• Mrs. Davis -- for more info about tests, look
over our special section, "Patient
Guide to Heart Tests". A nuclear stress test may
show if part of the heart is not getting enough blood flow (oxygen)
-- where the deficit occurs gives a clue as to which artery may be
blocked. A positive result usually means the cath lab is the next stop.
Another test is the CT Angiogram, also non-invasive and, if done with
the newer low-dose protocol, lower in radiation than a nuclear stress
test. Also, it shows a picture of the arteries -- visual confirmation
of blockages. Studies have shown it to be 98-99% accurate in ruling
out blockages, and some cardiologists now feel it may be a better test
for the intermediate patient than nuclear stress. But they are different
and measure different things. Ask your cardiologist about a CTA --
and read over the interviews and articles in our special section. Ultimately
the cath lab may be where the information is found out. One suggestion
is that you also discuss the use of IVUS with your interventional cardiologist,
if you go to the cath lab. It might be very helpful in yielding more
information about the health of the arterial wall (see our
IVUS Section). By the way -- a note to all readers --
the Dr. Feldman that Mrs. Davis refers to is Marc Feldman at the University
of Texas in San Antonio and Angioplasty.Org is working with Dr. Feldman
and his group in conducting research on DES hypersensitivity
(see the
stentstudy
notice
in the
right column).
Forum Editor, Angioplasty.Org, April 28, 2010
• Followup to March
24 post: Dear Forum, w/o
intention we have been changing interv/cardios like socks. We moved from
Tx to
Ks
and had
to
change mid
allergic reaction issues, the second cardio had a term/illness himself
and quit practicing after our second visit. We went to UT to see DR.
Feldman at the request of the third cardio, related to the allergy issue.
Post Dr. Feldman and on f/u with the third cardio we found his wife died
and he will be out for an extended period. So the 4th interv/cardio just
1 mo. after visiting Dr. Feldman, now says he believes recurrent shoulder
pain, increased heart rate, combined w/ polymer reaction issue means
the stent may be closing, scheduling a nuclear stress test, currently
delayed due to thallium shortage in Wichita, but said we should probably
expect to find an increasing blockage within the stent, then a trip to
the cath lab to confirm and the probable choice of bypass or placing
a stent in the stent, this time w/o polymer. I thought I understood a
stress test could not confirm a problem inside a stent, but I have read
so much and heard so much, I don't know anymore. He added metoprolol
for interim relief. What should we be considering/asking/doing at this
point?
Mrs. Davis, spouse, Caldwell, Kansas, USA, April 28, 2010
• I'm new to these stents I had one put in 4 weeks
back march 2010 and another last Thursday April 15th 2010.Both were taxus
drug eluting stents. I 'm on effient,lisinopril,325
aspirin,metoprolol,and lipitor.My problem is a little different I did have
hives for a bit but not a problem now. I have occasional chest pain (
very minor )
but if feel better every day and I have been working 5-6 hrs. a day.My problem
is sleeplessness I can sleep in the afternoon for 3-4 hrs. fine but when night
time comes its a different story. I am trying t adjust time I take the drugs
to help the sleep . i went to my dr and he put me on zolof and clonopen after
second stent? worked good for a couple days then back to the sleeplessness.
After the first stent I had really strange dreams and woke up exhausted
when the second
stent was installed I went 3 days with maybe 4 hrs. on restful sleep. That's
where I at now I need to figure out how no get back to restful sleep. I think
the drugs are my problem but don't have a clue what is right,I will discuss
this on my follow up visit in a week we see what they have to say.
larry, 54 years old, Eau Claire, Michigan, USA, April 23, 2010
• My husband just returned from a visit with
Dr. Feldman @ UT San Antonio. Well worth the 1500 mile trip. This is
what we understand from that visit: He is allergic to the Promus stent,
and the polymer is the culprit, the symptoms are NOT consistent with
metal allergy. The 1 test that can determine in-stent symptoms is the
OCT, and not available in the U.S. The stent CANNOT be removed. There
are only about a hundred currently KNOWN cases between the U.S. and Europe.
