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Heart Attack and Stents or Angioplasty (2011 and Earlier)

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Post experience with or questions about the use of stents and emergency angioplasty to treat a heart attack (AMI or acute myocardial infarction).

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Archived Postings on This Page from 2011 and Earlier (99):

• Risky in India -- Glad to hear your dad got to the hospital in time. If the angioplasty was done quickly enough, the damage to his heart muscle should be minimized. As for the other artery in the "pica" (we don't know this term) discuss this with his cardiologists as to whether or not this is causing reduced blood flow and should be opened. It may or may not be an urgent issue -- the main thing is that the artery causing the heart attack was reopened. What's important now is to adhere to medications, exercise as prescribed, lifestyle changes (no smoking, etc.).
Angioplasty.Org Staff, Angioplasty.Org, December 30, 2011

• hi, my dad got a severe heart attack yesterday. When his artery was 100% blocked, doctors did stenting procedure in his right coronary artery as we reached hospital at right time. He is in ICU right now, but my doubt is that another artery named pica is also involved 75 to 80 %. can u please suggest as to what are the procedures to be followed now????????
risky heart, life saved at last moment, New Delhi, India., December 27, 2011

• I have been a heart patient since 1997. At that time I was diagnosed with a collapsed artery. Angioplasty solved that situation. In 2006, I had seven stints [stents] inserted due to blockage in several arteries. I have never failed to take my meds. I walk 4.5 miles every day in approximately one hour and five minutes. I am now on only two drugs (Lipitor and Metoprolol Succinate ER). My BP is 110/65. I was recently taken off Lisinopril. I am 65 and never felt better. I would say that if you lose weight, watch what you eat, and exercise regularly, you will be able to live a very long and joyful life. I wish all of you the best of luck.
Sherald in Denver, Littleton, Colorado, USA, December 3, 2011

• MMB in Montana -- To be effective, emergency angioplasty to stop a heart attack in its tracks needs to be done within a very short time (hours) of the onset of symptoms. The guidelines are for hospitals to be able to open up the blocked artery that is causing the heart attack within 90 minutes of the patient presenting to the Emergency Department with chest pain. The idea is to open up the blood flow to the heart muscle so that it doesn't suffer permanent damage. 30 years ago this was not possible, so heart attacks were just left to finish out; today that is not the case. Unfortunately, those of us in rural areas often are far from a hospital that can perform emergency angioplasty -- so the default is to administer clot-busting drugs and transport the patient ASAP to a hospital equipped to do angioplasty. We cannot say why you were not identified as a heart attack victim ASAP and treated accordingly. But your EF is an important number, to see the state of damage to the heart muscle and your ability to lower your risk factors against future events is also important. EF can actually be increased somewhat. Let us know the outcomes.
Angioplasty.Org Staff, Angioplasty.Org, December 2, 2011

• Nov. 1st had chest 'banding' feeling, walked into urgent care with this complaint. While in office experienced cardiac arrest but remained awake (slurred speech,cold sweats etc pb 40) did not receive oxygen etc. Ambulance to hospital where I was monitored, placed on nitro drip, enzyme count up. It was decided to take me off nitro. I laid in room for hours without much care. Put in ICU and next day (24hr later) placed stent in. Cardiologist kept saying it was a shame I didn't come in sooner - Next day out of hospital - cardiologist not available for three weeks on vacation. Within two days (Nov. 4) back in with heavy chest pain and a second stent placed. Different cardiologist said first stent was too short and skin flap covered some. Have no idea what my EF is (just learned about EF from this forum). Did not know I had 2 heart attacks or dissection? until my general doctor told me. two weeks later. Will not see cardiologist for another week -will be four weeks from hospital to time to see him. Do not know if I have damage but can assume it. Not complaining but I somehow feel something was not done soon enough in the beginning at either urgent care or ER. i.e. emergency stent etc.
MMB in Montana, Helena, Montana, USA, November 21, 2011

• My father underwent his angioplasty surgery last week. He had two blockages and after surgery two stents have been inserted into his arteries. He occasionally feels his heart is beating faster. Is this common during recuperation after angioplasty?
Manippadi, United Kingdom, November 9, 2011

• My husband, now 52, survived the widow maker. He had his heart attack when he was 49. I feel so very fortunate to have him but he is always angry and experiences a lot of chest pain and anxiety. His personality was type I and that has not really changed. But, he is always so very negative and critical. I do not want him to have another heart attack but feel like he is heading that way. Has anyone else experienced this?
Helen, Suffolk, Pennsylvania, USA, November 3, 2011

• Kumar -- we are so sorry for your loss. Was it determined for certain that your mother died of a heart attack? Prediction of such events has gotten much more accurate but is still far from 100%. One technology that is being used more and more in Emergency Departments is the Cardiac CT scan. Much faster than a nuclear stress test, the Cardiac CT can quickly diagnose if the patient has a blocked artery. And if none is seen, the accuracy approaches 99% -- that is, if the CT shows no coronary artery disease, you don't have any. However, not all heart attacks come from blockages that can be seen on angiography (whether standard angiogram or CT) -- and chest pain also is not always present, especially in women. (Read our recent article, "Intravascular Ultrasound (IVUS) Imaging Reveals Hidden Heart Attack Culprit In Women") In any case, it sounds like it was never determined whether your mother had a significant blockage or not.
Angioplasty.Org Staff, Angioplasty.Org, October 22, 2011

• My mother 66 years old, diabetic, had a sudden abdomen pain and trouble in walking on right side her body. Suspecting a stroke, we took her to ER, where she showed normal BP and sugar. The doctors conducted tests for any brain stroke or blockage in neck. She was placed in recovery room with dosage of heparin and aspirin for three days and was advised of nuclear stress test. Her ejection fraction was 67% and a minor left ventricular infarction. She did not complain any chest pain. The cardiologist advised against doing any invasive procedure on her heart and she was released on aspirin and metoprolol. After 15 days in home,one day she went to bathroom in morning and immediately was found unconscious and declared passed away by EMR. Why would cardiologist release her previously if her condition was of imminent heart attack? We would have definitely thought about placing stent if cardiologist had strongly advised. - Bereaved family
Kumar, Somerset, New Jersey, USA, October 19, 2011

• Ron in Boca Raton -- thank you for your story. Our forums can easily become a "complaint dept." where patients, rightly so, are looking for answers to complications. That is a very important service, so that people don't feel alone in their problems. But this makes positive success stories like yours even more important -- to give hope to patients that there is "life after heart disease" and there are many many patients who, thanks to modern device technology and pharmaceuticals, are given a second chance and who take charge of their health, as you have done, and actually feel better than ever.

