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Drugs or atherectomy for heart disease?

Q: As beta blockers like carvedilol may cause serious problems like diabetes and impotence, in case of mild heart attack do the mildly damaged muscles have a tendency to recover on their own or with beta blocker medication for few months or once taken a patient has to be dependent on beta blockers throughout his life ? Notwithstanding preventive diet and medication, apart from invasive and surgical methods like angioplasty / by-pass surgery, is there any curative medication which can remove the existing plaque or dissolve the existing clot in coronary artery? How effective and costly is Atherectomy? Similar to an angioplasty, this procedure differs in that arterial plaque is actually removed by a rotating cylindrical blade. In my case angioplasty has been undertaken 2 months ago and a stent placed. Post angioplasty LVEF has improved from 25% to 57% now.

A:Beta blockers are usually well tolerated and do not always cause impotence. They do not produce diabetes. One has to be a bit careful when diabetics are administerd these agents. Atherectomy is a procedure done very sparingly in the days of stenting. It has in most cases no particular advantage. Ejection fraction improving from 25% to 57% is most unlikely. There is some error in one of the values. Good life style, use of aspirin, statins, beta blockers and ACE inhibitor group of drugs is very effective in avoiding new coronary events.


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