DES Stent Mfgs. see, hear, nor speak of any known evil. Stent allergies
are bad for business and therefore generally do not exist and are blamed
on the anything else, mainly Plavix, which is the last thing a DES patient
should stop without a sufficient substitute. GOING IT ALONE ON ASPIRIN
IS THE WORST ADVICE AVAILABLE!!! My husband has taken Prednisone for
most of the last six months & is advised to stay on it 1yr, then wean
off and see if the symptoms lessen as the immune system MAY adjust. Please
post my email address (amstrustATliveDOTcom). I would not give medical
advice, but six drs. later I can tell you how to be heard and if you
even THINK
YOU MAY have
this problem; Better to risk being wrong and thought a fool, than quiet
and dead!
Mrs. Davis, Caldwell, Kansas, USA, March 24, 2010
• I have recently had some luck with the drs.
taking seriously the potential for a DES allergic reaction in my husband.
His rash is so bad 2 of 3 drs. think
the stent should be removed. He has also had an episode of chest pain, and
increasing breathing issues and has less relief with each subsequent
round of prednisone
along with a more rapid and progressive return of symptoms with each dose reduction.
I am anxious to see if there have been additional outcomes reported on your
forum. Also my husband's dermatologist is putting a lot of effort into
this issue and
I think he would be happy to work with other such patients.
Mrs. Davis, spouse, Quinlan, Texas and Caldwell, Kansas, USA, January 20,
2010
• metal allergy -- www.MELISA.org
Chad, Washington State, USA, December 28, 2009
• My dad had 3 Promus stents put in October 09.
2.5 weeks ago he developed a rash that started on his calves but has
now covered his entire body -- looking
like shingles -- itches and burns -- has gone to his PCP who was suppose to
talk to his cardiologist but no word back from either so I had him go
to a dermatologist
who took a biopsy. If any one has experienced a similar experience please let
me know or if you know what it could be b/c we are getting nowhere and my dad
is extremely uncomfortable.
Debi B., Fairfield, Connecticut, USA, December 27, 2009
• To: Steve C., San
Diego, CA Your allergic reaction
sounds most like my husband's, especially the part about gaining relief
only from 40mg steroid dose or above. Wondering if you found a specific
cause for the rash and hopefully
a solution.
Mrs. Davis, Quinlan, Texas, USA, December 14, 2009
• Diana -- first of all, we're happy that you
got to a hospital during your heart attack -- the procedure prevented
serious heart damage which would affect the rest of your life. As for
the itching, this may well be the stent -- but it may also be the Plavix
or another drug. Hope you find out the source. Keep us informed. We have,
by the way, cross posted your story on our topic about "Metal
Allergies".
Forum Editor, Angioplasty.Org, December 14, 2009
• I had a heart attack on 11/23/09 and had an
emergency stent placed in artery with 100% blockage. After I got home,
I read the stent had Nickel and
was immediately concerned. However, I never had any adverse reactions while waiting
for a 2nd stent to be placed 3 weeks later, for an artery blocked at around 75%.
After it was complete and I came home, I began itching within several days. I
called my Dr. and he seemed baffled. I mentioned I have a Nickel allergy, but
he was sure that wasn't it and told me to take Benadryl (It was a weekend and
he was on call). The Benadryl helped, but as of this writing, and finding so
much information here, I am convinced that Nickel is the problem and plan on
contacting him on Monday to discuss. This site was a Godsend for me, and made
me realize I'm not crazy. Now to convince my Dr. and find a long term solution.
Will keep you posted of outcome. Thanks for this site and all of your input!
Diana D, Columbus, Ohio, USA, December 13, 2009
• i have 4 cobalt chromium stints in my rca
artery, put in 2007. i had no problem with these stents. in 2008
a doctor was able to get one stent in my lfc artery. three other doctors
said it was blocked 100% and that it was so hard they could not get
a stent in it. the hospital that i got the one in my lcr artery used
the taxus express 2tm eluting (medicated polymer coated). i was kept
over night and the next day i started itching and have been breaking
out with hives for almost 1 1/2 years. I'm working with two doctors
trying to confirm that it is the taxus stent. I also from time to
time
have a burning sensation in my chest. as some as there findings are
confirmed i will post the findings
on this site.
Charles M., Ottawa, Illinois, USA, December 3, 2009
• Arlene -- probably not a drug-eluting stent
(those are used primarily for the coronary arteries). Have you been
to an allergist or immunologist??