And speaking of environmental factors, Reaganis from Illinois, smoking is most definitely one of the biggest risk factors for coronary artery disease (not to mention lung problems, like cancer and COPD). This has been shown in study after study. Stopping smoking reduces your risk for heart disease. Period.
Angioplasty.Org Staff, Angioplasty.Org, October 18, 2011

• I have been looking for a site to share my good news and provide some hope for others in my situation. I am a 64 year old male and on March 26, 2011 had a major MI with 100% blockage. After angioplasty with 2 stents inserted I left the hospital 3 days later with a LifeVest after an ejection fraction reading of 25. Fast forward 6 months, I have lost 25 lbs. am on a plant based diet, exercise 1 hour a day, religiously take my meds and have never felt better. My recent echo indicated an EF of 65. I am unsure why I am so fortunate, but I do know that I am doing my part in maximizing my chance to continue on life's journey. I never lost my positive mental attitude and suggest that you try to do the same.
Ron, Boca Raton, Florida, USA, October 18, 2011

• Seems Dr.s' always blame heart problems on smoking? Is it maybe because our bodies are getting older? People that smoked one day or 10 years have same issues
Reaganis, Sainte Marie, Illinois, USA, October 13, 2011

• Malini in India -- prescription medicines have vastly improved the care of heart patients. Exercise is also important, but meds can help reduce risk factors like cholesterol levels, blood pressure, etc. If you father stopped taking his meds (and he is NOT alone in this) it may be because he is having side effects. He (perhaps along with you) should visit his cardiologist to discuss this. Prescriptions could be reduced, changed, etc. but a patient should always do this with the advice and consultation of his/her cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, September 20, 2011

• Hi,my dad is a heart patient once he had sudden heart attack first time and he was in the ICU and now after all the treatment he is fine and doctor gave him medicine and he was taking it continuously and now my father was not taken the medicine for 6 months but doing all kind of activity like walk in the morning for 1 hours reduce his weight and i am little bit worried about him because he is not taking medicine he so careless. would you please help me.
Malini Mani, Tamilnadu, India, September 14, 2011

• Renee in New Jersey -- Genetics are a well-documented risk factor for coronary artery disease. We've heard anecdotally of stories where identical twins developed lesions (blockages) in exactly the same part of the coronary anatomy. An early study from 1994 looked at 21,000 twins born in Sweden during the late 19th-early 20th century and concluded that there is definitely an increased risk from genetics but that this correlation decreases with age. Perhaps this is where environmental factors come more into play.
Angioplasty.Org Staff, Angioplasty.Org, September 13, 2011

• I am a 55 yr old female identical twin that had a heart attack August 2011, my identical twin sister also had a heart attack 2 years ago with a blockage in the same section in the capillaries on the back of the heart. Is this something that happens to twins? Are there any studies done on twins and genetic issues?
Renee, Blairstown, New Jersey, USA, , September 9, 2011

• In response to Ted, Atlanta, Georgia, USA, August 16, 2011. I am 42 and have almost the exact same symptoms except my blood pressure will spike real high and make me dizzy. I had a stress test and another cardiac cath done. My family doctor kept increasing blood pressure meds until my heart was only beating about 40 per minute. The cath showed no problems so they took me off blood pressure meds and gave me Xanax for anxiety attacks. I take half of one before work and then half when I start to feel chest pain and I feel great now. I take Ranitidine 150mg over the counter for my heartburn.
D Crandall, Cedar Falls, Iowa, USA, September 8, 2011

• Trying to find out about drug eluting stents and their risks. My father was admitted to the hospital because of an acute ST elevation inferior wall myocardial infarction. He had a DES stent placed in his right coronary artery and was discharged 3 days later. The day after discharge went back to hospital with chest pain. EKG showed ST elevation in leads II, III and aVF. ST segment was slightly improved. Angiogram showed that he had mild thrombosis at the place of RCCS stenting. They felt this was not significant and changed him from plavix to effient and discharged him. Is clotting in DES common and should further treatment have been offered to him?
Concerned, Haslett, Michigan, USA, September 4, 2011

• My father who is 80 had a 4 bypass surgery 16 years ago and stents put in 7 years ago. Just a few days ago he had a heart attack and the cardiologist discovered that one of his bypasses had completely blown. We have been told that he is not a candidate to have another bypass procedure and that they cannot put in more stents.He is going to be maintained with new medications. Is it possible to survive with a blown out coronary bypass graft? Or is he just another heart attack waiting to happen?
Terry-Florida, Pensacola, Florida, USA, August 27, 2011

• I am 59 yo nurse who retired about 3 months ago never smoked, am slender, but diagnosed with high bp and family history. All i had was jaw pain and found out LAD was 85% occluded -- got a stent and doing fine..no heart damage. Please know that heart pain can be anything between waist and earlobe. I never had any chest pain.
Anita, Albany, Georgia, USA, August 21, 2011

• My stents are keeping me alive. I have great recovery due to change of diet and listening to my heart. Don't over due anything...be patient with this recovery. You will soon forget that you had the event...but it is good to remember your diet...exercise..and general health. Get your dental work updated...avoid hospitals with bacterial problems...you need to stay away from sickness. I went off the Plavix after one year and upped the aspirin to 300 mg a day. I need to have a stress test regularly and always remember the how that felt..on the night it happened. Don;t try to brush it off. Get help quickly...life saving! Make sure you are near to a good hospital. Check the list of those that have on call highly recommended Doctors Do your homework...be on guard and relieve stress of intense life style. Great days can be yours.
walking miracle...thank you Duke Heart Institute, Florida, USA, August 19, 2011

• I finished my 25th birkie cc ski marathon (53km), 2007 at age 49; 4 months later I collapsed at 5 am...just off the toilet. i felt what i thought was indigestion, all night long. I remember looking in the mirror thinking how pale my complexion was.. so crawled my way to the phone, drenched with sweat... pissed off. i was really angry that i was dying like this. I had started to do more roof jobs(4), when i noticed my decline in stamin.so was all this for naught? my diet wasn't that bad. 6 stents, died for a while.
xc ski farmer, Boscobel, Wisconsin, USA, August 16, 2011

• Hi , My husband had a massive Heart attack about 3 weeks ago. Dr. said he very lucky to be alive because where the Heart attack was. We had some great news yesterday: the Heart has repaired itself there is not a lot of damage . The power of prayer is a wonderful thing . I just want to give hope to someone who might be going through the same thing ,,,,He still has to go to the Dr. and be check out and NO Smoking and NO Fried food . He got his second Stent yesterday, but there is hope.
Candy, Florida, USA, August 16, 2011

• Hi. I'm a 45yo male, in decent shape, exercise randomly, smoked for 17 years 1-1/2 packs/day. July 20 I had a heart attack, thought it was heartburn like many other here from what I read. I had one stent put in. On effient 10mg, coreg 12.5, lipitor 40mg and aspirin 325. Changed diets completely, fat free and lots of veggies and fruits. Cholesterol dropped from 331 the day of the heart attack to 170 (42 HDL) 1 week ago. My problem is that I feel almost constant chest pain, for which I have to take Tylenol and also have terrible heartburn still, to the point that sometimes it keeps me up all night. Had heart stress test and all the others - everything fine. But the chest pain has me worried although the doc said it is NOT the heart. I don't know how to deal with this or if anybody else experienced this. Also, I dropped cigarette smoking to about 10-15/day, trying to drop more daily until I quit by the end of the month. I appreciate anybody's input!
Ted, Atlanta, Georgia, USA, August 16, 2011

• To all, choose a holistic life style to increase your days here on earth. Remove all white sugars, High fructose corn syrup, bleached flours, Monosodium Glutamate & countless other poisons. Ck your PH , Blood sugar, Heart pressure, cholesterol levels.Move towards Fresh raw organic fruits & vegetables. We have become a slave to the lender by not knowing what we are putting into our God given bodies. It is a stewardship, we must be responsible and become educated, just because it looks & taste good does not mean we should consume it. Before your temple snaps & your whole world comes crumbling down, make the change. Doctor's are on this earth to help during catastrophic events with God given knowledge but do not have the knowledge of God. At age 54 I Just got my heart attack wake up call & refused bypass surgery, stents & medication. Had only 1 balloon angioplasty to restore my 100% clogged artery and am grateful. I have moved to an all natural lifestyle. Never felt better, no longer crave 2 to 3 midday naps, I wake up earlier & go to sleep later. Why didn't someone tell me sooner. I am awake now, but it took a punch in the chest to become aware my diet was killing me.
Mr. E, ESA Holistic, New York, USA, August 14, 2011

