Chest Pain after having Stent


Chest pain following successful balloon angioplasty or stent is a common problem. Although the development of chest pain after coronary interventions may be not a problem, it is disturbing to patients, relatives and hospital staff.

Possible Causes of Pain:

  • acute coronary artery closure,
  • coronary artery spasm
  • heart attack,
  •  local coronary artery trauma

The distinction between these causes of chest pain is crucial in selecting optimal care.  Early intervention can limit the damage. Management of these patients may involve repeat hospitalization for  coronary angiography and/or additional intervention.

Commonly, repeat coronary angiography following Angioplasty (PTCA) in patients with chest pain demonstrates  lesion to be widely patent/open  suggesting that the pain was due to

  1. coronary artery spasm,
  2. coronary arterial wall stretching
  3.  non-cardiac 

 Coronary arterial wall stretching is common and occurs significantly more often after stent implantation than after PTCA or coronary angiography alone. This may be a result of the overdilation and stretching of the artery caused by the stent implantation and the consecutively high degree of stretching and the elastic recoil is minimized. Kind of like a deflated balloon, the artery doesn’t go back to original circumference.

sciencedirect.com

After getting out of the hospital every little ache and pain makes you think  “Is my heart giving me problems?” It is really difficult not to panic.

Here are some tips that should be of help you to know when to seek emergency care:

  •  Is the discomfort you are feeling the same  or similar to the discomfort that brought you to the hospital? If so, this could be a problem. It is more likely to be a problem if it is similar…don’t wait until it is bad to seek treatment. Time is muscle and we don’t want  you to lose any muscle.
  •  Does the discomfort also have other symptoms that pair up with it? These symptoms might include shortness of breath, profuse sweating, nausea, radiating discomfort into neck, jaw, arms or back.  If there are multiple symptoms you should call 911.
  •  Can you reproduce the pain or discomfort with touch or movement of body. It is less likely to be a heart symptom if you can make it hurt through touch. This is usually muscle or skeletal origin or what is referred to as non cardiac chest pain.
  •  The 4 E test…does the discomfort come on with Emotional stress,  Exercise, after Eating, or with a cold Environment? If so these are common triggers of heart symptoms. If you rest and they go away it probably isn’t emergent but you should notify your doctor as soon as possible. Keep a log of the frequency of these symptoms..when they come on, how frequently, what were you doing when they occurred, how intense was it, and what made them go away.
  • Unstable Angina….this is angina or heart pains that are coming on more frequent, occurs at rest or wakes you from sleep, or you need more nitro than usual to relieve discomfort.                                                                                                                                                                                       

If your symptoms are that of unstable angina you contact your doctor  – call 911

If you suspect you are having a heart attack chew up an adult strength aspirin and call 911.

Do not drive yourself to the emergency room. The ambulance crew is your first line of medical treatment, they will provide you with emergency medications, alert the hospital to your condition so they can manage your care quickly and efficiently. Time is muscle don’t waste any time.

Chew the aspirin even if you take an aspirin a day as regular medicine. The extra one helps more than it hurts. Only chew one not a handful that could causes more problems.

Antiplatelet effect of chewed, swallowed, and dissolved aspirinChewing aspirin hastens its antiplatelet effect, as measured by the reduction in blood thromboxane B2 levels. It took only 5 minutes for patients who chewed aspirin to achieve a 50% reduction in baseline levels, versus almost 8 minutes after they took it in a solution and 12 minutes after they swallowed it whole.Source: American Journal of Cardiology Vol. 84, p. 404.

May 2005 Update

It is best not to lie down. Try to stay calm, do some relaxation deep breathing – think belly breathes – make belly go out when you breath in. Avoid short shallow chest breathing. Focus on staying calm. If you think you are going to pass out try coughing or bearing down like you are having a bowel movement.

If you have Nitroglycerin tablets or spray that were prescribed by your doctor use them.  I can’t tell you how many people forget about their nitro when they need it the most. Place one under your tongue, do not chew it. It should make you have a headache, or cause a flushing feeling, or tingle under your tongue. These are indications that your nitro is fresh. If you suspect your nitro is old (over one year if bottle unopened, or greater than 6 months since bottle was opened) find a fresh bottle. Nitro is a very volatile compound and breaks down rapidly if in contact with air, heat, light, or plastic.

