For decades, doctors believed that heart attacks and other serious heart problems were mainly caused by severe blockages in the heart’s arteries. These blockages, caused by hardened cholesterol (plaque), often led to chest pain and limited blood flow.
The natural solution seemed obvious: open up those blockages with angioplasty. But as it turns out, this theory was mostly wrong.
It actually started more than 500 years ago. Leonardo da Vinci, known not only as an artist but also a keen observer of the human body, noticed waxy substances in the coronary arteries during autopsies. He observed both soft and hardened plaque. But in the centuries that followed, medical science focused mainly on the hard, obstructive plaque — especially as imaging tools like angiograms and CT scans made these blockages easier to see.
Doctors became convinced that these were the main cause of heart attacks, chest pain, and sudden death. The approach was widespread: find the worst blockages and fix them with angioplasty. And with time, the tools got better and better, allowing doctors to reduce even severe blockages quickly and effectively.
Then came a surprise. In the early 2000s, a major study called the COURAGE trial shook the foundation of this thinking. Patients with stable coronary artery disease were divided into two groups: one got angioplasty right away, and the other received only medication unless their symptoms worsened.
The results? Both groups had nearly the same rates of heart attacks and death. Angioplasty only slightly improved chest pain, and even that benefit faded over time.
The medical community was stunned. Many cardiologists, who performed angioplasties at the time—struggled to believe it. But more large studies in the following years confirmed the same thing: angioplasty didn’t prevent heart attacks or extend life in patients with stable heart disease.
What researchers discovered instead was that soft, non-obstructive plaque—the kind that doesn’t show up clearly on standard tests and often causes no symptoms—was much more dangerous. These soft plaques were more likely to rupture and cause sudden blockages, leading to heart attacks.
Dr. Chavira, a North County leading cardiologist says, “While many cardiologists have since changed their practice based on the science, a significant number still rely on outdated thinking.” He went on to say, “And that means some patients may still be getting procedures they don’t need—based on a myth that took 500 years to correct!”
In addition to being a leader in in his field in cardiology, Dr. Chavira also offers a medically based and supervised weight loss program. He helps his patients get fit and achieve their ideal weight, while monitoring other factors that can occur with obesity such as: diabetes, hypertension and high cholesterol. If you would like more information on his safe alternative to weight loss, call for a free consultation. His office is conveniently located at 334 Via Vera Cruze #257, San Marcos, ~ 760-510-1808.