• I think that what save my husband, Are Hospital Air Ambulance him to Orlando, FL Hospital. He was in the middle of the Heart attack at the first Hospital and they don,t have a cardiac cath lab .......That is what save his life Air ambulance ...People don,t know where there a cath lab and they just go to there local Hospital ...... Thank goodness for Air ambulance and DR.
Candy, Florida, USA, August 7, 2011

• hello everyone I am a 51 year old male that has smoked about one pack of cigs per day and have been smoking for about 43 years, April 27 2011 I started have some chest pain and thought I was having some heart burn? come to find out I was having heart attacks four in all. I went to the hospital and they put a stent in my big heart, they told me that my heart attack was from smoking, they said that everything else was fine. blood pressure and cholesterol was all fine, so they put the stent in three months ago and now I have not smoked for three months thank God, and I currently am walking about four mile per day every day with my wife and am doing very good. just want to given anyone help that may needs it. God Bless you.
big heart of sheridan, Sheridan, Oregon, USA, July 31, 2011

• Candy in Florida -- The Dr. was correct in that your husband was born AFTER angioplasty was invented AND that he got to a hospital that performed emergency angioplasty quickly (we assume that he got to the ER within an hour or two of his symptoms). If the heart attack got stopped with angioplasty, then his recovery should be pretty complete (this was unheard of before angioplasty). Even if there was some damage to the heart muscle, it was probably minimized. Again we are assuming he got to the hospital and into the cath lab quickly. The cardiologist can take measurements, especially one called the Ejection Fraction or EF which measure the health of the heart muscle. Discuss these issues with the cardiologist and let the Forum know your husband's outcome. And your difficulty with this is certainly normal. What you have discovered is that you husband has coronary artery disease. But with lifestyle changes (diet, exercise, smoking cessation) and modern medications, you husband should "be great forever", assuming there was minimal damage to the heart muscle. This is why we urge anyone who is experiencing symptoms of a heart attack to call an ambulance and get to a hospital that performs emergency angioplasty ASAP. See "Big Heart"'s post above.
Angioplasty.Org Staff, Angioplasty.Org, July 31, 2011

• My husband had a Heart attack last Fri or Sat morning . It all work out . The medevac got him to the other Hospital .The DR said he was luckiest guy to be alive . He at home doing great now . He just turn 50 in good health but only his low cholesterol was at the danger zone .He goes back for second stent in a few weeks . He doing great , I am having a hard time with every thing going on is that normal for me to feel this way? It is what the DR said to us that make me worry . The DR said he is fine for right now but, they just don't know . I am praying he will be great for ever.
Candy, Florida, USA, July 31, 2011

• Ian in England -- check out our Forum Topic on "Not Feeling Well After Stenting" and you will read that many patients seem to have such symptoms immediately after stenting. These may last a few weeks, as the body adjusts to the stent, and also to new medications. But if you are feeling pains that are intense, or similar to the pain you felt prior to the heart attack, call your cardiologist for a check up to make sure everything is okay.
Angioplasty.Org Staff, Angioplasty.Org, July 31, 2011

• Hi I am 47. Recently had a heart attack. Over a period of two weeks I've had five drug-eluting stents fitted. I'm home and two weeks have passed, but I feel pains and twinges in my heart, some days all day long.
Ian A., England, July 21, 2011

• Worriedwife in Canada -- Hospitals strive for a 90 min window from the time a patient arrives at the hospital until he is on the cath lab table and his blockage is being ballooned open -- called "door-to-balloon time". The other measure is "onset-to-balloon time", or the time it takes from the onset of symptoms, something not under the hospital's control. In any case, your husband's cardiologist is the best source of answers to your questions because he/she will have the measurements and hospital records to see. One measure is the ejection fraction or EF -- a measure of how efficiently the ventricles of the heart are working. This is the area most often impacted by an acute myocardial infarction (heart attack). So his appointment with the cardiologist is the best time to get this prognosis (we would urge you to accompany him. take notes, etc. -- read our article, "You and Your Physician", to prepare). A recent study showed increased benefit to starting exercise rehab ASAP after a heart attack -- as soon as one week. That, of course, depends on your husband's condition.
Angioplasty.Org Staff, Angioplasty.Org, April 28, 2011

• My husband just had a massive heart attack and it took about 4 hours before he could get an emergency angioplasty where it was discovered he had four significant blocked arteries and 4 stents were implanted. He stayed overnight at the hospital for a few days. How do we know if/the extent of damage to his heart? Can we expect a full recovery (through proper diet, therapy, etc.)?
Worriedwife, Burnaby, British Columbia, Canada, April 28, 2011

• Dear Kent from North Carolina -- thank you for writing in and our sympathies to you as well. Smoking is a very big risk factor for coronary artery disease (CAD). The nicotine and other elements in tobacco smoke can irritate and disrupt the endothelial lining of the arteries, much like excess acid can cause an ulcer in the stomach. When the endothelium becomes diseased, blockages can occur and/or platelets begin to collect, forming a thrombus, blood flow is reduced or, if it occurs suddenly, a heart attack is the result. While there may be a genetic disposition to CAD, our environment and how we treat our bodies has a lot to do with it. Not smoking reduces your risk considerably. As for ongoing studies, you might want to contact the authors of the study mentioned below in Texas. They may still be working in theis area and, if not, they'd probably have a good idea who is. Andlet the Forum know what you find out.
Angioplasty.Org Staff, Angioplasty.Org, April 7, 2011

• Seeking Insight response -- I am the living identical twin who wants to know if someone in the heart field is or will be doing studies on identical twins where my twin passed away on 3-1-11 from a heart attack at the age of 59. He smoked for approx 45yrs while I the remaining 59 yr old identical twin never smoked and feel very well. Just curious if there is any medical studies planned in the future where I may participate. Any help would be greatly appreciated plus I want to thank my niece for passing on the info regarding my brother's death. She is in Nursing School and I thank her for he sincere interest in me and her profession.
Kent, Charlotte, North Carolina, USA, April 7, 2011

• Dear Seeking Insight -- first of all, we are most sorry for your loss. It's very hard to say from your description what happened: your father returned for "swelling" -- not sure what that means. Perhaps the doctors at the hospital can explain more specifically. And why they needed to do another procedure. A heart attack is caused when the blood clots (forms a thrombus) usually in or near a pre-existing blockage in a coronary artery. Getting quickly to a cath lab where the blockage can be reopened before the oxygen deprivation damages the heart muscle is the gold standard for treatment. Sounds like he may have formed another clot, even though many of the meds he got would be blood-thinners (antiplatelet drugs) like Plavix, aspirin, or possibly Effient. His twin would genetically be identical. There is much discussion in cardiology right now about genetics, and whether certain patients are resistant to Plavix, for example. (Read our interview with Dr. Eric Topol who is a leader in this area.) So maybe his twin might want to get a genetic test to see if he is in this category. Coronary artery disease definitely has a genetic component, so your uncle should definitely do what he can to minimize his risk factors, such as smoking, diet, exercise, controlling blood pressure and cholesterol. As for studies, here's one that might be of interest: "Identical Atherosclerotic Lesions in Identical Twins". It's a decade old, but certainly shows the genetic tie.
Angioplasty.Org Staff, Angioplasty.Org, April 7, 2011

• My dad (59) passed away last month. He had a heart attack. When he arrived at the hospital they sent him to surgery, where they placed 3 stents. After only a short stay in the ICU, he was sent home on (I believe) 8+ meds. Two days after returning home, he returned to the ICU for swelling. The last I heard from him, they just needed to "tweak" his meds. However, upon further analysis, the Doctors intervened with yet another operation. During this, he threw a clot. The end result was death. I am curious, if you know of any studies with identical twins (as his twin is healthy and alive). I am studying in the medical field and would love to read research to gain further understanding and insight on "what happened?" Also, my uncle would like to know about studies, and possibilities for comparing Cardiovascular diagnostics from my dad's medical history to his (Uncle). Any information you can provide me with will be greatly and forever appreciated. In advance, thank you for your time. Take Care!
Seeking insight, Colorado Springs, Colorado, USA, USA, April 7, 2011