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57 thoughts on “Chest Pain after having Stent

  1. Pingback: Chest Pain after having Stent | heart diseases an heart conditions | Scoop.it

  2. Pingback: Chest Pain after having Stent | Heart Attack Survivors Blog | Scoop.it

  3. I would like to thank you for the efforts you have put in writing this blog. I am hoping the same high-grade web site post from you in the upcoming as well. Actually your creative writing skills has encouraged me to get my own blog now. Really the blogging is spreading its wings fast. Your write up is a great example of it.

  4. i am a F and 59 years old . have stent for 3 years and have pain in my chest, i really sometimes want to be dead since cannot bare the pain. is there any way to get rid of this pain?

    • You really need to sit down with your healthcare workers to discuss the severity, frequency of your pain, and what relieves it. There are options out there, including external counterpulsation therapy EECP, long term nitrates or other medications to help keep arteries open or reduce spasm, further intervention such as more stents or perhaps surgery. You shouldn’t feel debilitated by this pain to where you don’t want to live further. Put together a good log, what triggers it, how many times a day does it occur, on a 1-10 scale what is the severity. If you can match it to your other vitals, such as blood pressure, weight, heart rate, then track stressors, sleep to see if there are any patterns. Good luck.

    • dear simin,
      my brother ,56 years old had 2 stents placed 2 years ago & has been in pain since then.he has been to 7 or 8 cardiologists,had extensive cardiac testing all of which found nothing wrong.the doctors seem to have no idea what is causing the pain.the pain originally would start at noon. ease towards late evening allowing him to sleep.now the intense pain(chest pain)starts when he awakes & lasts the whole day.it is accompanied by numbness in his left arm & hand.he has also been to neurologists & pain specialists to no avail.he is desperate.he feels his life has been ruined. does this have any similarity to your experience?

      howard

    • I am sorry to hear he is struggling so much. Once a heart condition occurs it isn’t unusual to have issues. Several questions come to mind, is there small vessel disease? Did one of the stents block another artery? Is he taking a long acting nitrate – imdur, or nitrobid? Has he looked into EECP therapy for angina? I would suggest he be persistent and keep working with his medical team to get relief.

    • Simin. I know the feeling and fear. I was in the same boat and actually I am still there. However, a couple of weeks a go I made a clear-minded decsion that I will not respond to the pain – I will respond to me. It changed everything. I still get the stabs but not the panic. Kiss your loved ones, watch a sunset, listen to quiet piano, swim in blue water…. Do whatever it takes to not let pain pull you out of the moment. You are far too precious.

  5. Pingback: Chest Pain after having Stent | Chest pains after stents and short breath | Scoop.it

  6. I am a 51 year old female. I had a MI at 48 y/o with a 99% blocked artery. Subsequently, i had a drug eluting stent put in. Every since that time i have had a recurring pain in my heart. It happens occasionally, about 2-3 times a month. Not sure what makes it start or stop. It usually lasts from 2-3 days. It feels like a grating feeling inside an aretery. Nothing seems to help get rid of the pain. Does anyone else have this problem?

  7. Oh, i forgot to mention, that i have had 2 other stents placed since that time for blockages. I am of normal weight. At the time of my heart attack i was 5’7″ and 135 lbs. No health problems except hypercholesteremia. I have a family hx of heart disease. During the stent placement an artery was damaged and i had to have a triple bypass. I have recovered and am back to work but, miss alot of work due to the same pain as mentioned above. I am a Registered Nurse and have a stressful job but i must work to support myself. The pain is almost disabling at times. Sometimes, i too, don’t know how long i can stand it. Doctors dont believe me since my cardiac stress echo was normal and chest xray was normal. Cardiologist said at first he would find it but, after tests were ran and returned normal i received a letter in the mail stating he did not believe it was cardiac related and that i needed to get a Family Doctor. Okay, so i get a family Doctor and what does he say? Well, i don’t know what it could be. Well, i Do!!!! It’s my heart. I know my body and i know what i feel. I just some help on how to proceed from here other than finding another Cardiologist. (I have been to 2 different Cardiologist so far.)

    • Have you looked into enhanced external counterpulsation therapy? It is known as EECP. It is cuffs – similar to mast pants or bp cuffs that are wrapped around legs, calves, hips they sequentially inflate immediately after the heart contracts. It is a treatment that typically you take for 35 session, one or two session per day. What this does is it increases the smaller collateral arteries which also feed the heart wall, thus the heart wall contracts better. It relieves angina in many patients, but the benefits won’t last if you don’t exercise. Vasomedical.com is a good place to begin with researching this treatment.
      For many women the arteries are too small to see on catheterizations and it is known as microvascular disease. They continue to have angina symptoms even though traditional testing cannot find anything to intervene upon. Thus your medical teams have a tendency to say they can’t do anything and pawn you off to the others.