Forum Editor, Angioplasty.Org, November 28, 2009
• In December 2007, I had a stent inserted
after an arterial embolisation procedure for fibroids, and ever since
then, I’ve suffered constant itching, all over. On some days the itching
is mild and on others, I am driven half berserk. The stent was inserted
into an artery in my right groin, it being the entry point for the
scope during the embolisation. Every night, the the skin around this
spot feels as though there are worms crawling around just under the
skin – it itches like mad. Every now and again, I experience piercing
pain in the artery.
I
don’t know whether or not the stent was drug-eluting or even what material the
stent is made from. Antihistamines seem to help, as does a hefty dose of vitamin
B complex, but it the relief from both only lasts for a few hours. Your advice
would
be much
appreciated.
Arlene, United Kingdom, November 27, 2009
• I need to find Steve
C., San Diego, California,
who last posted on March 18, 2009. I need to talk to you about your
procedure and your rash. Please be
very detailed about the following: When did you have your stent placed? At
what hospital was the stent placed? What was the name of the company
that made the
stent/the model/the type of elutant/the serial number? What was your post stent
protocol? (ex. ASA 81/Clopidogrel 75 x 6mo) Describe the itch: Where does it
start? Are there any visual marks on your skin? Where does it spread to? How
often do you get it? Does it remit? What is the itch like? Can you sleep with
it? What medications have you taken to try and make it better? What medications/activities
make it worse? What have the biopsies shown specifically: T-cells/Plasma cells?
What were you allergic to before the stent? Have you had a bone marrow biopsy,
if so what did it show? please find a way to get in touch with me. if someone
knows Steve C. please get him back to this message board. Thank you.
Max S.,Fort Lauderdale, Florida, USA, November 13, 2009
• I had two of the medicated heart stents on
Aug 10, 2009. In October, i have started experiencing dry tongue,
splitting of the tongue and dry cracked lips. Testing for dry mouth
syndrome
has been ruled out. Is there anyone that
has had the same reaction.
B Everett, Mississippi, USA, November 13, 2009
• Joanne and Barbara -- we're surprised to hear
of suspected hypersensitivity reactions with the Endeavor stent.
One of its advantages is that the polymer is more biocompatible than
the
early first generation polymers of the CYPHER and TAXUS stents. However,
please keep us informed. We might mention also that sudden angina
isn't a typical hypersensitivity reaction. After only a few weeks
it might be a sign of restenosis -- this can be caused
by any number of things -- it is specifically what the drug on the
drug-eluting stent is supposed to prevent, but sometimes incorrect
stent placement or incomplete stent expansion can also be a factor. We
assume in both your cases that your patients are taking Plavix and
aspirin.
Forum Editor, Angioplasty.Org, October 28, 2009
• Today, my husband had a MEG test - magnetic
imaging of brain. Researcher at V.A. explained brain activity was exaggerated
and most likely coming from heart signals to brain. Husband has been
having more or less "intractable angina" beginning several weeks after
Medtronic's Endeavor Drug-Eluting Stent. I believe he is hypersensitive
to the polymer coating on the stent after review of literature. Any
others with same problem? He has no sign of rash, itching, etc. I had
hoped anti-histamines such as Benadryl at night (1/2) and Claritin
(non-drowsy) during day would help but he starts having delusional
symptoms and I have had to discontinue. He was prev dx'd w/Alz but
improved after I moved his elec clock radio off nightstand, stopped
statin and started him on melatonin. Not have Alz but there is no diagnosis.
I say "Reactive Dementia." He does quite well on melatonin so hugely
tragic re constant problems after the DES. He knows he may not live
long now.... Take care - Joanne website: www.guineapigsrus.org (re
moving elec appliance)
Joanne C. Mueller, Guinea Pigs "R" Us , Minneapolis, Minnesota USA, October
27, 2009
• Barbara -- were the sirolimus stents placed
inside the Endeavors? It's not clear from your posting if the original
Endeavor stents closed up, or if these were two new blockages.