• I had a heart attack at 3:00am this morning. Wow that was scary. I had some minor tightness in my chest all week and didn't really know what to think of it. Then at 3:00am I awoke to the sound of the rain outside my window. I got up to put away a few things that the kids left out in the rain and I broke into a very heavy cold sweat and started gasping for air. I felt some tightness in my chest and fell to the floor. I Yelled for my wife to call 911 and to get me the aspirin bottle. I took three aspirin and waited on the floor for the ambulance. Fire trucks and ambo [ambulance] showed up and gave me oxygen and nitroglycerin and put me in the back of the ambo. In about ten minutes I was at the hospital. They did some tests and gave me some more meds. Then I was in the cath lab getting shaved for the procedure. All the while I'm gasping for air. They put in a stent and I have been resting since. I am meeting with the Cardiologist in the morning for more details on what happened. Right now I am just happy to be alive.
Flyfishtom, Norwalk, Connecticut, USA, April 4, 2011

• Stoppullingmyheartout in Houston -- not clear if you've been treated with angioplasty or stents during this time. As for an aneurysm being inoperable, have your doctors discussed the option of a stent graft?
Angioplasty.Org Staff, Angioplasty.Org, April 1, 2011

• TODAY is the 2 year anniversary of my first MI. I have had 2 in 2 years. The last one was Dec 20, 2010. I then had a cardiac asthma event in Feb 2011.. I am going today for a consult for a defibrillator. Between the 2 MI's, the cardiac asthma, pneumonia, and EF of 202, I think it is time. If all of this was not enough, I have a rather large aneurysm which I have been told they cannot operate on, so I run around every day wondering if this could be the day?
Stoppullingmyheartout, Houston, Texas, USA, April 1, 2011

• Deadpresident (what kind of screen name is that anyway!!??) from Massapequa -- your post is a testament to all readers that they need to stop smoking. Smoking is a big risk factor for people who have coronary artery disease. It sounds like your cardiologist saw something that clearly indicated a blockage and that he didn't need to do the stress test. By the way, was that a nuclear stress test? In any case, he's scheduled you for an angiogram, most likely. No way to know if an angioplasty (or stent) will be needed until he sees the angiogram. Sometimes, however, a stent is put in during the same session to save you having to come back another time. It adds about 15 minutes to the diagnostic procedure. But we would strongly suggest talking to your cardiologist in advance so that you understand what the options are if they do find blockages. Read our article on Angioplasty 101.
Angioplasty.Org Staff, Angioplasty.Org, March 22, 2011

• My cardiologist called me today to cancel my stress test. I took an echo two weeks ago. Now he wants me to go for an angioplasty because he states something in the echo did not look good. I am a little overweight; smoked heavy for most of my adult life until four months ago (I'm 54 years old). Does this sound like prudent advice and just being cautionary or am i about to bite the bullet. Thanks. PS: my dad died when he was 43 of massive heart attack. He was in decent shape but smoked cigs regularly.
Deadpresident, CSEA Nassau Local 830, Massapequa, New York, USA, March 21, 2011

• Further to my post on 15th. January 2011 and Dear Editor's valuable suggestion & comments of 4th February 2011, it is for all to note that Mr. Editor was correct in saying that COURAGE TRIAL's things are not applicable to me since my RCA was dominant and block was 95% at proximal and 80% at PLV. I got the angiogram on January 10th., but as the days passed by, I was experiencing chest pain and discomfort. My echo started to show bad result (EF became 50% instead of 63% within a month. Mild MR was detected in LV valve). I did not take further risk and ultimately got stents on 8th of March 2011. One of the Stent is of Abbott (DES) and another one of Vascular Concepts (BMS)of India. I got the procedure done at B M Birla Heart Research Institute at Kolkata under Dr. Dhiman Kahali. No problem till this time. Driving car as well. Taking Prasita and ecospirin along with other medicines.
Subhasis, Kolkata, India, March 13, 2011

• Angelwings -- Not sure where you saw the figure you quote, that "38% of women who have had a heart attack die within a year", but a study published just last month in The American Journal of Medicine quoted one-year survival at 92% for STEMI (ST segment elevated myocardial infarction) and 81% for NSTEMI. This was a survey of over 3,000 patients in the Worcester, MA area, almost 50/50 ratio of men and women. As the authors write, and we agree, the survival rate is extremely dependent on a number of factors, so any average figures, like these, can only show trends. Given that you have stopped smoking and are otherwise in good health, there's no reason to be fixating on getting a second heart attack. Meeting with a mental health counselor is an excellent idea. Patients with heart disease need all the emotional support and clarity they can find -- coming to grips with the event, and processing it in order to move on forward is every bit as important as any medical device or procedure. We'd love to hear from more patients on these subjects -- they are very important to all!
Angioplasty.Org Staff, Angioplasty.Org, March 8, 2011

• I really appreciate everyone sharing their stories. As I posted earlier, I had a heart attack 12/30/10 and ended up with drug eluting stent in my LAD. I am still very anxious and nervous and emotional. I met with mental health nurse after cardiac rehab yesterday and she said all this is normal. I still have pain in my jaws sometimes and it scares me to death. I do not want to run to the ER every time I have some pain. What are the chances of it being another heart attack? I have also read that 38% of women who have heart attacks die within a year. How true is this figure now? I am not sure how old the article was that I read. My main concern right now is these pains and how to deal with all the anxiety. Any ideas, suggestions are most welcome. Thank you
angelwings, Lawrence, Kansas, USA, March 8, 2011

• heart attack Dec. 2009 with 4 stents. Since that actual time experienced intermittent jaw pain, burning cheeks and lips (for one year) Cardio Dr. feels it is nerve related and see neurologist. Neurologist found no actual cause after x-ray of mandible. Any suggestions re cause? thank you. please reply to E.B.
EB, New York, USA, March 3, 2011

• Thank you for your reply. My cardiologist was the cardiologist on call the day of the stress test/heart attack and he was very upset that nobody had contacted him, let alone told him I was even in the stress lab. He said it would be several months before we knew how much damage and how much was permanent. I think he did say that most of the damage they know about is in the bottom of the heart. I am just concerned for others. Had I not known to chew 4 baby aspirin, and had I lived further away from the hospital, the outcome could have been so much worse. Just trying to make sense of all of this and deal with all these emotions I am experiencing. I just think had something been done when they say the irregularities on the EKG, maybe I would not have had the heart attack. I don't know...just looking for some answers. I am sure I am not the only person "scared" about what lies ahead after a heart attack like mine. Just looking for help. Love this forum because I read about others like me. Thank you!
angelwings, Lawrence, Kansas, USA, February 22, 2011

• Have you discussed this incident with your cardiologist? If you heart attack was "full-blown" an hour after the stress test, then one might think that irregularities in your EKG were probably signaling something, but it's impossible to say much long distance and without all the data. Curious -- did a cardiologist look at your EKG during the test? From your earlier post, it seems that you were revascularized (opened up) within an hour after arriving at the hospital, so any damage to your heart should have been minimized -- has your doctor discussed anything about that?
Angioplasty.Org Staff, Angioplasty.Org, February 22, 2011

