What is it about?

Heart attack is often managed by putting a stent in the arteries to the heart and has sparked debates on profit-driven overuse medicine. We report the case of a 55-year-old man with a heart attack who came to our internist team for a second opinion as cardiologists insisted on stenting his arteries even when he was symptom free. We review the literature on this topic and explain how this would not only put the patient on a potential journey toward bankruptcy but also how this would have no potential benefit to the patient.

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Why is it important?

There is a blossoming heart disease industry due to increasing demand for heart stents in India, which has the world’s highest death rate from heart diseases among developing nations. The high rate of heart diseases and the increasing need for heart stents provides an opportunity to evaluate its appropriate use and highlight potential overuse. In this paper, we have also discussed the consequences of overuse of these heart stents, and current lack of shared-decision making between physicians and patients along with misconceptions about the true beneficial effects of heart stents among both the patient and physician community.

Perspectives

Health is a fundamental right and everyone should have access to right care with affordable cost without affecting their financial status. In this case report, we addressed four global health issues affecting significant numbers of patients around the world. Any inappropriate medical procedures (without medical indication) impose a great deal of financial, mental stress to the patients. It does not only affect them but equally to their caregivers whose life revolves around care-giving and visiting hospitals causing a social disconnection and distraction from their personal life goals and entertainments. All of the family members including the patient lead a life that only make them feel as if every moment they live is a life closer to death. This BMJ global health case report can help answer how inappropriate use of PCI are affecting people and how we can overcome this from a global health perspective.

Vivek Podder
Tairunnessa Memorial Medical College and Hospital

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This page is a summary of: Middle-aged man who could not afford an angioplasty, BMJ Case Reports, March 2019, BMJ,
DOI: 10.1136/bcr-2018-227118.
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