      You could also research Prinzmetal angina which is treated with nitroglycerine and calcium channel blockers.

    • For 2 1/2 years the doctors kept diagnosing me with acid reflux, which I kept telling them it was more than that. I finally insisted on taking a stress test and collapsed on the treadmill at which time they finally recognized that I had heart problems. I have since had 5 stents put in and am still having the same symptoms. I was first diagnosed at 43 years old. It truly is frustrating that I can now barely walk to my car after work without feeling like I am about to pass out. I am on about every medicine imaginable, but nothing helps!

    • Do some research on EECP therapy. There may be a provider near you. If you are topped out with medical management and medications this may be the answer. I have seen many patients who have similar issues get fantastic relief from this. Check out Vasomedical to watch a video and learn more about it.

  8. I am a 50 year old who had 95% blockage, following a successful angioplasty with a stent placement, I experience chest discomfort after eating. After discussing this with my cardiologist, he believes it may be acid reflu. Anyone else experience similar symtoms?

    • The challenge here is some medications may cause clopidogrel aka. Plavix to not work as well. Examples include certain acid reducers (proton pump inhibitors/PPIs such as omeprazole, esomeprazole), fluvoxamine, fluoxetine, cimetidine, fluconazole, ketoconazole, voriconazole, etravirine, felbamate and ticlopidine, among others. Promptly ask your doctor or pharmacist for more details.

      Do not use non-prescription medications that contain PPIs (such as omeprazole, esomeprazole) or cimetidine for relief of upset stomach or heartburn. These medications can prevent clopidogrel from working well. Ask your doctor or pharmacist about safer alternatives such as liquid antacids, ranitidine, or famotidine.

      This is where I see a future change in medicine. We should be able to analyze a person’s genetic makeup and know what drugs will and won’t work, rather than by trial and error.

  9. I had two stents put in about a year and a half ago (95% LAD blockage) and have been doing well, exercising, etc, since, but occasionally I experience tightness across my chest. It isn’t really pain. More like a low level burning. The symptoms I had when I was admitted with a heart attack were not similar – extreme pain in the shoulders and neck. I saw my doctor yesterday and he said it may just be spasming, but he did schedule a stress test, EKG and sleep test. I asked if it might be stress, and he said more likely spasming. This didn’t happen for nearly a year after the stents, so I’m wondering what is triggering it now, and how concerned I should be. (Family history of heart disease and cholesterol problems).

    • Jim,
      You did the right thing by discussing it with your doctor. I would ask you if the burning sensation follows any particular pattern, such as occurring with activity, lying down, after eating, with emotional stress, cold or very humid environmental conditions. The other thing is what relieves it? Nitrates, rest, antacids? Put this information together and discuss with your physician when you review your stress test results.

      Different locations in the heart may produce different symptoms and heart disease is progressive. It isn’t unusual to have symptoms, you can do everything right through diet and exercise and still have further issues develop, that is what we mean when we talk about heart disease being progressive. Know that you will need further interventions in the future and it is better to identify the issues before you lose any further heart tissue due to a heart attack.Work with your your healthcare team to make sure you have nitro in the event of another blockage and you know when and how to use it, keep it fresh.

      Stress can produce heart symptoms, it would be good to track your symptoms in relationship to your high stress, and evaluate your blood pressures during these episodes. You could consider asking for a referral to your local cardiac rehabilitation department for “stable angina”. Cardiac Rehabilitation does a great job of tracking symptoms, EKG, blood pressure responses of patients.

      Thanks for stopping in and reading the blog and hope you found value in the discussions.

      Beth

    • Thanks so much for your reply, Beth. I don’t have nitro, but my doctor has told me to take 6 Effients if an attack occurs, which I do keep handy. My guess is that this is entirely stress related. I’m a single parent of two teenagers, we’re moving this weekend, and I’m struggling with financial issues with my ex-wife. I sincerely hope it is stress, because this is transitory and will get better. I never experience the pain when exercising, and we go to the gym 4 nights a week. I will look into cardiac rehab and stable angina. My blood pressure yesterday was 126/84, and it’s almost always in that range. I did find it odd that he immediately asked me how I slept and do I snore. He scheduled me for a take home sleep monitor that I’ll pick up in a couple of weeks.
      As for timing of the pain, it almost always occurs when I am sitting (and probably worrying). The only thing that seems to relieve it is passage of time.
      Thanks again:)
      Jim

  10. Hi are using WordPress for your blog platform? I’m new to the blog world but I’m
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    Any help would be really appreciated!

