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Heart Attack and Stents or Angioplasty

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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Current Postings on This Page (17):

• 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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)?
Forum Editor, 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.
Forum Editor, 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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