DEAR Dr. Fritz,

I hope everything is alright. I have been following your column for about a year now. Please call me Dave of Davao City. I have a heart problem. My cardiologist told me that I need an angioplasty. I am really anxious about this. How safe could this procedure be? I am scared because I am also diabetic. The truth is, I really don't know what to do. Shall I go on or not? I am afraid that I might die during the process. I have heard stories of patients who had heart attack during angioplasty. How true is this?

Please help me decide, doc. Thanks and more power to you.

Dave of Davao City

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Dear Dave of Davao City,

I understand your anxiety. The truth is, even I am a physician and a surgeon, I am still scared of needles, when you prick them to me. I am only good when I do this to anyone else or to my patients. But, when you get these sharp instruments to me, I wish I could run to the ends of the world. haha.

Yes, as I've said, I am really scared of needles. So, how much more with a more complicated procedure like yours? - and that of angioplasty. If I were in your case, I would be scared to death, too. After all, even if I am a physician and a surgeon, I am still human.

But, let us get to the data of this procedure - so, our anxieties can rest.

So, how safe is the procedure? Well, in the hands of experienced cardiologists (so, be sure, that you have a very good cardiologist), and with the availability of modern day technology, it is estimated that the risk of death is during an angioplasty procedure is usually less than 1% and the chance of requiring emergency bypass surgery is around 2% or less. So, this is a relatively safe procedure. This is also being done all over the world.

This procedure can even be done on an out-patient basis or an inpatient uncomplicated angioplasty which requires 23 hours or less of hospitalization after the procedure. That means, this is something that doesn't really mean life and death.

Now, let's get to some scary issues. But, let's again get to the statistics - so, you can again relax. Talking about the complications, the risk of other serious complication is estimated to be less than 4 and probably around 1 to 2 per thousand. So, some of the stories are true.

But, the chances are very slim. Maybe, Heaven just can't wait for them. However, the risk of a heart attack and bleeding that requires a blood transfusion could be increased. But, then again, your risks are relatively low and acceptable in most cases when you balance the potential benefit against the expected risk or the risk-benefit ratio.

In your case, where you are diabetic as well, there could be an aggravation of kidney function because of the large amount of contrast material that is usually required. In your case, your cardiologist should take extra precautions to prevent this possible complication.

Well, I hope that helps. Good luck!

Dr. Fritz

(Dr. Fritz Legarde Espedilla is an aesthetic dermatologist and surgeon and a clinical sexologist. She is also trained in hypnotherapy and Medical Acupuncture. She is also in the broadcast media (DXAB 1296) for more than a decade now. For your questions, you may send them to Dear Dr. Fritz, c/o Sun.Star-Davao Publishing Inc., Ebro-Pelayo Building, Jacinto St., Davao City, (former Department of Foreign Affairs office), across Ateneo de Davao University and beside Holy Child School of Davao, or you e-mail them to dokfritz@yahoo.com. Sorry if we cannot answer all your questions. Thank you for your understanding.)