Hyderabad: Not all chest pain requires a stent to be implanted, according to a recent study published in The Lancet. The study revealed those cardiologists who have referred their patients to psychiatrists for dealing with emotional distress have saved them from the tedious procedure.
Dr P.K.N. Chaudhary, a senior psychiatrist in the city, explained, “We get very few references from cardiologists of patients who are suffering from severe chest pain but despite different medications there is no relief. These chest pains are not due to blockages but due to emotional distress and physical fatigue. Most of them feel much better after two to five rounds of counselling.”
Only a few cardiologists in the city refer these patients to psychiatrists for treatment. The age-old claim by psychiatrists that treating chest pain is not just a cardiologist’s work has been ratified by the recent study which shows that all chest pains are not due to blood clots but sometimes may also be caused by emotional distress. Researchers have found that those who have stable angina can be treated with medication and stenting does not help them. The researchers have also found that those who have been stented without valid evidence may have side-effects like sudden heart attack, stroke and internal bleeding.
A senior cardiothoracic surgeon, on condition of anonymity, explained, “About 10 per cent of patients come with complications that cannot be treated with stents. They have clots in the smaller blood vessels. These have to be followed up with medication only. But since the introduction of stents it has become easy to target the large coronary vessels and claim that the heart disease has been controlled. But that is not so.”
Stents are required for those patients who have blocked coronary arteries and where the plaque of cholesterol and other materials is blocking the blood flow. It is often an emergency operation where the clot is very thick. Those who come with chest pain may suffer from it due to blocked arteries or heavy clotting of the large vessels or due to anxiety, fatigue and physical strain. Hence chest pain has multiple reasons and the patients need to be evaluated for all these parameters before opting for a stent procedure for them.