  11. It is somewhat reassuring to know my wife is not the only one dealing with intense chest pain after a heart attack and a stent placement. She has seen 3 cardiologists, had multiple tests done that all come back normal but has been to the ER 3 times since her attack with unmanageable pain. She is on a lot of meds of course but none really help the pain that is occurring all day every day.

    My question is… Has anyone worked with the Mayo Clinic for the same or similar situation? And if so, we’re they any better at diagnosing the true cause of pain and a stopping it.

    Any comments on this would be greatly appreciated.

    Thank you and I hope everyone finds resolution to their issues.

    • I personally know Dr. Randall Thomas from Mayo, if you choose to see him let him know you were referred by Elizabeth Dole. I have had many patients go through who were able to have alternative treatment plans. EECP is one option to talk to the physician about.

  12. Yes Thank you… three weeks after a very rough Stent placement and I am having some pains.. but they feel nothing like my heart attack and there are no other symptoms as outlined above.. just a darn pain below my right pectoral where they went in… it hurts but its not heart pain.. just a panic manufacturer ;-)

    heal up fellow humans.. we are all connected

  13. I am a 53 year old man who just had a “surprise” MI. I am a distance runner, eat well, and (besides working too hard) live a stress-reduced lifestyle. The heart attack was intense and life-threatening and shocked my wife worse than it did me. She had to talk to the doctors as I laid on deaths’s door prior to a successful LAD stent procedure. Things worked out well in the ICU and I was home and at work within 3 days. After 10 days my doctor said I was progressing well and I took that for a (false) signal I could return to light exercise. Bad idea. I went paddle boarding, then for a quick ocean dip, ate a hearty meal with 3 glasses of delicious red wine, the went to bed feeling exhausted. I suffered scary chest pains all night and awoke thinking I may need return to the emergency room at any moment. We alerted our doctor and, my wife convinced me to rest all day. The pains dissipated and I think all is well. I learned that recovery from an MI is a awesome journey that demands contemplation and lifestyle changes. I will take care of my injured heart so it can heal strong and go on loving.

    • Thanks for sharing your story. It is the case for many, great diets, exercise etc. who have heart attacks as fitness and diets are not the reason for many heart attacks.

      I always counsel it was probably the active lifestyle and fit diet that saves someone like yourself though. It does take time for the heart muscle to heal, if you tore a muscle you wouldn’t go back to activity until the muscle healed. It is important to allow the healing to take place.
      My question to you…did you use your nitroglycerin? If not why. I find many people will experience chest pain and never think to use their nitro.

    • Thanks for the response. I was not prescribed ACE inhibitors or nitro. I am on beta-blockers, blood thinners, and platelet inhibitors. As for rehabilitation I am committed to slow but sure process of return to training and cardio sports. At the moment I am still enjoying the glow of life and love that accompanies my recovery. So grateful for these moments.

  14. I am quite concerned. I had a small heart attack on september 10 and had a stent put in. I had a stent put in of large artery in the back of the heart. I was 99% blocked. It has been 2 or 3 months now. I am having frequent chest and throat tightness . It seems to occur every time I am stressed about anything. It last for most of the day or evening. Stress to me can just be a simple aggravation during the day . For example: my tooth bridge came out last night and I got upset thinking it would cost me a great deal of money, the next day I had the bridge re-cemented and was a minor charge. Meanwhile the chest pressure and throat tightness remains all the time now. Hopefully it will diminish soon . Anxious and have very little answers to these episodes. My doctor does not comment on it. It seems to happen almost every second day.. Please help Pauline

    • Pauline,
      First of all thanks for reading the blog. I understand your concern, as the symptoms you describe are the warning signs of heart disease. However there are other things that can cause the same symptoms such as a restricted esophagus, or acid reflux which could be triggered by the stress. Both of these might be relieved with the use of a nitroglycerine tablet as well. Have you tried a nitro to see if it relieves the symptoms? Keep a log of the timing of when the symptoms start, what if anything may have provoked the symptoms such as stress, exercise, cold weather, eating. Also note if the symptoms are relieved by anything. If the symptoms are changing in severity, the pain is worse, is accompanied by shortness of breath, profuse sweating, nausea, radiation of pain in arm, jaw or back, then get to hospital ASAP.

