood clots and heart attacks.
• Nitrates, such as nitroglycerin, to stop chest pain.
• Calcium channel blockers to increase blood flow to the heart. They also can relieve or prevent chest pain. This medicine is sometimes added to the other medicines.

All medicines have side effects. Your doctor may lower the dose or give you another drug if side effects bother you.

• Statins: The most common side effects include muscle aches, an upset stomach, gas, constipation, belly pain or cramps, and feeling more tired than usual. In rare cases, statins can cause liver problems or muscle pain and damage.
• Beta-blockers: Side effects include dizziness, and feeling more tired than usual.
• ACE inhibitors: Side effects include a dry cough, nausea, diarrhea, and swelling of the face and hands.
• Aspirin and other medicines to reduce the risk of blood clots: They can cause an upset stomach and bleeding.
• Nitrates: Normal, temporary side effects of nitroglycerin include a warm or flushed feeling, a headache, dizziness, or lightheadedness. You may also have a burning feeling under your tongue when you put the pill there.
• Calcium channel blockers: The most common side effects include headaches, dizziness, constipation, and weakness.

Even if you choose to have angioplasty, you may need to take at least some of these medicines.

Medical therapy and angioplasty can both stop chest pain. They also can make it easier for you to exercise, which is a key part of keeping your heart healthy.

With angioplasty, you'll feel relief from chest pain sooner. But over time, both treatments work the same to ease chest pain and improve quality of life.¹

Many people try medical therapy first. But it doesn't always work. You may decide to have angioplasty if you still have chest pain and can't exercise even after you have taken medicines and made lifestyle changes.

While angioplasty can ease chest pain, it has not been proven to help you live any longer than medical therapy does. Also, angioplasty does not lower the risk of having a heart attack any more than medical therapy does.²

Your doctor may recommend angioplasty if:

• You have chest pain that keeps you from exercising and enjoying your life.
• Medical therapy hasn't stopped your chest pain.