After effects of Angioplasty and side... - British Heart Fou...

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After effects of Angioplasty and side effects of drugs

Tab1966 profile image
22 Replies

Hi, I'm 51 years old and have just had 2 Angioplastys resulting in 5 stents. The last procedure was last Friday.

This has all been a terrible shock to me. I'm only slightly overweight, my cholesterol is Ok, I have never smoked and I don't drink. Up until a year ago I was also going to the gym twice a week and only stopped because of feeling unwell.My blood pressure has been a bit high but controlled for a few years with medication. My dad died at age 60 of Coronary Heart disease and my 2 paternal uncles were both dead, one at 62 and one at 58, again with heart disease. All three were ill for many years. I never wanted to be like that so I tried to avoid all the triggers, but apparently to no avail. Doctors have told me that they have no doubt the main factor is genetics. Which greatly upsets me as I feel that it is all totally beyond my control!

However, I am making some changes to my diet (trying to follow the mediterrean diet) and I look forward to the Cardiac Rehab course and going back to the gym again.

Additionally, I had a cardiac ablation at 24 years old to cure Woolf Parkinson White syndrome but have continued to live with erratic heart beats and ectopics. It was only because I was insistent and upset about this, and because I was sure there was something else not right, that I was referred back to Cardiology and then (despite all other tests being normal - including the ct angiogram) was diagnosed with Cardiac Artery Disease. I'm still trying to get my head around it all and am struggling quite a lot mentally.

Ok, so now I am on a variety of drugs and I'm wondering if one of the side effects is a common one. Two of the drugs are Aspirin and Clopidigrel which I take in the morning as well as Omeprazole. About 8 hours later I suffer with the most unbelievable wind, burping for hours and in a lot of discomfort in my central chest. I'm not really in any doubt that it's indigestion, but there is always that little voice in my head saying "but what if it isn't?". Combined with the usual erratic heartbeats I find it quite scary. My Gp has advised me to take a second Omeprazole in the evening but it doesn't seem to make any difference.

Does anyone have any advice please?

Thank you for reading my (very long!) post and for any replies.

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Tab1966
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22 Replies
laura_dropstitch profile image
laura_dropstitchHeart Star

Hello and welcome. I take different medication from you (for heart failure) but I remember my cardiologist telling me that a lot of heart meds do cause digestive issues. I was the same as you - 99% sure it was indigestion but 1% worried enough to raise the issue at my checkup. I guess stress/anxiety could be a factor too, plus you say you've made changes to your diet recently. You really have had a lot going on, haven't you? If the indigestion feeling is stressing you out, always worth raising again with GP/cardiologist/pharmacist, if only to set your mind at ease. You're definitely not alone in finding the emotional aspects of your condition hard to deal with, but it sounds as though you are doing all you should be. Take care of yourself and good luck with it all x

skid112 profile image
skid112Heart Star

Hi there, I am on similar medication but don't appear to suffer that particular side effect. As Laura suggests I would ask your GP again to revisit your meds

in reply to skid112

Omeprazole didn’t agree with me, them had lomeprazole same problem now on been on ranitidine a couple of years with no issues. I take them twice a day. Had a stent Feb 2014 age 43, the shock and emotions of it are scary, there is a lot of support here and go to your gp, I feel like I have my own seat in the waiting room 😁 Cardio rehab is great gave me the confidence to start to exercise, this year I completed my 1st marathon. This time is for recovering, take it easy and good luck x

Tab1966 profile image
Tab1966 in reply to

Wow! A marathon! That's amazing- well done 😀

Hi there - sorry to hear about all your burping! Omeprazole in itself can cause this, so it might be worth having it reviewed to see if you'd tolerate something else better.

It might be worth asking if you need a drug like this too - even though aspirin and clopidogrel can irritate your stomach lining many people are fine and don't suffer any side effects. Obviously, that's only if they haven't given you omeprazole for another reason such as existing gastric problems.

Hope this helps, Chris

Heather1957 profile image
Heather1957

I am afraid I can't help with the advice part. I take Clopidigrel (no asprin) and the occasional Omeprazole but I don't have those side effects. I'm with the 'it can't hurt to ask' group.

Welcome!

Tab1966 profile image
Tab1966

Thanks for all your kind words and advice. After a particularly difficult night I spoke to my lovely GP this morning.