      What type of stress management techniques have you used? Have you tried any relaxation or meditation when you get the symptoms? Deep breathing can be very helpful, focus on the breath, deep and into the lower lobes of lungs. When anxious we breath shallow and fast, which can make symptoms seem worse. See my posts about stress for further help there. Overall however it sounds like you need a followup appointment with your MD to determine the source of the symptoms, and develop a plan of care to relieve them. One shouldn’t have to live in constant fear of their chest tightness. They will probably want you to take a stress test to help determine the patency of the stent. You can always request a stress test as well for your own piece of mind.

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  16. Hi there..I really appreciate your blog..just found it. I am 46 yrs old and just survived my first heart attack three days ago. I had chest pain for about 10 days – later called unstable angina. The doctors really didn’t take me seriously at first because I presented with no risk factors. I have never smoked, am not overweight, eat well, low cholesterol and any heart issues in my family occurred at older ages. I have also never taken any medication for health issues. 7 days before my heart attack I visited the ER and every test they took came back negative and they sent me home with pain meds. I pushed my family doctor to order more tests. I had a chest CT scan and that was also negative. I was scheduled for a stress test but never made it. One artery was blocked 95%, the other 99%. I had angioplasty and a stent. I am now on 5 different medications. Just wondering if there are any other women of around my age on here that have had similar situations. The thing that scares me the most is they did not find any plaque in my arteries..so they do not know what caused the arteries to narrow.

    I also was wondering if anyone could share successful strategies on coping with the mental aspect of all this. I am having a really hard time wrapping my head around all this and feel really down. I also have a husband and two children, one with special needs that I need to stick around for:)

    Blessings to all of you!

    • I have a great place for you.

      http://myheartsisters.org/

      you won’t believe how many women have similar issues. I find there articles are full of good reputable scientific and practical information.

      Also follow the works of Nanette Wenger MD. She is the best scientific resource out there if you ask me when it comes to research on women and heart disease.

      On a promising note women like yourself can live a long time. A key is recognizing symptoms or changes in your body, (which you have already demonstrated beautifully) Stay on top of it, establish a great medical team, participate in regular exercise and manage stress.

      That is a lot to take on so start one step at a time, learn as much as you can. Find your resources. Find an outlet for stress such as relaxation, yoga, exercise, meditation. Eat fresh, lean, nutrient rich foods, eat a rainbow of colors of fresh fruits and veggies daily. You need the best fuel possible when your body is under stress.

      Live life to it’s fullest and be a voice to guide others down the path of women living with heart disease, including mentoring youth. The energy you spend wrapping your head around it takes away from living. Love your family, cherish your friends, lean on them, don’t be to stoic, accept help when offered, ask when you need it. Some days are better than others. Don’t overdo the good days and then crash. Find your balance. New medications and health issues rock that balance, take time for to re establish the new you.

      Thanks for reading, keep in touch and let me know if I can be of further help.

  17. 66 yr old male. Had burning sensation, fatigue. Some family history of heart disease. Went to ER then hospital where a sent was inserted. Enzyme at admission was zero. Doc said I had no heart attack. 90% blocked distal RCA. This was 7 months ago. I take Effient once a day. MOST days I get sensations in my chest in various places. Twinge and maybe a little burn sensation in a very isolated small spot. This last only a few seconds. I still fatigue moire quickly than before. I ski and play racquetball as OK’d by my cardiologist. He said go FULL BORE. No nitro prescribed. I went in for routine check up and mentioned the symptoms, he said I’m ok! Ejection rate of 70. I am a bit hi-strung(stress). If I take an ativan I have no symptoms. I have always been a shallow slow breather. I am still concerned/stressed over this development and the daily sensations. Am I overly sensitive as the Dr and his nurse tell me?
    Any inputs would be appreciated. Me 5’7″ 180 cholesterol(bad) is under 70 .(Lipitor)

  18. You did an excellent job describing your history. What I can add is ….so far so good! You are physically active and doing well. Fatigue is probably due to medication…but as with your chest pain watch and track it. Fleeting stuff is going to occur….as long as it’s just that fleeting. That is part of stable angina symptoms…the key is “Stable”….as long as it goes unchanged then live life, be active and play….at a sudden and dramatic change in symptoms then you have clear instructions for what to do with use of nitro and return to ER most likely provided from you doctor at discharge from the hospital. Try some relaxation and meditation when they are irritating you…i.e. practice the deep breath, or other stress management tools you have acquired over time that work best for you. Maybe add these in practicing them on a weekly or daily basis. Best of luck and thanks for reading!