Forum Editor, Angioplasty.Org, September 28, 2009
• I'm 49 had two Endeavor Zotarolimus-Eluting
coronary Stents placed in the LAD in April of 2009 within a week
started have sharp pains and burning sensation in the left breast along
with
sharp pain down the left arm and up in to the neck on the left side,
along with nausea and periodically shortness of breath, this continued
until August 2009 when two more stents Cordis Sirolimus-eluting were
placed in the distal and M/D LAD due to restenosis, now on top of
the other symptoms I've started having arrhythmias V-tach twice and
PVCs
almost daily. The pain in the breast I'm told is a muscle spasm of
the artery and has been seen while they performed a heart cath. none
of this started until after the placement of the first two stents
could it be a reaction to the stents.
Barbara R., Columbia, South Carolina, USA, September 27, 2009
• Hello I am a fit, happy (triple bypass survivor) now 8 months later I
have had the same jaw pain and discomfort in the epigastrium nb. NO pain or discomfort
and at rest GOING FOR ANGIOGRAM on the 31st Aug. again (STENTS MAYBE?) my previous
history includes taking myself to hospital and told I HAVE A PANIC ATTACK! ECG
at 5 different cardiologists over a period of 3 years was "normal"? But a clever
DR performed an angiogram on recommendation of Dr Marius Barnard *yes, THE MARIUS
BARNARD, who happens to live nearby. (I had 7 very bad blockages in 3 diff arteries
of 78% & 98%
i was stunned but saved I am scared. Come and c the
whales.
Tertia B., Hermanus, South Africa, August 28, 2009
• Aug '95 Heart attack, bare metal stent placed
in RCA. No problems. Aug 07 chest pains, stent implant (Cypher Drug
Eluting) 2nd stent implanted 1 week later. Have been diagnosed with
Granuloma Facial, a type of Small Vessel Vasculation. Will have blood
work and urinalysis ran to determine if there is any ANCA in my system.
Constantly tired, itch ,rash recurring. Was not involved in decision
to use Drug -Eluting Stents. I feel like I have been betrayed by
my Cardiologist. I think that those of us that have had sensitivity
responses
to these stents will be told in the end that no one is responsible
and that we will just have to live with it. Hopefully something can
be done to preclude patients from being exposed to more maladies.
Small Vessel Vasculation can involve one or a number of organs and
the outcome
is not good. Do Your research
G. Parker, Pine Mountain, Georgia, USA, August 27, 2009
• To Jo
Lambert: I had a stent put in over two years ago. After one year
and four months, I began to have unexplained allergic reactions, including severe
itching and swelling and even anaphylaxis, about once every six weeks, which
has now reduced to about once every four months. I have been tested by an allergist,
and absolutely nothing has been found. Please let me know what your husband finds
out. Thanks.
John Haley, Tega Cay, South Carolina, USA, August 19, 2009
• I had a stent placed in my LAD artery for
a 90% or better blockage in August 2004. Not too long after that I
started having what I thought was a terrible "crick" in my neck. The
pain just kept getting worse, and after going thru a cervical disectomy
and fusion to stop the pain, the pain got much worse. I was finally
dx with Cervical Dystonia which is a neurological condition caused
by some type of problem or blockage in the basil ganglia of the brain.
I never had any type of neck problem until this and i just wonder if
the stent had something to do with the misfiring of the basil ganglia
in my brain? It is a long shot ... but who knows?? I am also allergic
to nickel. I am just searching for answers.
Regina Van Etten, Elko, Georgia, USA, August 18, 2009
• My husband had these stint [stent] put in 1 1/2 years ago he has started
having allergic reaction for no reason, I am wondering if this could be the stints
[stents], Sat morning I thought he was gone from a reaction to what we don't
know he has
to go to doc tomorrow to find out what is going on.
Jo Lambert, Ashland City, Tennessee, USA, August 16, 2009
• I had a Cobalt Chromium bare metal stent
put in Jan.'09 to open a 98% LAD blockage. I just had another stent
placed inside this stent, only this time it is a Taxus drug eluting
stent. I bounced back right away with the first stent, this one I
have a burning sensation in my chest. Anyone else having this burning?
Shannon, Valencia, California, USA, August 6, 2009
• Beverly -- don't know of any literature showing
hypertension caused by stents -- in fact, a stent should lower bp
if anything. Have you brought this to your cardiologist's attention?
What does he/she say?