He suggested doubling the dose of Omeprazole taking one in the morning and another in the evening. Also to take the morning Omeprazole, eat breakfast and then take the aspirin and Clopidigrel afterwards.

He wasn't surprised by the side effect at all so Im guessing it must be fairly common.

Tonight I've taken the second Omeprazole and I'm not burping but...do still have central chest pain. Although that could be caused by the stretching of the arteries during the Angioplasty - a problem I did suffer with after the first procedure .

Fingers crossed it will work because it really is quite unpleasant - and not something I want to be doing in polite company !!

Xauras profile image
Xauras

Hello - I notice you are on a Mediterranean diet. Does this include 'Garlic' Only I found every time I have garlic it affects me the same way as you described. Just a thought that maybe if you are having garlic it has the same affect on you. If not hope you find the cure.

Tab1966 profile image
Tab1966

Hello! Yes, I'm still trying to follow the healthy meditterean diet (with quite a few lapses I might add!) and have managed to gradually lose over a stone and a half which has obviously got to be a massive benefit. However, I never include garlic and haven't eaten it for many years as it's my biggest trigger food for IBS....even though I miss it! But thanks for the advice, I really appreciate it.

I do still get the same symptoms but suppose I have learnt to live with it and am used to it now.

David-75 profile image
David-75

Hi there Tab, I am pretty much the same as you but a bit younger at 43 and had an MI last August... but we both have 5 stents! And CHD - mine after stents is mild to moderate (with the moderate in a very small part); my LVEF was initially low but as of last week I am delighted to say it back in the normal range and apparently my ECG stress test results would allow me to fly a plane (not sure I would want to be on that plane as a passenger though!). My echo would even now be passed as normal (i.e. the damage is very hard to see now!£) - so I was very chuffed with this small victory.

I too have the digestive issues and shared your anxiety about differentiating the chest pain! Fortunately after not agreeing with Lanzaprozole (a PPI) I switched to Rinatidine and the discomfort is very rare now ; it’s most likely the Ticagrelor causing the issue - I had mild duodenitus (inflammation of the gut lining) diagnosed.

Yes having some control is also what I have tried to do with my diet ; I have switched to pescatarian, but mostly veggie, cut out virtually all oil, vastly reduced refined sugar intake etc... did quite a bit of reading (Ornish, Esseltyn, Furhmann and of course BHF) and decided on what’s best for me. I also regularly exercise and will continue to challenge myself (but careful not to overdo it) . I also pay for an appointment with a cardiologist (it will be every twelve months and also do an exercise stress test). I have also got into meditation (but light touch, not that hardcore!). This is all I can think to do and of course try to be positive- which I manage most of the time. There are of course advancements in technology happening all the time and I also hope I will be able to benefit from this too. I have managed to waffle on longer than your post! , but just wanted to say I know what you are going through and I hope this is of some reassurance / help to you!. Good health and enjoy that sunshine tomorrow. Best wishes , Richard

Tab1966 profile image
Tab1966

Thanks Richard, it is literally a real pain having a digestive system that doesn't live up to its name, combined with CAD! The pain that I get in my central chest daily is always caused by indigestion and I know this because of all the other symptoms of IBS that are happening at the same time (I won't go into details!!). However, there is also always a momentary feeling of panic before that realisation kicks in.

My GP has said that he thinks that my IBS symptoms will improve again once I stop taking Clopidigrel. As I had my stents fitted last October I have another few months to go yet sadly. However, I've had a few chest pains whilst exercising so I'm scheduled to shortly have a stress MRI test and my Consultant says I could possibly have another Angiogram as a result of that. He thinks that maybe one or more of my stents hasn't bedded in properly and that this can happen in about 5% of cases in the first 8 to 9 months after the angioplasty. If that's the case I'll have a whole other year if Clopidigrel to get through!

On the diet front, my GP recommended the Fodmap diet a couple of years ago.It has a very high success rate amongst IBS sufferers and certainly made a difference to me pre stents. My main problem apart from garlic, was lactose and cutting it out improved my symptoms beyond belief! Google it, it's definitely worth a try!

By the way, think I've beaten the waffling record this time!