  19. I’m a 53 year old male and had three stents installed march 2013, I never felt this bad in my whole life, wish I didn’t go to E.R, that night. All my vidal signs were good and I wasn’t in pain anymore but they wanted to do more test. They scheduled a explore catheration and they put 3 stents in me, and they didn’t hold pressure on my side long enough and I lost 3 liters of blood from my artery, stayed in hospital ICU for 8 days, It took a long time for my blood to absorbed into my muscsles, I take plavix, aspirin,and a statin, and my biggest complaint is I get strange sensations thoughout my body, sometimes it is a wave of skin crawling cool feeling moving up my legs or other times could be in my arms, It’s a tingling feeling with a slight numbness. Does anyone have ideas on what this could be? My doctors don’t. I also feel chest pain but the tingling is whats pissing me off!!!!!!!

    • Sounds like there could be some nerve issues. Have you talked to the doctor about this. With a large bleed in the groin, you get a hematoma, this could be putting pressure on the nerves as it takes a long time for the body to absorb it. There could also be what is called a psuedoanuerism. These are a few areas to explore with your MD.

  20. Hi, I am 57 years old. Angioplasty was done on me 5 months ago. 2 stents were inserted. From that time I am having some sort of discomfort at the chest area like some tightness. About 3 weeks ago I had a chest pain for 3 days and lasted for about half an hour. When I consulted my cardiologist, he wanted me to do an ECG. He went thru’ the ECG report and said nothing wrong on me. But 2 weeks ago I had a chest pain while walking (one day). When I stopped pain also stopped. Thereafter I have been walking as usual but no pain, but feel the tightness. But again When I walked yesterday I felt the pain again. But today I walked, no pain. What would be the cause? Have I got to do an angiogram again to ascertain the cause? Please advise. Thanks

    • I am responding to several persons who have noted intense and often troubling chest pains after a heart attack and subsequent stent placment. I am 53, eat healthy, don’t smoke, excercise regularly, mediatate, etc and four months ago ended up gasping for breath in the emergency room with a full block of my lateral descencing arterery. Since that trauma I have had perfect stress test results and regained most all of my running strength. Unfortunately, I have the same persisten chest pains described by other followers of this blog. After some soul searching I had decided that I trust the doctors when they say that these chest pains are not likely a cardiological problem but a more likely a complication related to the original trauma mixed with stress and middle-age recovery process. I have decided I will live and play as hard as I can. I will run regularly, watch my diet and drinking, and if the next heart attack comes so be it. Living with pain is fine. Living in fear is not.

    • Everyone has good days and bad, several factors may cause one to have more angina one day and not the other. Timing of meals, weather – if colder or windier, stress, sleep patterns, length of warmup, blood sugar levels etc. can all contribute to exercise induced angina.

      A basic ECG only tells you if something is happening at that time. A stress test is the better test to determine what might be happening with exertion, and of course the angiogram is the ultimate test – but much more invasive, costlier and riskier – it gives us the most information.

      Many people will feel occasional angina symptoms. It is best to log the incidents, use nitro when indicated, and be watchful of worsening symptoms. The occasional angina may not need to be treated unless it becomes unstable, meaning it takes more and more nitro to clear the symptoms, it comes on with resting, or wakes you from sleep, or is accompanied by other symptoms such as shortness of breath, nausea etc.

      Does it go away with slowing down or resting? Do you do a nice prolonged warmup with exercise giving the vessels lots of time to widen to provide blood flow to the heart?

  21. I am a male 54 years old and was touring Central America on a motorcycle in January when I had to have 3 stents put in. I was in Nicaragua and did not know I had unstable angina. They saved me and I am back in the USA now. I no longer have the chest, neck and jaw pains, but I get fatigued easily, especially if I bend down much. The worst thing is that I often find myself drawing deep breaths and if I do any bending down I feel like like I really need a lot more air and may breath deeply for minutes at a time. Is this normal? I am doing cardiac rehab and can do the exercises OK, my blood pressure is good and normally a little low, and my heart rate at rest is normally around 60. Taking coplavix, atenolol, pantoprazol and lipitor.

