Most Unnecessary Heart Surgery: What You Need to Know

Heart surgery sounds serious, right? But here's something wild: doctors still perform thousands of heart procedures each year that probably don’t do much to help. The biggest culprit? Stents for people with stable chest pain—also known as stable angina.

Before you start picturing dramatic moments in the hospital, let’s set the record straight. Not every blocked artery needs a stent. In fact, stacks of research suggest that popping in a metal tube (the stent) does almost nothing to prevent heart attacks or help people live longer—if you’re not in immediate danger.

So, why does this keep happening? Sometimes it’s habit. Sometimes it’s pressure, or a “just-in-case” mindset. And yes, sometimes it’s money. If your doctor says you need a stent and you’re not having a heart attack: slow down and ask questions. Your body (and bank account) will thank you.

• Why Unnecessary Heart Surgeries Happen
• The Controversy Around Stents for Stable Angina
• Real-Life Cases: When Surgery Did More Harm
• Spotting Red Flags and Asking the Right Questions
• What the Science Says: Safer Alternatives
• How to Make the Best Decision for Your Heart

Why Unnecessary Heart Surgeries Happen

This might sound odd, but not every heart surgery is based on solid science. A lot of folks assume if a doctor suggests surgery, it must be 100% needed. Honestly, that’s not always true, especially when it comes to the unnecessary heart surgery problem.

The most famous example is putting in stents for people who aren’t having a heart attack. Sometimes, the wrong patients get rushed into surgery they don’t really need—just because they have chest pain or a mild blockage on a scan.

So, why does this happen?

• Doctors want to help quickly, even if meds work just as well in some cases.
• Old habits die hard; for years, surgery was the go-to move.
• Hospitals and clinics make big money from these procedures.
• There’s pressure to "do something" when a patient is scared.
• New science and guidelines take time to shift real-life practice.

Take a look at these numbers to get the scope of the problem:

Even after studies proved that medicines work just as well for many patients, tens of thousands still end up on the operating table for no strong reason. Old habits, money, urgency, and fear drive a lot of these choices. It’s easy to get swept up in it—especially if a doctor sounds certain or if you’re scared something bad might happen. Always know you can press pause and ask questions before agreeing to an operation that might not help you.

The Controversy Around Stents for Stable Angina

Here’s the thing about stents: they sound lifesaving, but when it comes to stable angina, their true value is pretty shaky. Stable angina means chest pain that comes on with effort but isn’t an emergency and can usually be controlled with medicine. The idea used to be that putting in a stent—a tiny metal tube to prop open a narrowed artery—would fix this problem for good and stop future heart attacks.

Then along came the ORBITA trial in the UK, which shook the heart world in 2017. Patients with stable angina got either a stent or a fake procedure (a placebo), and guess what? Both groups did about the same. Even those who got the real stent didn't have less chest pain than those who didn’t. Other big studies, like COURAGE, said basically the same thing. Stents for stable angina don’t lower your chances of a heart attack or help you live longer any better than just taking your meds and making some lifestyle changes.

So why do so many people still get stents for stable angina? Part of it is old habits—or doctors wanting to be extra cautious. There’s also that natural urge to “do something” when you’re worried about your heart. But these unnecessary heart surgeries add risk: infections, blood clots, or bleeding. Plus, they cost a small fortune.

If you only get chest pain when you walk fast or climb stairs, and it goes away with rest or medicine, there’s usually no rush to the cath lab. Specific situations—like unstable chest pain, a recent heart attack, or blocked arteries that could cause sudden death—are a different story. For stable angina, most people do just fine with meds, exercise, eating better, and regular doctor visits.

Real-Life Cases: When Surgery Did More Harm

Let’s get real. There are plenty of stories where a unnecessary heart surgery did more damage than good. A big one that made headlines involved the COURAGE trial. This huge study looked at over 2,200 people with stable chest pain and found that those who got stents didn’t have fewer heart attacks or live longer than people who just took medications and improved their habits.

It’s not just numbers. In California, a group of patients at a Bakersfield hospital found out the cardiologist was putting in stents they didn't actually need. We’re talking about hundreds of people having stent procedures, then facing things like bleeding, blood clots, or infection—all for nothing. The doctor lost his license, and hospitals around the country started checking more carefully who really needs what.

And check this out: in Maryland, a cardiologist at St. Joseph Medical Center inserted stents into more than 500 patients who didn’t need them. The hospital ended up paying millions in settlements. Worse, some patients had serious complications like kidney problems and even stroke, all because they trusted the "just in case" approach.