Forum Editor, Angioplasty.Org, July 26, 2009
• I had a Taxus drug eluting stent put in almost
2 years ago. Recently I have several high blood pressure episodes,
as high as 235/116. I am 76, small
build, weight 135, 138 cholesterol, mostly the good kind. I get regular exercise
and my doctor says I am in very good health for my age. Has anyone heard of stents
causing this kind of problem?
Beverly M., Georgia, USA, July 26, 2009
• I have a coated stent implant for 4 years..During
the last 4 years have suffered with burning sensation and itching,
I have to take Zirtec every 3 days and could not survive without
Zirtec. Didn't get any allergy test carried out. On reading comments
on this
site, I will have to get allergy test carried out.
Jimmy M., Dublin Ireland, July 7, 2009
• I had a medicated drug eluting cordis johnson & johnson
2 stents. the very next day i had a cardiac arrest right in the hospital
on a breathing for
a couple of days.
Mikey, July 6, 2009
• Mike -- do you have any metal allergies? And
which stent (brand) precisely was implanted?
Forum Editor, Angioplasty.Org, July 5, 2009
• I am a 59 year old man who received a titanium
stent last month after having 99.9 blockage of main artery to heart.
i am now suffering extreme pain in my wrists, hands, and right shoulder.
the pain is so severe that i had to be given Demerol injection and
steroid meds. my sed test came back pretty high and i am waiting for
lab work that was done to show if i have lupus or rheumatoid condition.
i feel that it is a reaction and am fearful what will happen if they
do not get it right. please--need feedback. thanks.
Mike D., Hermitage, Pennsylvania, USA, June 30, 2009
• MO -- good for you. Yes, all the instructions
for implanting stents contain warnings NOT to implant a stent in a
patient with known hypersensitivities (allergies) to any of its components,
and nickel/stainless steel is specifically mentioned. Unfortunately
many, if not most, patients are not queried about metal allergies prior
to implantation -- we have actually opened up a topic specifically
on metal
allergies. We are cross-posting your message there as well.
Forum Editor, Angioplasty.Org, June 15,
2009
• THANK GOD, I did a lot of research, i need
to have angioplasty and stents but when i found out they contain
metal / nickel which i am highly allergic to, the Dr said it was a
no go.
Had I had the stents put in, I would have suffered extremely bad
to them. I think this is the case with many of you that have problems
with the stents, NO MATTER WHAT KIND, because they all contain NICKEL!
MO, New York, USA, June 11, 2009
• Hmmmm...weight loss, rashes, metallic taste
sounds like what have going on-- short story long, Xience drug
eluting stent placed into circumflex last Oct '08 90% blockage
thank you
doc. End up in ER a month later with hypotension am told I have
anemia, so they adjust the Bp meds (lopressor, lisinopril) problems
all
winter also on Plavix and aspirin the usual post stent drill from
what I
understand
around mid Feb am dizzy all the time itching rash gets worse
end up in ER again, cardiologist figures it's the Plavix sends me
to allergy doc who thinks it's the Lisinopril. 4 months later still
feel
lousy
and am med sensitive to stuff I have taken for years rashes
on
neck, tongue burning and swelling feel like crap.ANA comes back
positive along with dna Lupus? rheumatologist repeats blood work says
no! I'm
beginning to think it's the stent any input would be greatly
appreciated.
J.S., Detroit, Michigan, USA, May 21, 2009
• Carol -- these are hard questions to answer
-- but you might want to contact the cardiology group in Texas (see
stentstudy in right hand column) with your story.
Forum Editor, Angioplasty.Org, May 21, 2009
• My husband had a Boston Scientific Liberte
stent put in last September 2008. He was already on coumadin and then
put on Plavix, and aspirin after the stent. One week later he was admitted
to the hospital for an internal bleed and a blood count of 8. They
found two bleeds in his stomach and ended up having two endoscopies.
Once he came home he started losing weight, no one had an answer as
to why he lost about 38 lbs. He has been through endoscopies, colonoscopy,
scans with and without dyes and chest x-rays. Has seen an oncologist
and has had numerous blood tests, all negative. We have exhausted all
possibilities and finally started thinking that all this started with
the installation of the stent. I did a web search and found this website.
It would seem that we are not the only ones that have experienced weight
loss or side effects. The only other side effect that we could pin
to the installation of this stent was nausea but he never had the metallic
taste. Please let us know if there is anyone else with this problem.
