Just been left a bit bewildered by what my partner has come home and told me.
She was with a friend who's dad had been to harley Street and had a stent procedure. A few days later he apparently flew to Australia on business .Came home and died of a heart attack in he's sleep.Im shocked and won't deny a little bit worried for us stent patients. One week after a stent and he's dead of heart attack, that the stent was as I believe,was to stop a heart attack happening. I feel more sorry for my partners friend the daughter .Who wasn't even told he had been in for a stent..He kept it all secret and she only knew after he had died
Such a sad time
But I'm absolutely gobsmacked! How can someone die of a heart attack one week after a procedure to stop just that a heart attack "
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Rob6868
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Stories like that stop me in my tracks, life is so precious but so fragile.
Regarding your question,
"But I'm absolutely gobsmacked! How can someone die of a heart attack one week after a procedure to stop just that a heart attack"
Here's my understanding of the process.
A heart attack occurs when a plaque (or atheroma) in your artery ruptures, as the liquid, waxy contents emerge into the blood stream they are turned into a clot. Many people seem to think this clot gets carried along the arteries until it wedges into a narrow or obstructed section. Yes, that can happen, but often this clot stays attached to the original plaque where it first formed. And even quite a small plaque is capable of producing a clot big enough to completely block an artery in the heart.
Here's the critical thing. A stent is generally fitted only to the very largest plaques. But these large plaques are often quite stable, the waxy filling has become calcified and is less likely to burst. These plaques however are the ones most constricting your arteries, so they're the ones that get stented.
More at risk of rupturing are the smaller, newer plaques. There can be dozens of these within the arteries of the heart, and hundreds more in other arteries within the body of anyone who has atherosclerosis or heart disease. It's impractical to stent them all, so they're left alone, even though they can of course rupture and cause a heart attack.
There was a thread recently about stenting, which mentioned that the evidence is that stenting doesn't so much increase life expectancy as improve the quality of life. Personally I'm sceptical that there's NO increase in life expectancy following stenting, however I wouldn't be surprised if the increase was actually fairly modest for the reasons I've just outlined.
Incidentally, this is one reason why statins are important. Leave aside their headline function of cholesterol management, they actually have the secondary benefits of reducing inflammation and stabilising plaque, so reducing the chances of a rupture.
One of the other possible causes of a heart attack is a blockage due to a blood clot .
Post stent clot formation is a real risk and why aspirin and anti platelets such as clopidogrel are prescribed following the procedure.
Statins as you indicated are very important to reduce inflammation and stabilise plaque whatever it's size.
The BHF article about treatments for Coronary artery disease very carefully says that surgery and stents reduce the symptoms of angina.
I have had to sign a few consent forms during my life the most sobering was the ones I signed prior to my angiograms. They listed even though unlikely heart attack, stroke and death as known risks.
hi there i was taken into LGI last may with severe chest pain and had 2 stents fitted and being told on the table that they had sorted the problem is the last i remember till next day when i sort of woke the nurse said they had lost me twice to cardiac arrests ,, so the procedure isnt without risks
The real reduction in risk of plaque rupture comes from taking statins such as Lipitor. Statins stabilize the fibrous caps over plaque, making them less likely to rupture.
Hi Rob,
Great replies from Chappychap and Milkfairy.
Another thing to consider is that long haul air travel is a risk factor for the formation of clots which can then lodge in the brain, heart or lungs causing death with no pre warning symptoms.
If there is one thing that chronic disease has taught me it’s get out there and live your life to the full as we never know what’s round the corner.
That's strange you should say that Tynemouth because apparently it's now said that they suspect a pulmonary embolism but nothing is certain until the autopsy. They jumped on that reason when 5hey found him so I'm told.But no one knows yet.
He had he's stent over in UK then flew straight out to Australia and died out there a week later found in bed
No way would I fly so soon after having a coronary stent!
Just because someone goes to Harley Street does not increase the success rate of a heart operation, neither is it any better or worse after care although I would guess that the NHS would be more thorough and fulfilling with it's after care, purely because of the size of the beast. As a NON expert I am sure there will be valid reasons for a heart attack post stent procedure and am also quite sure that a 20 hour flight to Australia some 48 hours after leaving hospital - it's bad enough for a fit person - and would be a risk that could have been avoided. By the way did the man wear support stockings during the flight to prevent an embolism (blood clot) and did he advise his medical team of his decision to fly half way round the World? Its a'' very well for any of us to be shocked however the reality is that any heart defect and consequent operation carries major risks and is why we have to sign a consent form waiver regarding those risks during and after an operation. On a more personal note, I felt very relieved to have actually woken up after a triple heart bypass and equally grateful that I have actually survived a further 12 months..............Even the most simple of procedures carry a risk that everyone is advised of before hand and even in this day and age, stuff happens. I am, as every other person here, grateful for the hard work and dedication the hospital cardiac teams have invested in rescuing my heart from the scrap heap. I was aware of and willingly took the risk of surgical intervention and am sorry that your friends father did not make it and who became the statistical low percentage failure of these wonderful gifts.
I like the analogy of Harley Street V NHS. A friend of mine needed a new hip, seeing the consultant she asked, can you do the op privately or do I wait for the NHS, the consultant said the difference was china cups and saucers, NHS you still get me
Sorry to hear about this - it must have been a shock for everybody involved. My first on reading your post was also DVT. Sometimes aspirin and similar drugs are stopped for a day or so to prevent excessive bleeding during an angiogram/stent insertion.
Whilst some people are flown from the mainland a day or so after angiogram/stents this is quite short haul. Guidelines I have seen suggest waiting 2/3 days for short haul and 1/2 weeks for long haul.
I do wonder why he did not mention the procedure to his daughter. Might she have suggested having the procedure done in Australia or delaying the return flight?
An embolism is when a clot breaks off from the plaque and is carried along the bloodstream until it lodges in a restriction. If the restriction is in the lungs then it's a pulmonary embolism, but it could end up lodged anywhere.
In the majority of cases, if the plaque ruptures and starts spewing out waxy liquid into the bloodstream, then the clot will form there and then and remain anchored to the plaque. This fixed clot is the more typical heart attack, rather than the embolism.
Having a stent fitted is a fairly major procedure to the heart and needs time to settle down. A long haul flight is inevitably very stressful and perhaps should have been deferred for a few months.
So sorry to hear that. When I had my third heart attack they said to me that a stent is too dangerous for me to have not sure why but I'd a triple bypass which has saved my life. I use the nhs I don't believe in going private for anything the NHS have some of the best consultants and surgeons in the world my surgeon was wonderful that's all I can say. Sorry again.
Hi Rob. I had a stent last year following a silent heart attack, but 5 days after discharge was blue-lighted to another hospital having collapsed with ventricular tachycardia. Obviously, because different hospitals were involved, I didn't get a proper explanation, and the implication was that the first hospital hadn't done their job properly, but it rather proves that stents are not infallible!
My husband had a HA out of the blue in Dec 2005, saved by thrombolytics and discharged 1 week later on Christmas Eve. Struggled to do anything without going grey and breathless but we thought that was normal!! At end of Jan 2006 at his ) week check up they decided to take him in the next day for a stent. All great, pink and healthy. In Sept 2006 he was taken off Clopidogrel as standard treatment, had another HA in Feb 2007, another stent inserted inside the first one, and now on clopidogrel for life. Fortunately he’s still fairly well just always tired and can’t physically do all he wants as he gets exhausted but no pain, no angina, we’re so thankful xx
I had stents fitted in early Dec and was booked to fly to NYC for Xmas my surgeon told me to cancel as was too soon to be flying! Very sad to hear about you’re friends Dad.
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