Overlapping stents and chest pain niggles after exercise

[jon22]

My cardiologist is phoning me later today to discuss my intermittent chest pain niggles over the last nearly 2 weeks (at rest and with exercise).

I eventually managed to get a copy of the notes from the cardiologist that performed my angioplasty and 4 stents. It said :

"I placed a 2.5 *18mm Xience drug-eluting stent in the distal vessel and then proceeded to place a further 2.75 *23mm , initially , Xience drug-eluting stent overlapping with the first followed by a third 2.75 * 28mm Xience drug-eluting stent and then finally a 2.75 * 18mm drug-eluting stent, all overlapping , confirmed on stent boost. The stented area was post - dilated with a 3 * 20mm NC balloon taken to high pressures in the distal and mid vessel and there was residual disease in both the distal PLV and the proximal vessel but I elected to treat these conservatively"

This is the very first time I have had this information. I previously thought I had only one overlapping stent and an additional 2 separate stents.

So if you add up the length of the overlapping stents it comes to 87mm (nearly 3.5 inches)! That seems a long stent to me?

My question to the cardiologist is when I overdid the swimming (44 lengths of a 25m pool for the first time after 5 months : all breaststroke) could I have disturbed this long overlapping stent which led to the intermittent pain over the last nearly 2 weeks.

Only today do I feel that I am pain free so far , but I have been resting over the last 2 weeks , doing walking only, no running, swimming, cross trainer, gardening etc.

What I am hoping the cardiologist will be able to tell me is how to avoid repeat episodes in the future and what additional tests would be helpful for my symptoms. I dont want another 8 hours in A&E!

Many thanks.

[jon22]

Had a cardiology nurse led telephone call this afternoon, which was very informative.

First of all I learnt that a stent length of over 60mm is known as a 'full metal jacket' , and mine was 87mm!

The nurse did say that I may have aggravated the long length of stent by my vigorous exercise (44 lengths of my local swimming baths in 50 mins). I was advised I not to swim at present, only walking up and down the swim lanes for now. Also to limit other exercise to walking for now.

I had a full review of my meds and the tests that I now needed to have were:

1. Echocardiograph - waiting circa 4 to 6 weeks.

2. Review of my records by 2 independent cardiologists to see if my other artery (LDA) that had mild to moderate disease also needed to be stented or treat with meds. Some discussion around meds under the tongue?

3. Possible angiogram just to look at the LDA.

4. Some of my medication needed to be changed as they also found that my liver ALT was raised 152 , but this could have just been a blip as 2 months ago ALT was ok at 39.

5. Change in meds also recommended to see if it positively affected my low neutrophil count.

6. Another blood test in 3 weeks!

I will keep you posted!

[Henry20]

I have a 40-50mm long stent + a short one; put in 2 years ago. I still get 'niggles' and twinges quite a lot; they go in spells, some good days some bad. I've talked to docs, but they don't seem concerned.

There are things that aggravate the situation, like heavy lifting and reaching up. So I try to limit them to essentials only; use steps etc when previously I wouldn't have bothered. But I do take exercise at cardiac rehab classes. There are a couple of things I try to avoid but it keeps me moving and I feel a lot better for them.

Being retired, I've come to the conclusion that I should live with them; and learn to recognise the warnings my body gives me. It's not a situation I like much, but I don't seem to have many options.

Good luck, it would be interesting to know later how you get on and what you do to improve things

Henry

[jon22 in reply to Henry20]

Thanks Henry.

I will let you know what they say after I have had my tests. I am learning all the time about this cardiovascular disease and its taking me a lot longer to come to terms with things than I thought.

I have lost 3.5 stones and now down to the right BMI for my height of 5 foot 11 inches and my cholesterol is 4.6 (down from 7.6 pre heart attack) + I have been pushing my fitness to the limit with couch to 5k, the swimming, sit ups, walking etc. I will have to continue to learn what is good and what aggravates my long stent (assuming that is the problem?).

My cardio rehab classes at my hospital were cancelled due to covid after 4 weeks so I will have to look into whether they do online classes from home(like you I assume?).

As regards retirement I will be retiring at end of next month and have some choices to make. I am in a DB scheme and have to decide whether to take a monthly pension or transfer out all the benefits into drawdown. All depends on how long I think I will live!

I will have to start a thread about the longevity of full metal jacket club members!

Will be in touch.

Thanks again for replying.