And if so have you started regaining any of the weight back?
Carol S., Winthrop, Maine, May 21, 2009
• Note to Peter V -- I also experienced an allergic
reaction to Plavix and resolved it with a one day desensitization program
at the Scripps Clinic in San Diego, California No problems in the two
years since then. This might be an option for you so you might want
to contact the Clinic and see if there is a facility near you that
could administer this program. Good luck.
Roger L., Los Angeles, California, USA, May 1, 2009
• My mother had two stents put in , in December
2008. Since then she has been miserable. She has had increased blood
pressure. 200's over 100's. She had dental work done not long after
that a now has a burning throughout her entire body including her mouth.
Her bp is still very high but for some reason it bottomed out the other
night. dropping from 198/100 to 80/42. What the hell is going on with
my poor mom. She is getting very depressed and can't take all the doctors
visits and no answers.. Somebody please help my mom..Her only daughter
Tracey.
Tracey, Howell, New Jersey, USA, April 27, 2009
• hi I'm back. I just wanted to tell you that
I still have my rash it comes and goes and hard not to scratch .
The only time I can if my wife is not looking hehehe I will be 71 in
june
and I just wanted to tell you. I walk on the tread mill every morning
for half hour speed 3.4 on mark up I'll want to be ready when I see
my doc here and he says stress test its there favorite thing to do.
Maybe if they would do that themselves sometime they would have more
of a idea what it is like heheh. Anyway its been since February since
I had my three stents put in and all I can say is give your self
a little time .I just cut my lawn fist the front and I used a push
mower
can remember as far back as ten years that I used to get a pain and
would have to stop for a while .This time I felt nothing I was walking
cutting with a big smile on my face. I came in and drove my wife
to work and thought why not do the back also and I have a big back
yard
i usually use my tractor for it but i was so delighted I couldn't
stop and cut the whole thing my yard is 100x 200 I did it and in proud
of
it i feel like a 20 year old again.So if you feel a little discomfort
at first its normal . I just wanted to share this with you all. I
say thank God the Doc in Florida did a angiogram and found my blockage
3 x 75%. I feel great and you will to see you till next time, don't
look at my typo's I'm not a good typer hehehe but I can cut grass
hehehe.
Peter V., Ontario Canada, April 25, 2009
• I'm extreemly happy with the quick response
I got about the cypher stents I'm on. As my rash is getting worse and
you explained to me several options.The problem here is when you read
all the problems there are with the stents, it's all doom and gloom
including myself. I thought ok is the the end of the road for me. But
when you think of it only the people that are having a problem are
writing. And all the success stories you wont hear. I am going to write
in here even after I get everything in order as it can help a lot of
people. They need to hear the good things as much if not more then
the bad. I'm 70 years young just celebrated our 50th wedding anniversary
have 5 wonderful kids and more grandkids then I can count including
great grandkids So let's look at the positive side as well. I know
if I didn't have the stents installed I was a walking heart attack.
I do think that the doctors should talk to their patients and explain
what each stent does for them. Me I was totally dumbfounded I didn't
know one stent from the other. Had I had the time beforehand to research
that I for sure would have but, things don't always work that way.
I had no idea I had three arteries blocked. Anyway my bp is normal
and my heart rate is good just that darn rash. and I hope all will
work out for all of you. Feel free to post here to discuss our problems
we face see you later and God Bless.
Peter V., retired??? mmmmmm not really so far i don't have the RE part
and I'm just Tired:), Whiby, Ontario Canada, April 12, 2009
• Peter -- patients with drug-eluting stents,
like the CYPHER, are recommended to take a minimum of 6 months of dual
anti-platelet therapy: aspirin plus clopidogrel (Plavix) or Ticlid
(ticlopidine). Many cardiologists extend this to 12 months or longer,
to lower the risk of late stent thrombosis, or blood-clotting inside
the stent while the artery wall "heals" over the stent itself.
Check out our related topic on Plavix
and aspirin: dosage and allergic reactions for some stories from
other patients, a number of whom report rashes as well. An allergic
reaction may be the results of a number of things, one that you mentioned
-- the contrast dye -- is not uncommon, and can be a delayed reaction.