• I have a question regarding the stress test prior to my MI. I was having a thallium stress test and after the actual stress part of the test, the EKG had the nurse really concerned and she kept commenting on it. However they still sent me home without asking anyone to look at what they were seeing. I was back in ER within an hour with a full blown MI of the LAD needing a stent. Now, I know I would have needed a stent anyway, but if they had called someone to look at what they were seeing, it is possible that they could have done something to prevent the MI and damage to my heart by going in and opening the artery and placing the stent prior to the actual heart attack? I just feel like something was missed and there needs to be some kind of process in place that may help the next person.
Angelwings, Lawrence, Kansas, USA, February 22, 2011

• Retired Nana and Angelwings -- sometimes angina is not entirely relieved by revascularization (re-opening of the artery which may be done by surgery, angioplasty/stenting or clot-busting medications. You should discuss this residual pain, sometimes called refractory angina, with your cardiologist. A variety of treatments may help: stress reduction, exercise or anti-anginal medications, such as Renaxa, for example. Sometimes it just takes time. Additionally, women experience these symptoms differently -- and there is some research being done now into the microvasculature of the female circulation -- i.e. the very small arteries branching off. These are far too small for stenting or surgery, but may be causing pain nevertheless. No damage to the heart is a very good result. Stopping smoking will do wonders in many ways. Light-headedness m ight even be due to all the new meds you are taking -- and if this continues, discuss a possible adjustment your drug regimen with your cardiologist. Reducing the risk factors under your control, averting damage from the acute event of the MI, and staying with optimal medical therapy will do much to prevent this from occurring in the future. And because of angioplasty and modern medications, the prognosis for heart attack patients has radically changed: 30 years ago one out of four patients who arrived at a hospital in the midst of a heart attack died; today almost 99 out of 100 survive!
Angioplasty.Org Staff, Angioplasty.Org, February 19, 2011

• I am a 52yr old female. Smoker for several years until day of MI on 12/30/10. 100% blockage in LAD. Was in and out of cath lab within 1 hr of arriving at ER. One DES placed in LAD and was told other arteries look good. Have had lightheadedness and pain in lower legs in past week. I am currently on Effient, aspirin, coreg, metformin, lipitor, and hydrochlorot daily. What are the odds of having another MI? I presented with severe lower jaw pain and at times since stenting, I feel tinges on pain in jaw (not really lower) and it goes away quickly. Don't want to be panic stricken all the time, but scared still about what to expect. Looking for some support and answers.
angelwings, Lawrence, Kansas, USA, February 19, 2011

• 55year old female. Heart attack almost 2 years ago. Tests found a blood clot at a junction of a small artery on the front of the heart. During heart attack, EKG, blood pressure, O2 level were normal, blood works showed enzymes elevated. Only symptom was severe chest pain. I now take Plavix, baby aspirin, blood pressure pill and a cholesterol pill. Problem is, I still get angina like I did prior to the "big" event. Dr. say, clot was not in a spot they could fix and I was lucky there was no damage to my heart. I take nitro when I get these pains and always after 2nd nitro pain stops. All tests they give me are still normal. What else can be done?I retired from my job and the pains reduced in frequency but not gone. The pains come later in the day when I am resting. I am active and still 40 lbs over weight. I do have sleep apnea. Been using bi-pap and O2 for several year. Last sleep study was done 1 year ago. I just wonder if there is something else I need to do. Thank you.
Retired Nana 55, Canon City, Colorado, USA, February 18, 2011

• XYZ in India -- Obviously getting a total blockage at age 25 is a relatively rare occurrence and would indicate that your son has some specific needs that should be addressed by his cardiologist. What patients can do for themselves is lowering all their risk factors as much as possible through diet, exercise, stopping smoking if they do, stress reduction, etc. But modern medications are a significant help. We suggest that he see his cardiologist for specific recommendations and set up a rehabilitation plan. Let us know how he fares.
Angioplasty.Org Staff, Angioplasty.Org, February 10, 2011

• my son aged 25 got heart attack, one XR-pronova (SES) 3x18 mm stent was installed since 100% blockage in proximal LAD. post angioplasty tests show homocysteine 38.22 umol/l total cholo 147.10 hdl 36.4 TC'HDL ratio 4.04 c reactive protein > 1.09 mg/dl. He has been advised to take 2 medicines PRAX-10 and Disprin 325 permanently.Pl advise what should be his routine? what should he do so that such a situation do not recur.
xyz, Chandigarh, India, February 10, 2011

• Subhasis in Kolkata -- chest pain with a 95% blockage is usually grounds for a stent -- in the COURAGE trial, published in 2007, stents plus medical therapy had no better results than medical therapy alone. However, these were not patients with a 95%, 80% and other disease who were experiencing unstable angina (not sure if that's what yours was classified as). Stopping smoking definitely an important step forward no matter which way you go. If you're not sure, maybe get another opinion. Were the doctors who suggested medicines and exercise cardiologists? For more information, read our article, "Answers to Top Ten Questions About Stents and Angioplasty vs. Drug Therapy".
Angioplasty.Org Staff, Angioplasty.Org, February 4, 2011

• I am 52 years male with good health and normal ECG, Echo and Sugar, Lipid level is also ok. I was a heavy smoker before 7 days. Following a chest pain 7 days ago, Angiogram done, with 95% blockage in RCA (proximal area), 80% PLV and 40% LAD. Interventional Cardiologist suggested PTCA with 2 stents for RCA & PLV. But other docs. suggested to go for medicines and exercise without smoking. Cannot understand what to do! I am in India near Kolkata.
Subhasis, West Bengal, Kolkata- Durgapur, India, January 15, 2011

• I had angioplasty 18 years ago after a massive heart attack, often referred to as the widow maker. nothing but a baby aspirin and statin since, i watch the diet, exercise and completed a marathon several years after my recovery. We are now saving lives with our stories in Heart to Heart. please cut and paste the link brucejohnsonhearttoheart.com
life after angioplasty, Washington, DC, USA, December 9, 2010

• Hi, My dad had an heart attack a week ago,his condition says 80% blockage in right artery and 75% blockage in left artery. Dr suggested for stent or by-pass (open heart). Now we are not able to make up our mind which is better in terms of long life. Could you please suggest and tell the pros and cons of both. Thanks
Aditi, Delhi, India, October 12, 2010

• BJ in Colorado -- the guidelines for "door-to-balloon time" are for revascularization (opening up the culprit artery) within 90 minutes of presentation at the hospital. Why the delay in your husband's diagnosis or treatment occurred we cannot say. Hospitals that perform emergency angioplasty to stop heart attacks normally have protocols that include things like the cardiologists on call must live within a short commute to the hospital (e.g. 15 min) and that all systems in the hospital are in place to deliver these therapies quickly and successfully. The American College of Cardiology and other organizations have been very active in promoting these guidelines and have achieved good results. Unfortunately not all hospitals are so equipped.
Angioplasty.Org Staff, Angioplasty.Org, October 10, 2010

• husband had angina at 4:30pm,sept 16, first clinic not equipped for total heart care. airlifted to another hospital,arrived there about 8pm. blood test showed troponin level at 5.1 at about midnight, increased to9.1 at 3:30 am,topped off at 15.8 by 6:55am sept17. cath and angioplasty not performed until 11am on the 17th. ekg was done on arrival but we understand that he could have had an MI early on the 17th, was the cath and angioplasty done too many hours after the troponin levels remained high? Also, IV nitro was given around 5pm with the onset of chest pain on the16th at the first clinic and given continuously through early in the morning the next day,was this too long? My concern is, should he have had a MI in the hospital, with the troponin levels consistently high, or could this have been prevented with much earlier intervention at the second hospital? Cardiologist was on call, but as far as I know never showed up, no doctor talked to us until 11am the next day, right before the angioplasty, when a DES stent was inserted. please respond
BJ , Fort Collins, Colorado, USA, October 5, 2010

