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    Mayo Clinic Minute: Medications versus surgery for heart patients

Coronary artery disease is the most common type of heart disease in the U.S, according to the Centers for Disease Control and Prevention. The condition develops when the major blood vessels that supply your heart with blood become damaged or diseased. Plaque buildup narrows your coronary arteries, causing symptoms such as chest pain and shortness of breath, and it increases your risk of heart attack.

Dr. Todd Miller, a Mayo Clinic cardiologist, says that certain patients with coronary artery disease may be able to manage their condition with medications instead of a procedure or surgery.

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Do heart patients who have ischemia, or blockages, in their coronary arteries that reduce blood flow to the heart need a procedure or surgery? Or are there less-invasive options?

"The ischemia trial evaluated patients with stable coronary artery disease," says Dr. Miller.

Traditionally, these patients have been treated with stents to open blockages or coronary artery bypass surgery.

"(The study showed that if a patient has) coronary artery disease and their symptoms are reasonably well-controlled, they could certainly treat this with just medication and lifestyle measures alone," says Dr. Miller. 

Medications, such as statins to lower cholesterol, plus maintaining a healthy weight, exercising, eating a heart-healthy diet and not smoking may be what many patients need to manage their heart disease.   

"They should, of course, be cautioned that if their symptoms worsen or if they are dissatisfied with their lifestyle, then other treatment measures which are more aggressive, can be helpful," says Dr. Miller.