This post was written by Daniel W. Hugenberg, MD, PPG – Cardiology, Parkview Heart Institute.
After receiving a coronary artery disease diagnosis, patients frequently ask me if there is a way to reverse the plaque or “blockage” build up in their heart. The answer, of course, is more complicated than a simple “yes” or “no.”
Can plaque be removed or reversed?
The realistic goal after the diagnosis of coronary artery disease is to slow down plaque formation. On rare occasions, someone will have mild decrease in the total plaque burden over time, but this is the exception.
The reason plaque can’t be completely reversed requires a deeper understanding of the disease process. When plaque forms in an artery, it starts under the surface of a previously normal blood vessel. This means as plaque grows, it is now a part of the blood vessel wall and not just a blockage on top of a normal artery. Because the plaque is so well incorporated into the wall of the vessel, it unfortunately can’t be simply removed or reversed.
What happens to the plaque when we place a stent or do bypass surgery?
When a stent is placed in a blocked artery, the stent acts as a support structure to keep a blockage propped open. The plaque itself is pushed out of the way by the stent so blood can get through the previously blocked area.
A bypass surgery uses a healthy artery or vein in your body to re-route blood flow around the blockage, which again, does not remove the plaque but does improve blood flow. On occasion, procedures such as atherectomy or endarterectomy are performed, which can remove some of the plaque from the body. This is one case where we can remove some of the plaque, but most of the time coronary artery disease is treated without these plaque removal techniques.
What other treatment options are available?
Although we can’t fully reverse coronary artery disease, we can provide a lot of treatments to help reduce your risk in the future. Your cardiologist will work with you on medical therapy for your coronary artery disease. The specific medicines will be individualized by your cardiologist.
In addition to the medicines specifically for coronary artery disease, any risk factors that can make it worse will also need to be treated. Some of these risk factors also may require medicines, such as diabetes or high blood pressure. Improved diet, exercise and weight loss are also important. Specifics on these should also be directed by your physician, as your program will depend on your medical history. The use of tobacco products and illegal drugs such as marijuana and cocaine can also cause coronary artery disease and should not be used.
In summary, coronary artery disease is a chronic disease, which needs lifelong treatment. Although there is no current medical therapy that can completely stop plaque formation, you and your cardiologist can work together to treat the disease and reduce your risk moving forward in life.
