Many heart problems effectively treated with medication, physicians say

While symptoms of chest pain or pain in the legs can indicate a problem with a person's heart or clogging of the circulatory system, many of these disorders can be treated effectively with medication rather than more invasive procedures.

"A large percentage of the time, those symptoms can and do go away on their own," said Dr. James Orford, a cardiologist at the Utah Heart Clinic at Intermountain Medical Center.

When symptoms persist over time and doctors can diagnose the problem, medications often work well in controlling the condition, Orford said. However, when offered alternatives, many people opt for the more invasive treatment, he said.

Orford and Dr. Edward Miner, also a cardiologist at the Utah Heart Clinic, answered questions for several callers Saturday during the monthly Deseret News/Intermountain Healthcare Hotline.

"People must realize that every time you have something done to your body by a physician, there is a risk," Orford said, noting that patients often opt for more invasive treatments because their insurance will cover the cost.

"People accuse us of being arrogant, and sometimes that is unfortunately true," he said. "But other times, there is a patient perception that we know a lot more than we really do."

Doctors can't simply intuit either medical problems or the outcome of a particular procedure and how successful it will be, Orford said.

Callers asked about the details of taking drugs such as Plavix and aspirin following the placement of stents to open an artery narrowed by plaque. Orford said with most stents, the drugs should be taken for several weeks or months after the procedure.

With drug-eluting stents — which deliver a tiny dose of chemotherapy to the vascular wall to help limit the formation of scar tissue — the recommendation is that patients will continue to take the drugs indefinitely "if it's physically tolerable and financially feasible," he said.

That's because the body can recognize an exposed stent as an injury and try to form a blood clot, which creates problems of its own.

"But the risk of having a blood clot form with a stent after one year is very small," Orford said.

Some research has indicated that, rather than the stent creating future problems in the same area, a different form of disease enters and can cause clotting issues, he said.

Other callers asked about atrial fibrillation, which isn't caused by a narrowing of the arteries or other circulatory problem, and restless leg syndrome, which is not believed to be associated with circulatory disorders.

e-mail: carrie@desnews.com