    Thanks!
    Steve

    • The fatigue is most likely related to atenolol. That is a beta blocker and the biggest side effect is fatigue. It takes a full month for your body to adapt to it. Some people will always have some level of fatigue and learn to live with it. If you are so tired it that it is effecting your daily living then discuss with the MD as maybe it can be switched to a smaller dose or a different drug. The bending down bit is very normal as well. We naturally hold our breath when bent over, the medications have slowed you heart rate and blood pressure, the body senses the need for oxygen and probably signals your brain that you need more air. Watch that you are not holding your breath when bending over is the only advice I can give you, it is not a worrisome issue though.

  22. I am a 64 year old woman not overweight, with high cholesteral and smoked for 40 years. I had a sudden heart attack in Jan. One artery (RCA) was 95% blocked had a drug coated stent put in. My doctor told me to his amazement all other arteries were pristine no blockages at ALL. Since the day of the procedure I have been plagued by chest pain all over. Some of it feels like costrochondritis which I used to get 2 times a year. My initial symptom the day before the attack was bad pain in my throat. The day of the attack had bad pain in throat then went to chest left jaw and L arm. A week before the attack I had pain in throat that went to RIGHT jaw. Yesterday suddendly at rest got excruiating pain in throat and RIGHT jaw. Lasted for 15 minutes. No other symptoms. I have been off Effient for 9 days. Doctor put me back on today and said need to do cath. Now I do have esophageal motility issues but never had bad pain unless eating or drinking. I am very hesitant to do cath as the pain may be GI what do you suggest

    • You should probably have a talk with your primary or your cardiologist and discuss your concerns. They could try a GI cocktail to see what effects it has, but another cath would give them a good visual of how the stent is seated and make sure that isn’t the cause. They certainly can block off above or below the original stent placement. Do you use nitro for the symptoms? The thing is GI and costalchondritis don’t refer up to the jaw..in most cases.

  23. Thank you for your response. Nitro makes me VERY dizzy so do not take. Also cardio doc said nitro would help GI or cardio pain PERHAPS. So pretty sure going to do cath because pain in throat was pretty much like pain when had heart attack. So very hard to make right choice. Thanks again. Oh when got pain in throat the other day it when immediately into jaw like 10 seconds, if that gives you any clue.

  24. Had a stent placed a few weeks ago. Still having chest pains which sometimes go over to the left arm. Very stressful and affecting me physically at work. Ya true, sometimes I forget my nitro…

  25. My husband is 46 and had alot of episodes of chest discomfort, blood preasure spikes ect. He went to the doctor he felt he had a blockage. He had 100% blockage had an angiplasty done a week ago Monday. Came home on Tuesday. Wasn’t feeling the best, but felt it was just the healing process. Finally Sunday {Easter} he emailed his doctor to see if the way he’s feeling is normal. They said no and Monday he was back in the hospital for a second angiogram which they found the 50% blockage that they found with the first angioplasty was misread, it was 80% so he had another stent put in. With all of this he never had a heart attack according to all the tests. He went home on Tuesday. Now today he’s back at the hospital with the simular things as before? Could he be having artery spasm’s or could it be one of the new medicines that he has to take now? He has another 50%, 30%, and 20% blocked as well. The doctor in the cath lab did say he has a really tiny vessel that is 100% blocked, but they don’t do anything with that because it’s so tiny? Could it be giving him problems, but if its that tiny maybe not? It’s all very frustrating.

    • Diwakar
      April 24, 2014

      Male,aged 53, on May 21 one Stent was inserted – CAG and was discharged from hospital after 7 days, but since then leaving happy life without any problem even just a single day after the Angioplast!!!!. But just from the past 4 days sensing unstable angina, numbness on the left side something uneasy and pain persists only during the day time. Am pure veg with good healthy habits with lot of exercises. I have gone through lot of cases mentioned in your site and now can you suggest me please whether this pain for me will remain for long time, however will go to Cardiologist for check up. Thanks in advance for the reply.

    • If the pain is similar to what led to the initial stent get in to your physician. If it is becoming more frequent or requiring more nitro for relief go to the emergency room. Stable angina is predictable comes on with the same conditions i.e. exercise, eating a big meal, emotional stress, cold weather…are typical triggers. It sounds like this is a change, which means it needs to be evaluated soon. Angina is something that comes and goes for many heart patients for the rest of their lives and must be managed with medications, occasional angiograms and stents/angioplasties. It is rare that one procedure fixes the problem as heart disease is a chronic heart problem. Best of luck with you check up.