Others are to medications, several of which are often initiated after
a diagnosis of coronary artery disease. The incidence of allergies
to the stents themselves are very rare, although if other causes are
ruled out, this may be the case. A larger number of patients report
a hypersensitive (allergic) reaction to Plavix, specifically causing
a rash. The challenge is to pin down the cause. If it is thought that
Plavix is the issue, there have been a number of studies done on how
to desensitize a patient to the drug. One recent study suggests a short
course of antihistamines and steroids may solve this. It was presented
at the American Heart Association meeting in October and is titled Successful
Treatment of Clopidogrel Hypersensitivity Without Drug Interruption.
Most importantly, do not stop taking either aspirin or clopidogrel
without consulting your cardiologist and work with him/her to solve
this problem. We're glad, however, that outside of the rash, you feel
great!
Forum Editor, Angioplasty.Org, April 12, 2009
• I am a healthy 70 year old and I live in canada.
I was on vacation in Florida in February and went to the hospital with
a pain in my chest, after a angiogram they found 3 blocked arteries
75% so they installed 3 Stents the name of them is Cypher Sirolimus
eluting. I feel great but I have this rash all over my body. mostly
on the chest area. First I though that it was the dye they used/I had
two stress test in canada , before I left and they showed normal. then
the angiogram also with dye and putting in the stents dye again. and
a week after that they did a nuclear stress test also with dye. So
they put me on plavix and a 81 mg aspirin along with the sotanol I
was on with the 4 mg warfarin and a pravastatin. The sotanol is just
a prevention of AF I get now and then. also the warfarin.what I like
to know is will this rash get better as time goes on? I'm at a total
loss here. My Cardio doctor in Canada don't seem to sympathetic and
just told me to drop the aspirin to see if that will help. Any advise
would be really appreciated thank you.
Peter V., retired not really so far i don't have the RE part and I'm just
Tired:), Whitby, Ontario, Canada, April 11, 2009
• My father aged 67 received Angioplasty treatment
with 1 drug eluting stent and 1 simple stent on 1st March 2009. He
had suffered severe pain in hand for about 10 days, which has subsided
now. From 10th March he is having constant hiccups The Doctor prescribed
Liofen (Baclofen), which gives him temporary relief. He also takes
Dygene to eliminate Acidity if any. Still the problem is not solved
permanently. What could be the probable reason and solution?
Rupesh S., Gujarat, India, March 21, 2009
• Steve et al -- see the notice in the right
column about a research project being done regarding allergic reactions
to drug-eluting stents. The research team believes the reaction is
to the polymer coating on the stents, namely the first generation DES.
They have some pretty significant data to suggest an inflammatory response,
which may account for some of the reactions reported in this topic.
Other reactions are often due to the various medications that are prescribed
for heart patients, medications that are often only started once a
diagnosis of coronary artery disease has been made -- as such they
are not related to the stent at all. A third possibility exists, and
we've started a separate
topic on this -- metal allergy. Virtually all stents, bare metal
and drug-eluting, are made with alloys that contain nickel. A percentage
of patients, more predominately women, have nickel allergies (you'd
probably know that from jewelry, etc.). Whether or not a nickel allergy
can cause adverse reactions from stents has not been proven, but the
FDA requires language in all stent packaging to warn against implanting
these devices in patients with known hypersensitivities to any of the
components, specifically nickel or stainless steel. We encourage patients
to read and post
to this new topic, especially if you have a known metal allergy.
Forum Editor, Angioplasty.Org, March 21, 2009
• Two years ago I had DES placed in my heart.
I have had itching on my forearms ever since that have gone from mild
to wild. Prednisone seems to help but only if dosed greater than 40mg
per day. I have tried every cream, ointment, salve available to no
avail. I have seen a dermatologist who biopsied several areas and said
they showed some deep cell irritation like a reaction to medicine.
I stopped taking all my medications and the itching continued. I have
seen an allergist who started testing but stopped when I had a reaction
to one of the elements of the test and a recurrence of the itching.
He prescribed 10mg to 20mg of Prednisone to help control the reaction.
Like I stated earlier, I only get relief from larger dosing. I am open
to any and all suggestions. Please help.