• Bharath -- it's impossible to answer this question long-distance and without access to her medical information. We're most sorry for your loss. Stroke can be of two types: hemorrhagic, where the blood vessel bursts, and more commonly, ischemic stroke, where a blood vessel to the brain gets blocked. The ischemic stroke is like a "heart attack" of the brain and is caused by the same disease process: atherosclerosis. A CT of the brain can tell the difference between these two -- very important because the treatments are the opposite: for example, giving drugs to dissolve the blockage or clot will make a hemorrhagic stroke worse.
Angioplasty.Org Staff, Angioplasty.Org, September 30, 2010

• My Mother aged 81 years was admitted to hospital due to a fall in the bathroom after an attack. she is undergoing treatment for unstable angina since 2 years. There was no external injury. In order to rule out stroke I questioned her and she responded in a feeble voice. She was obeying my commands and also shook my hands which I asked her to do. She had difficulty in swallowing and was vomiting too. She could not stand without support. Unfortunately in spite of the heart attack symptoms she was treated for Stroke. The CT scan of the brain was negative. Moreover due to aspiration she was inserted with a NG tube to flush out the liquid and food particles. All of a sudden the same day night she collapsed and never recovered. I feel that the proper treatment was not given for heart attack and the Doctors were of the opinion it was stroke. Please let me know the exact cause for her death. Is it due to heart attack or stroke or due to aspiration Pneumonia. To my knowledge she was not given the treatment for Heart attack. Her death report says CAD and Hypertension and stroke was not mentioned. Please let me know whether due to her age she could not withstand this attack.
Bharath, Mannar and Co. , Chennai, Tamil Nadu, India, September 27, 2010

• Shivalika from Punjab -- Stenting and angioplasty are used to stop heart attacks from progressing (or starting) in acute cases like your dad's. Before this procedure, an acute coronary syndrome could easily an quickly progress to a full-blown heart attack in which the heart muscle is damaged by lack of oxygen. Sounds like your dad's was caught in time and before any muscle damage occurred. This solved the immediate problem -- the long term problem is a chronic one: coronary artery disease. while there's nothing we can do about inherited risk factors for this disease, it is possible to reduce many risk factors for a recurrence through diet, exercise, smoking cessation, and modern medications to control blood pressure, cholesterol, etc. Your dad's cardiologist should be able to work with him to help achieve these goals and live a healthy life going forward.
Angioplasty.Org Staff, Angioplasty.Org, September 10, 2010

• recently ma dad chest pain and was diagnosed with acute coronary syndrome with 99% blockage and stenting is done. but ma mum is very worried for him and me too. can ny1 tell me the prognosis of stenting. and what all precautions should be taken. I'm very much stressed plzzzzzzzzzzz help!!!!!!!!!!
shivalika, pathankot, punjab, India, September 1, 2010

• Amini from Iran -- Your clinical situation is a complex one and the decision as to whether to do stents (PCI) or CABG will probably depend on the cardiologist or surgeon you ask. One question might be answered by whether or not the blockages in your LCX and RCA are causing functional problems. Yes, one can SEE the blockage on an angiogram, but is your heart getting reduced blood flow/oxygen or not? This can partially be answered via a nuclear stress test, or during the cath itself, using FFR (Fractional Flow Reserve) to measure directly the flow. As for costs, you can look over our topic on "Costs of Stent and Angioplasty", although these vary widely.
Angioplasty.Org Staff, Angioplasty.Org, July 17, 2010

• I am 49 yr old male, in excellent health (no diabetic, no high cholesterol, no hypertension, etc) had a heart attack 10 years back, LAD TOTAL OCCLUSION AT OSTIUM, LCX stenosis 60-70 percent at three location a small area of dyskinetic at apex, failed to reopen LAD put three stent in Lcx at same time ( medication ASPIRIN, LIPITOR 10 mg/day). 10 years after 1st MI did angiography week back because of chest pain ,all three stents were patent with an excellent retrograde filling from RCA and antegrade filling to LAD, in new angio More than 70percent blockage of LCX at trifurcation ares 60 percent block in distal segment of RCA were reported. RCA is dominant no symptom.my father had MI at age 50 with same trend of blockage and did BY PASS AT 64 and now he is 80 healthy and active without any symptoms .my cardiologist Cannot decide confidentially because of location of LCX stenosis and says chances of restenosis is about 20 to 30 percent so prefer CABG but my preference is PTCA. After 1st attack MY EF was 45 and remained same till today . at present no cardiac medication .considering my problem could anybody give the second opinion and how much is the average cost for Two stent angioplasty in usa.
Amini, Iran, July 15, 2010

• I was told that I had a slight heart attack because of 90% blockage in Rt. Coronary artery. A stent was put two months ago. I am having moderate to severe burning sensation in both legs below knee and feet. I am only getting 4-5 hours of sleep per night. help!! I told the Heart DR., but he showed little interest.
EKC, Central Louisiana, USA, July 9, 2010

• Stenting increases blood flow. However, heart muscle that has been damaged from an infarction (heart attack) may or may not be able to function correctly, no matter how much blood flow it gets. Ask your cardiologist about this and what your ejection fraction (EF) is. Also note that some posters in our topic "Not Feeling Well After Stenting" report a period of discomfort for a month or more that in time does go away as the body adjusts.
Angioplasty.Org Staff, Angioplasty.Org, July 8, 2010

• how long does it take for ischemia weakened heart muscles to revive after stenting? I have a stent in for six weeks and feel intermittent 20 to 30 minute discomfort in heart area, no pain, ea with light headedness and need for deep breaths. I thought the increased blood flow after a stent would stop this.
oldie, Villa Nueva, Guatemala, July 2, 2010

• Stephen79 -- your cardiologist, the physician who best would know you and your clinical condition, is really the person to ask this question of. There are many variables at play here. Obviously you need to do whatever you can to reduce risk factors (via smoking cessation, diet, compliance with medical therapy, etc.) for the advance of the coronary artery disease that keeps blocking your arteries and causing these MIs, but this is challenging, especially in diabetic populations. Let us know how you are doing and good luck to you.
Angioplasty.Org Staff, Angioplasty.Org, July 2, 2010

• I'm 31 year old male. Type 1 diabetic since age 4. First MI in 2005 with stent placement in LAD. 6 months later 2nd MI with 100% blockage at stent. 2007 3rd MI major with 3 stent placement. At that time I was dismissed as a candidate for bypass surgery due to a minimally viable myocardium. Since then my EF has been 20-25%. I had another minor MI in 2008. How long can a person live with CHF?
Stephen79, Raleigh, North Carolina, USA, June 11, 2010

• Forum Editor - Thanks again for your prompt reply. As per your question about inability to do certain things; I am very active and can do most everything except when it comes to weights and sprinting. Being in track all my younger days and an active athlete it is frustrating. I can walk for 1 hour a day without any difficulty, but when I try running or jogging I can't run more than a few minutes (not sure if it is heart related). Also lifting heavy objects anything over 40 - 50 lbs does get me tired. For reference I am 5-8 and 160 lbs. One thing I would like to add is that I get less tired now than before. In the first year after the MI I got tired very quickly and needed a lot more sleep than I do now.
RD, Dallas, Texas, USA, April 26, 2010