Getting stents isn’t like popping a pill. They come with real risks: reactions to the dye, blood clots in the stent, bleeding at the entry site, not to mention months of blood-thinner drugs afterward. When the benefits just aren’t there, those risks aren’t worth it.

If you’re told you need a stent for stable angina, the best move is to ask for a second opinion. A lot of trouble and pain can be avoided just by making sure surgery is really the answer.

Spotting Red Flags and Asking the Right Questions

It’s easy to feel overwhelmed when a doctor says you need a procedure, but pushing back isn’t just okay—it’s smart. Most people think surgery is the only answer, but that’s not always true, especially when it comes to stable angina. Here’s how you can spot when you might be headed for an unnecessary heart surgery.

If your doctor recommends a stent but you haven’t had a heart attack or severe symptoms, pause for a second. Guidelines from big organizations like the American Heart Association say stents are usually only proven to help during an actual heart attack or when medications don’t work at all. If your doctor skips over basic medical therapy and jumps to surgery, that’s a big red flag.

Real talk—some hospitals do more stenting than others, even for folks with mild chest pain. Check out these stats from a study published in 2023:

That’s a huge difference, just based on where you go.

Not sure what to do? Here are some straightforward questions you can ask your doctor before agreeing to a procedure:

• Is this surgery urgent, or can we try pills and lifestyle changes first?
• Have you checked all non-surgical options?
• How many of these surgeries have you done, and what’s the usual outcome?
• What will happen if I wait, or try something else first?
• Can I get a second opinion from another heart specialist?

If your doctor can’t answer these clearly or gets defensive, take it as a warning sign to slow things down. There’s no prize for being the first to the operating room—especially when your health and money are on the line.

What the Science Says: Safer Alternatives

Turns out, you probably don't need that stent if you have stable chest pain and your heart isn’t in full crisis mode. Doctors have put this to the test. The biggest game changer happened in the ORBITA trial back in 2017. In this study, people with stable angina who got a stent did not see much more symptom relief than folks who just got a fake procedure (yep, a placebo). Serious difference? Barely any. The COURAGE trial took this further: adding stents to medication and lifestyle changes didn’t help people avoid heart attacks, or live longer, compared to just sticking to meds and better habits.

So, what should you actually do if your doctor brings up a stent? For most with unnecessary heart surgery risk, doctors recommend lifestyle tweaks, medications, and cutting the big risk factors down to size. No fancy stuff, just things that are proven to work.

• Eat smarter: Focus on fruits, veggies, and healthy fats. Less bacon, more berries.
• Move your body: Regular walks or light exercise can help open up your blood vessels over time.
• Stop smoking: Quitting drops your risk fast. Seriously, it’s probably the best single move you can make.
• Take your meds: Drugs like statins (for cholesterol) and beta-blockers (for blood pressure) are stars here. They beat stents in stable angina—every time.

Let's check some key numbers from major studies:

Want the best shot at keeping your heart safe? Stick with what works. Talk honestly with your doctor, ask about proven options, and don't rush into surgery if your situation isn't an emergency.

How to Make the Best Decision for Your Heart

This is where things get real. Making the right call about heart surgery—especially when it comes to the unnecessary heart surgery we talked about earlier—starts with good info and a little courage to ask tough questions.

First up, don't rush. If your doctor mentions a stent or any heart procedure and you're not having a heart attack or really unstable symptoms, you've got time. Guidelines from the American Heart Association say medical therapy (think meds and lifestyle changes) works just as well as a stent for most people with stable angina. Only about 1 in 50 patients with stable chest pain actually need urgent stenting.

Here’s how you can make sure you’re making the best choice:

• Ask: "Is this emergency or do I have time to decide?" Most stable cases aren’t emergencies.
• Request a second opinion. Honest doctors won’t mind. Some hospitals even offer second opinion programs specifically for heart issues.
• Check if your symptoms match guidelines for surgery. If you’re pain-free or get relief from meds, the benefits of surgery are super murky.
• Read your test results. If you’ve only failed a stress test but have no symptoms, stents rarely help.
• Push for clarity about alternatives—medications, diet, quitting smoking, exercise—all lower risk of heart events.

Numbers don’t lie. Here’s how stenting for stable angina compares to just sticking with medication and healthy habits:

See those numbers? No big difference between stents and medication unless you’re unstable. You should only agree to surgery when it really improves your odds or fixes a life-threatening problem.

Bottom line: Don’t feel pressured by the word "surgery." Take time, ask smart questions, consider all options, and get a second opinion. Your heart—and your future—are worth it.