Steve C., San Diego, California, USA, March 18, 2009
• I had a taxus stent implanted 3 years ago.
for almost 2 years I have been suffering from hives, swelling, burning
sensation on my skin diagnosed as Chronic Idiopathic Urticaria. I am
being treated with allergy meds and steroids and creams. the hives
come and go and move all over the body. I believe I am having an allergic
reaction to the coated stent. I have been to two allergists, a dermatologist
and my cardiologist. all do not know the cause. my question is has
anyone suffered from skin hives, (urticaria) as a result of a drug
coated stent that was implanted?? what is the best recommendation to
prevent flare ups that has worked for others? any info would be greatly
appreciated! thanks.
Sadie, Miami Beach, Florida, USA, March 14, 2009
• I had two des implanted in May 05, and was
only asked about sensitivity/allergy to drugs, but I have hayfever,
and a nickel allergy. 1 week after implantation I had severe chest
pain and had continued angina pain. I have never been completely pain-free.
Please note, I have been taking Plavix for probably 2 1/2 years out
of the almost 4 yrs since implant. In Sept 07,I had worse Angina pain
ever, but was on holiday in Egypt at time and so chewed 300 mg aspirin,
took gtn spray several times and also painkillers, until pain subsided.
Following day came out in hives, all over body, neck, arms, legs. Bought
over counter antihistamine tabs and cream and eventually rash subsided
after 5-6 days (whilst continually taking antihistamines). As soon
as I stopped taking them itching started. Back from holiday, I saw
my local doctor who sent of blood samples, which were ok, but itching
continued. Had referral to dermatologist, who prescribed Zirtec 10
mg (April 08), and have been taking these daily since then. No allergy
testing was done, and I did not make the connection between the worsening
angina and rash/itching at that time. Also in November 07 whilst standing
in kitchen had syncopal episode. No warning whatsoever. I have never
had one before. During 2008, my angina worsened and exercise tolerance
continued to decrease. In October 08, my Cardiologist stopped the Plavix
and changed Amlodipine 10 mg to Felodipine 2.5 mg(because of terrible
feet/leg swelling). Since November 08, my breathing has become increasingly
laboured, severe exacerbations of breathlessness, later found to be
caused by Felodipine, which has now been stopped. Initially there was
some improvement to dyspnea,but this has deteriorated, and continues
to do so limiting all aspects of life to extreme. In January 08 I had
a selective angiogram which showed minor in-stent restenosis of 20-30%,
ostial stenosis of around 90% in the first small septal branch, and
a 20% plaque in the mid LAD beyond the stent implant, (which had not
been there at time of angioplasty}. No further angiogram since.
MY QUESTIONS ARE:
- WOULD ANY INFLAMMATION SHOW UP IN AN ANGIOGRAM?
- WOULD THE ZIRTEC ALTER BLOOD TESTS, WITH REGARD
TO C REACTIVE PROTEIN, PARTICULARLY AS I AM ON A STEROID INHALER
AND HAVE HAD TWO COURSES OF STEROIDS, PRIOR TO THE BLOODS TAKEN.?
- WHAT MIGHT HAPPEN IF I STOPPED TAKING THE ZIRTEC?
(I DID MISS A DAY ON TWO OCCASIONS, AND HAD TERRIBLE ITCHING AND
RED SPOTS AND WEALS.)
- COULD I BE HYPERSENSITIVE TO THE STENTS?
I am waiting to see Dermatologist/Allergist and wonder
how long the Zirtec remains in a person's system. Thanks for any info/opinion
you can provide.
Barbara, Great Britain, February 9, 2009
• Beginning Jan '05 I have had 4 interventions
each one requiring 2 stents for a total of 8. I am 62 and just had
my last procedure. The first went fine, then in Aug '05 I had 2 more
stents and for months I felt like hell. Weak, extreme fatigue. The
3rd went fine March '08 I was OK then Jan '09 the 4th. Again extreme
fatigue. I'm ok if sitting but moving around I just want to lie down.
I cannot do 1/3 of what I could before this last. I have always been
sensitive to any statin or ace. They put me on lisinopril I quit a
week ago to see. No change. I have been on plavix, metoprolol, aspirin
for years. I am finally leaning towards getting a by-pass. I can't
stand this fatigue.
Tom L., South Carolina, USA, January 18, 2009