• An ejection fraction of 45% is below normal (normal value is 55-70%) but it's not bad. Do you find yourself unable to do certain things? But having gotten the stent during an active MI probably saved a lot of your heart muscle. (See our recent article on this subject, "Heart Attack and Angioplasty: A Public Education Challenge".) As for your family decision, there's no advice but just to say if everyone suffering from coronary artery disease decided not to have children, we'd be a much smaller nation than we are -- it is still a very widespread disease. It is in fact very important to be aware of the family history, so that you can be extra-vigilent in controlling all your risk factors. Genetic tendency is just that -- a tendency. Environment and lifestyle can go a long way toward negating those tendencies -- or amplifying them.
Angioplasty.Org Staff, Angioplasty.Org, April 26, 2010

• Forum Editor - Thanks for your reply. The original stent put in while i was in active MI. My EJ fraction is 45%, which i am told is not good. As per the cardio there was some damage to the walls and the heart muscle itself. I know if my wife and I plan to have kids, there are greater chances for the kids to have heart disease due to my condition. I would like to know if others have had kids after such an incident? And if my wife and I do plan to have kids will it be the right thing to do since they may be at a greater chance of having heart disease.On a side note, after i changed cardios (cause the first one did not have technology to conduct CTA scans) they found lumps in my chest and luckily I did not have lymphoma cancer, but have granulomatous lymphadenitis, which does give me chest pain, but is unrelated to the heart. Thank you for your reply and looking forward to your advice.
RD, Dallas, Texas, USA, April 26, 2010

• Raja -- these questions should be answered by your father's cardiologist, including the correct medicines. For your information, stents have been used very successfully in all ages, including very elderly 80 and 90-year-olds. And RD -- was there damage to your heart from the heart attack -- or was the original stent put in during the heart attack, and kept the heart muscle from dying?
Angioplasty.Org Staff, Angioplasty.Org, April 9, 2010

• Should I have kids after a MI? I am 32 now and at age 30 had a MI with 100% blockage in my LAD. I have had to go back at age 31 (within 6 months of my first stent) to get a drug-stent put in. Have had history of high BP. I am healthy, with normal body-weight and exercise regularly. Wife and I are thinking about starting a family. Want to know if anyone has had children after an MI. Any doctor's advice you've consulted with would be great as well.
RD, Dallas, Texas, USA, April 7, 2010

• Just few days back my father got a heart attack. doctor suggested two stents needed for his heart. now he is 65years old is it correct age and one more thing is his heart is supports with that stent can any one suggest the right medicine and his heart is supports or not
Raja S., kbg, India, April 7, 2010

• Rosammajohn -- sounds like your brother didn't have a heart attack (the topic here) but is suffering from congestive heart failure (CHF) -- what happens when a damaged heart is not functioning -- as you report, it is working only 15-20% normal on a ventilator, which is pretty low. This is a complex situation and you should ask your doctors about your brother's prognosis
Angioplasty.Org Staff, Angioplasty.Org, January 22, 2010

• My brother had a heart failure. he is in ICU and in ventilator. The time he was admitted his blood pressure is 100/60. his heart beat is 120.There is fluids in his lungs and was very difficult to breathe. Pumping of the heart is only 25%. After 2 days in ventilator, his pressure is normal, heart beat is normal, but pumping of the heart is only 15 to 20% with ventilator. doctor says it is critical. what is the risk?
Rosammajohn, Kerala, India, January 21, 2010

• My 77 yr. old mom has always been very active and healthy with her only daily medication being a multi-vitamin. On Tues. of last week, she had a massive heart attack with 99% blockage of right coronary artery. She had three stents placed in the artery. Had bleeding from blood thinners, 4 units of whole blood, 3 of plasma, has developed pneumonia. Her vitals have been good, but she is experiencing a lot of anxiety. Was moved into room today from ICU but is so weak and still complains she can't breathe. She has sat in chair a few times but it is almost a week later and I'm concerned she can't walk yet. Will this get better and when. They are talking about dismissing later this week from the hospital and I don't feel she is in anyway ready. Has anyone experienced a parent that panics and has trouble breathing from this? Is this normal?
Deb, Healdton, Oklahoma, USA, January 4, 2010

• Aileen -- much depends on the clinical status of your father's heart -- was there damage done during the heart attack. Angioplasty and stenting is best done as soon as possible once symptoms of an infarction occur. There is debate about the value of stenting that long afterwards -- but much depends on whether those blockages are blood flow-limiting and whether they pose a risk to another heart attack.
Angioplasty.Org Staff, Angioplasty.Org, November 28, 2009

• Hi, My Father has a heart attack 5 days ago. He had an angiogram 4 days ago and two blockages were identified. They think one of the blockages can be treated by putting in a stent but the other is too close to the heart so may need to be treated with drugs. From any reading I have done it does not seem advisable to treat a blocked artery using a stent this long after the attack? Is it normal to do one anyway and is it not better to try and treat both blockages with drugs or a bypass? Any advice much appreciated.
Aileen M., Budapest, Hungary, November 23, 2009

• On May 18 I had a serious heart attack at that time I had two stents placed in my right coronary artery. Prior to leaving the hospital the operating physician, not my normal cardiologist, scheduled me to have a nuclear stress test in order to determine the amount of damage if any done to the heart muscle. That was to have been done on the 24th of June, on the 18th of June my cardiologist's office called to notify me that the nuclear stress test was not necessary. They wanted to do a regular stress test and get me into cardiac rehabilitation. I was wondering if someone would be able to share with me the tests that they had after having a heart attack. Your insight and information is greatly appreciated.
Fay, New York, USA, June 20, 2009

• My age is 38, male. . I was admitted in the hospital on 1st january last year.Medication started from 1st jan to 18th jan.I have been underwent angiogram on 14th jan and two stents were plased on 18th January. My present condition is moderate lv dysfunction with BP 90/60 and 40% ejection fraction. I fere some damage took place to the heart. Now I am walking, doing all works without any difficulty, with occational mild burning pain for little time. Is there any medication/procedure to get back good BP and good ejection fraction.
Narendar, Osmania University, Hyderabad, India, March 16, 2009

• Mr. Singh -- very sorry for your loss. Your father's case sounds very complex and there's not much anyone without specific knowledge can say, except for some general facts about heart attack treatment with angioplasty. It is the "gold standard" -- emergency angioplasty, opening up the culprit artery during the heart attack, can actually stop the attack and save the heart muscle. Your father had angioplasty after the attack (MI) was completed. The internal bleeding can be caused by a number of things, but it is a complication of interventional and surgical procedures and definitely is associated with increased mortality. There has been much debate about whether opening an occluded artery well after the actual heart attack is beneficial -- the OAT trial in the States showed it was not.
Angioplasty.Org Staff, Angioplasty.Org, February 5, 2009

• My father,67,one night ,with no history of any heart ailment or complaint till that time, had an attack was revived with an electrical shock and after 2 hrs. again had same attack and was revived. In the morning angiography was done and angioplasty procedure was performed the next day morning and one stent was put. after 3 hrs. of the procedure he had another attack and was revived with the shock again. After 3-4 hrs ,he was put on ventilator and the doctors said he is bleeding internally and started the blood transfusions and gave him about 21 units . then they started giving blood plasma transfusions and in total they gave about 32 units of blood plasma over the next two three days. The we were told after another day that he has developed ARDS and the next two days we were told he is having septicemia ( very bad lungs ) the fight ended after 19 days with Multiple organ failure and ultimately he passed away.We wonder still ! Was angioplasty really required ? Was there anything wrong done during angioplasty procedure ? Shouldn't the stent be put at the time of angiography only ? shouldn't he be kept under observation for some time after the attacks before the angiography ? Could he have some how survived ? Please help in understanding this,please...!
N P Singh, New Delhi, India, January 25, 2009