    • Sorry to hear of the return visits to the hospital it can be very frustrating. Yes small vessels can cause angina pain. Microvascular heart disease – also known as small vessel disease is very common in women. Remember when they are doing an angiogram they are visualizing in only one plane of view the arteries, which are full of twists and turns, and at the largest about the width of a piece of cooked spaghetti. It is really difficult with a tradional angiogram to get a solid 100% accurate diagnosis. There is a method called IVUS intravascular ultrasound which can better directly measure the amount of blockage.

      Unfortunately the process of angiograms probably cause irritation to the vessels and may potentiate problems for the short term. You are having a radioactive isotope added to the arteries, you are getting irritation from the placement of the catheter and from the stent, the balloon can overstretch stiff vessels causing cracking and further irritation to plaques, potentially increasing instability to an unstable plaque.

      Doubtful a medication causing the heart problem, but could be giving problems that are similar to heart pains. The blood thinners can have side effects that might give some symptoms. It could be coronary spasm as well. You need to make sure the doc takes some time to sit down and answer all your questions. Be patient, try not to be accusatory with the doc, just state your concerns and ask for a plan of care to be outlined that you both can agree with. Best of luck.
      BD

  26. I have similar symptoms I had a stent put in 3 weeks ago. I feel better but I still get a little winded when I am talking to some for a while. I also have insomnia I have to take Xanax to get a few hours of sleep. When I lie on my back I still get that same feeling that my heart is not pumping properly. My resting heart starts out around 60 and it wakes me up in the morning at about 85 and I also get up in the middle of the night cause I have to pee so badly. I am going to take a sleep study so they can see what’s going on with my heart, oxygen, and brain while I sleep I hope they can tell me why I am feeling this way. I am 40yrs. old and I have always exercised I don’t know where this all came from but it has my hole world upside down. The cardiologist says I am just panicking but I know by now I should be feeling better than this I should not be getting short of breath talking and I get chest pains after I eat a big meal.

    • I had 3 stents put in during a trek through Central America back in January. Like you, I too was short of breath with much effort, and I stayed that way for 2.5 months. I then developed a chest pain that made my heart throw PVCs every 3rd beat with any cardio effort. Cardiologist did another catherization and everything was fine. Then a family doctor would see me and gave me a steroid injection and a steroid pill pack. It took 5 days before I felt any relief, then it was like flipping a switch. 2 days later I resumed cardiac rehab with no chest pains and no PVCs showing up on the monitor. I now feel way better than I did before the symptoms began in the first place, last year. I can breath easy and have plenty of stamina again. I see this going the way of feeling better than I have in years, and very soon too! Maybe something as simple as a steroid can relieve your symptoms. Having chest pain makes you focus and worry too much about your heart. That psychological stress is not good. If the cardiologist clears you, I would consider seeing a family doctor and give it a try. It worked for me. :)

  27. I am 59 old female and had heart attack three months ago with (%95 blockage) in left artery. I had a stent placed, however; still have some pain in jaw,lower back of the head, mid chest discomfort, and heart palpitations. I have been at the Emergency many times (3 times admitted to the hospital for the same symptoms) and been in many tests done which showed everything looking good without knowing a reasonable cause of the pain and my cardiologists want me to go the ER each time I have the pain (having the pain EVERY DAY).

    Please I am seeking for help at any hospital in the world to know what is going on with my heart.

    Does anyone know if this pain is normal and will it go away soon?

    • Pain that is felt to be non cardiac in origin is challenging. There are many things that can cause chest pains and palpitations. And if you ask me it’s called practicing medicine because it is not always an exact science and sometimes takes lots of trial and errors to get things figured out. Consider going to an internist for a check up and discussion about a plan of care. If it isn’t cardiac what is causing. How should you manage these symptoms if they are the same each time to avoid un necessary ER trips.

  28. Have you ever heard of pain in the roof of the mouth from angina. I also have some throat pain. Had heart attack 3 months ago 1 stent in RCA. Had one day of terrible severe pain in throat. recathed all ok, but today have mild throat pain and pain not soreness in roof of mouth/ thanks

    • I haven’t heard about the top of the mouth, but it wouldn’t surprize me, as have had patients experience pain in their ears, their wrists, and various other odd locations. It is tough to tell which pain is heart sometimes, you did the right thing with the cath. If in doubt about angina you could see if your nitro makes any difference. If it does help it is likely angina.

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