David-75 profile image
David-75

Yes, I am on Ticagrelor instead of Clopidigrel- but having seen on here someone say there was research they had seen stating there is benefit for taking more than a year- I checked with cardiologist and he agreed but there is an increased chance of bleeding in continued use- so it is weighing it all up; but I will probably continue on a lower dosage for another twelve months .. I think..

yes I heard from cardiologist too the 5% fail rate; but I would say it is only now (nearly a year later) that I would say that my stent settling chest pain has subsided , so i hope this is the same for you - not fully settled in yet. I get the odd twinge, but nothing that lasts for seconds just instant and not when exercising ; so think this could be muscular.

I would like to think that I could come off some meds in the long term- but I will follow the cardiologist advice ; I have read a lot, but I don’t have years of training and decades of experience!.

Anyway mate, I hope all turns out well. Let us know how you get on. Thanks for the fodmap tip, I will have a look.

Best wishes,

Richard

Nrfnmr profile image
Nrfnmr

Hi. Would love to know did you take any medications everytime you had the symptoms(burping etc)? Also did you still have these symptoms recently or did it go away after few years?

Tab1966 profile image
Tab1966

Hello, I took indigestion remedies every day (2 x omeprazole) plus ranitidine if and when the central chest pain indigestion was bad, or I was burping a lot. After finishing taking Clopidigrel it improved immeasurably and I rarely get the continual burping now. I do still get the central chest pain though but having had 3 angiograms now I am reassured that it is indigestion rather than caused by heart issues. However, because of the location of the pain, I'm not certain I will always feel reassured!!

Are you having the same issues?

Nrfnmr profile image
Nrfnmr

Thank you for your response🙏.. Really feel reassured to know im not alone to feel all those symptoms. Yupp.. Did angiogram and stent last week. After discharge from ward, im having central chest discomfort almost everyday that relieved after burping a lot.. It seems like i hv a lot of wind at the central chest area.. Now im taking glyprin, clopidogrel, bisoprolol and pantoprazole..I still hv few questions here.. May i know how long did u take clopidogrel? Did u take sublingual gtn whenever you have the central chest pain n frequent burping symptoms?

Glad to hear that ur symptoms hv improve a lot 👍😀

Tab1966 profile image
Tab1966

I took Clopidogrel for 12 months. I have taken GTN spray but had quite an extreme reaction to it, so I avoid it at all costs really! I have central chest pain very frequently - I have it now! - but I rely on indigestion meds and convince myself it's just that. I do have a follow up appt with the cardiologist in a few weeks though so I feel another conversation about changing meds coming again.

My stents were put in almost 2 years ago now but because of this pain, I feel like I need regular reassurance from my consultant. So far hes been marvellous and sees me 6 monthly but I know he wont do that forever!

Hopefully you'll get some relief soon though as I think it's very normal to have pain so soon after treatment. I'll keep everything crossed for you 🤞

fergusthegreat profile image
fergusthegreat

I'm surprised that you have been advised to take omeprazole and clopidogril at the same time as omeprazole can reduce the blood thinning effects of clopidogril.

My cardiologist told my to take the clopidogril in the morning and the omeprazole at 6 in the evening.

Tab1966 profile image
Tab1966 in reply to fergusthegreat

How interesting! Was never told that. Happily I don't appear to have had any ill effects 😁

fergusthegreat profile image
fergusthegreat in reply to Tab1966

I'm not a medical professional so cannot give medical advice but as the omeprazole reduces the blood thinning ability of clopidogril the only side effect you might feel is the clopidogril not preventing a heart attack.

I would definitely check this out with you gp.

Just Google omeprazole drug interaction and the information is there.

Tab1966 profile image
Tab1966 in reply to fergusthegreat

I find that all very extraordinary! Having read lots of posts on here I believe a lot of heart patients also take Omeprazole alongside their heart meds, and many of those will be taking Clopidigrel too!

However, as I stopped taking Clopidogrel last September I think I'm ok for now....but will definitely ask questions if I need to undergo further treatment and another course of Clopidogrel.

Thanks for the info 😁

fergusthegreat profile image
fergusthegreat in reply to Tab1966

I myself take clopidogril and omeprazole and I think its common to take both as you say. The omeprazole reduces the production of stomach acid which can effect the digestion and hence effectiveness of the clopidogril.

You simply take the clopidogril in the morning to allow it to be properly absorbed and then the omeprazole in the evening and statins if you are on them, before you go to bed.

Aviseymour1 profile image
Aviseymour1

Hi , my wife has a very similar problem like yours. Still trying to figure out as to how can I ease her discomfort.Avinash Seymour

avinash@ksilindia.com

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