• In 2007 my husband (64 years old) had one coronary artery drug-eluting stent placed. The procedure went fine. He was 70 % blocked before stent, completely clear after stent. He spent the night in the hospital, came home at 7:00 a.m. and at 2:30 in the afternoon developed massive chest pain, nausea, tightness,fullness, etc. We took him to the emergency room of the hospital where the procedure had been performed (It was only 4 miles away). He was at the triage window within 10 minutes of the beginning of the chest pain. They triaged him within 3-4 minutes, gave him a level "2" rating and put him in a patient room. There he stayed for a little over 3 hours with no pain medicine for the first hour and a half. BP 224/109; sweating profusely; horrible pain, in chest, up neck, and down left arm. The ER physician refused to call a cardiologist when I requested one. I reminded him of the time window for various treatments to reduce heart damage. He told me that it might not be a heart patient. He said only time and tests would tell. The 3rd EKG came back ACUTE MYOCARDIAL INFARCTION. Still he did not send him to the cath lab. I had left a message on my husband's cardiologist's phone (it was his day off)and when he happened to check it, he came right to the hospital - 3 hours after Bob's admission. In 3 minutes Bob was headed for the cath lab. I feel the ER physician made a terrible mistake and my husband has to pay for it with a severely damaged heart which will greatly decrease his quality of life and decrease his remaining years of life. I am in Florida and there's not much you can do if your ER physician makes a mistake.
Kathleen, Florida, USA, October 5, 2008

• LB Ohio, your husband may have pain in the scar area for months. As long as the Drs rule out infection, it takes up to a good year to feel 99% better. If he's lucky, sooner. I had same surgery and the scar area and my entire chest hurt for many months after. I don't know if it has to do with diabetes (as I am diabetic also) or if this is the norm but hang in there.
Kathy F., New Jersey, USA, January 30, 2008

• my husband david 43, had a quadruple bypass on jan.4th of this year. on jan.2nd was his heart attack. he was on the vent for 2wks. a diabetic since and now a non-smoker. its the 28th and for the past couple of days david has been suffering spasms in his chest around the scar. at times bad ones! his drs. dont know why. everything else ok. has anyone else know of this?
LB., Ohio, USA, January 28, 2008

• Steve -- Tenormin (a beta-blocker) and Lisinopril (an ACE inhibitor) can possibly cause light-headedness and it's possible that an adjustment to dose may be indicated. While dosage is usually done by clinical assessment and body weight, some individuals are more sensitive to meds than others. If these symptoms persist and are potentially limiting your functioning (you don't want to get an attack of light-headedness on the highway) definitely put in a call to your cardiologist and describe your symptoms. Couldn't hurt. But don't stop or reduce your meds without talking to him/her first.
Angioplasty.Org Staff, Angioplasty.Org, November 23, 2007

• Thank you for your reply. it's been 3 days since the procedure and sometimes I feel little light headed. I noticed on the medication plavix, tenormin could cause this as well as I am taking lisinopril for bp, and addition of tenormin could be lower my bp too much? my follow visit is still 10 days away, should I be concerned or is my body getting used to the medication?
Steve, Woodside, California, USA, November 23, 2007

• Steve -- you're correct. The LAD (Left Anterior Descending) artery IS one of the main vessels. As for your fears about correct placement of the stent -- you must have been reading some of our articles about intravascular ultrasound (IVUS) -- and why some cardiologists urge its more widespread use. The good news is that these concerns and this message has been getting out to the cardiology community and physicians have been more aware of this. There's no reason to think that your stent was NOT placed correctly -- especially dramatically opening up a 99% blockage. Also, the message is less that the stent has not been placed correctly, but that it needs to be fully expanded.

If you have concerns, certainly ask your interventional cardiologist. You are in an area where there are many excellent facilities and cardiologists. (In fact, IVUS was developed not very far from Woodside.) There's no non-invasive test accurate enough to test the precise expansion.
Angioplasty.Org Staff, Angioplasty.Org, November 23, 2007

• I am 42 yr old male, in excellent health, but was found to have had a heart attack, I just received (Nov 21st) one DES due to 99% blockage in my "LAD" I believe it is one of my main vessel, I understand all my other vessels are in great condition. Although, the before and after image they showed me after inserting DES is dramatic, I am concerned, after reading the articles on the site about misplacement of DES, I do have a follow up visit with my cardiologist soon, is there a test they can do to confirm the correct insertion of the DES?
Steve, Woodside, California, USA, November 22, 2007

• Hi, my Dad had 2 stents put in his main Coronary Artery it was 99% blocked. He had a major heart attack and thanks to my mother she took him to the ER fast. They told him he is very lucky to be alive anyway, he had this done 8 months ago and is doing great! The technology today is awesome thanks to this I still have my Dad in my life.
C., Illinois, USA, September 3, 2007

• Rick -- family history is certainly a risk factor. The fact that you have had negative nuclear stress tests is good, showing low probability for coronary artery disease. What does your cardiologist say about the near-fainting episodes? Has he run a test that would show potential valvular problems, for example, a stress echo (not sure what you mean by a sonogram)?
Angioplasty.Org Staff, Angioplasty.Org, July 8, 2007

• My two younger brothers, ages 49 and 51 respectively have had heart attacks, the younger one just a few days ago. After the older one had his which he survived with 5 stents to deal with his 95+ blockage, I had a nuclear stress as well as a sonogram, both of which were negative conducted by my cardiologist. Now the younger one, a former world record holder in distance events just suffered his heart attack a few days ago and also survived. He would appear to be in excellent shape with daily workouts and not a likely candidate compared to me, his oldest and much heavier brother, age 53 but also a former runner. I have had no chest pain but a two instances of almost passing out that weren't fully explained along with several of lightheadedness and just not feeling right that have lasted from several hours to a day or two during the last year. Should I seriously be thinking about a angioplasty?
Rick, Tehahchapi, California, USA, July 3, 2007

• MMD - I am very sorry to hear about the way that your husband was treated. My experience was almost exactly the opposite as that of your husband. I experienced an MI in February. As soon as I arrived at the ER, I given an EKG and 15 to 20 minutes later was in the cath lab where a balloon angioplasty was performed and three drug-eluting Taxus stents were placed my LAD. As the result of the prompt treatment, and possibly because I had a system of collaterals as the result of frequent exercise prior to the MI, damage to my heart muscle was minimal. Six weeks after the MI I had an echocardiogram which indicated an ejection fraction of 65%. I would also add that as the result of both luck and knowledge, I happened to have selected hospital that has an interventional cardiologist either physically present at the hospital 24/7 (as was the case when I arrived) or who is on call and could be at the hospital within 15 minutes.
Larry T., Virginia, USA, May 24, 2007

• MMD -- one of the challenges with emergency treatment of heart attack is for hospitals that can perform angioplasty to have a system in place to get the patient diagnosed and on the cath lab table within 90 minutes to two hours. In this way, the infarct can be stopped and damage to the heart muscle minimized. It is one of the undisputed benefits of angioplasty. Sounds like the diagnosis took place later in your husband's case. An important measure would be how well your husband's heart is pumping -- sometimes called an ejection fraction.
Angioplasty.Org Staff, Angioplasty.Org, May 22, 2007

• Recently my husband had his 5th heart attack and this is the 6th stent. He is only 41 years old, thanks to good old genetics. The majority of the stents was boston scientific the latest on was Cypher. He had his MI on Friday 1am, he was not cath till Monday am. His cardiac enzymes increased on Friday was never diagnosed until Monday. This is totally out of character of what we are used to. His last cath was done by military med, within one hour he was being cathed. It appears that that Friday the cardiologist had a Saturday family commitment and the hospital was going to release my husband to come home that Saturday. I refused to bring him home. We have an appt with a new cardiologist...Does anyone else have any ideas we can look into.
MMD, Ohio, USA, May 22, 2007

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