Drugs pits stent: Had stents done... - British Heart Fou...

British Heart Foundation

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Drugs pits stent

Cruise1
Cruise1

Had stents done yesterday. Now given Perindopril (used prior to stents) Bisoprodol Fumerate, Trangina XL (used Momomax XL prior to stent) concerned they will lower blood pressure too much as prior to stent BP was 125/75 or slightly less. Was surprised that nitrates are continued too. Think it is OTT and don’t want to go dizzy.Happy about Aspirin and Clopidogrel.

Brother in law had bad experience with his meds list heart intervention.

Any advice/experience. appreciated.

13 Replies

With previous BP of 125/75 you've got a LOT of wriggle room before you're likely to feel dizzy. The vast majority of people won't get symptoms until fairly well below 100/60 or so. Given you were already using 2 of them, the only "additional" lowering will be from the bisoprolol, and it's main effect us to lower heart rate, not BP.

The standard drug pack is there to protect against things that you REALLY don't want happening, like restenosis and blood clots.

If you do get side effects they tend to be unsettling, if you get either of those they can be lethal or permanently harmful. Out of "possible but extremely unlikely dizziness" or "blood clot heading to my brain" there's really no contest!

I'm in agreement with Thatwasunexpected. Normal BP range is 90/60 to 120/80. Yours is pretty well at the upper limit so I would have thought that the meds would be unlikely to take you into the dizzy zone. A lot of heart medicines have a tendency to make you a bit wobbly when you first start taking them but once your body has got used to them that goes away.

I'd be inclined to give them a try and see how it goes, if you do start having side effects which are hard to live with and don't go away contact your GP

I am not going to. Asking to be referred to heart failure clinic.

Cruise1
Cruise1 in reply to Cruise1

Having had 2 misdiagnoses in the past and nearly dying as a result of botched surgery for appendix and gallstones I am not very confident with medical professionals. My brother in law also nearly died when given Contra indicating medications for his heart.

Well, having clearly already made your mind up, not entirely sure why you asked for advice?

Because the only sensible advice anyone can give is:

Take the meds because they are proven beyond any doubt to greatly reduce the chance if you ending up dead or having a stroke.

Once again have to agree with Thatwasunexpected. It appears that you had already made up your mind on your course of action, so assume you were posting and expecting to get replies from people agreeing and suggesting you don't take the medicines. One of the first principles/rules of this forum is that no one should suggest that medicines be discontinued, so it would be unlikely that anyone would offer that sort of advice - if they did, they would correctly be reported.I won't reiterate what I've previously said, good luck with the referral.

I was posting because having researched the procedure beforehand there was no mention of some of the additional meds I have been prescribed and wondered if anyone else had been prescribed the same cocktail of drugs. You are just handed a bag of drugs on leaving hospital and told to follow the doses prescribed on the packs with no explanation as to why and what they are supposed to do. Life is a lottery anyway - more so with Covid.

Well, the only "additional" ones you were prescribed were the aspirin, clopidogrel, and bisoprolol because you were already on blood pressure meds and nitro.

As a general rule, hospitals will NOT stop a medication you're already on unless they need to prescribe something that clashes. Changes like that are up to your GP or whatever specialist had prescribed them in the first place. Which is why they've left the nitro.

The absolutely standard drug pack, which is explained in virtually all reliable online sources of info about the procedure, is:

Aspirin, another anti-platelet (usually clopidogrel), a beta blocker (usually bisoprolol), a PPI (usually lansoprazol), and an ACE inhibitor or ARB regardless of your blood pressure.

The aspirin and clopidogrel provide a huge protective benefit, at least for the first 6 - 12 months, in terms of blood clots and restenosis.

The bisoprolol is a virtually automatic prescription after heart procedures because it greatly reduces the load, and hence the oxygen demand, of the muscle. Given that you've had a stent because the blood (and therefore oxygen) supply was compromised that makes a lot of sense at least until it's certain that the stent is successful.

Although biso is normally considered "for life", it's probably the one they're most likely to agree stopping IF everything is successful and your figures (mainly heart rates rather than BP because its effect on BP is incidental to its rate lowering effect) are good once things have settled.

The consultant was right that he's "fixed it" but there's no absolute guarantee that fix will be successful - only time can prove that.

Thank you. That’s very useful. Only wish the hospital had made the effort to explain all this or even the consultant. Seem to have been given 2 lots of nitrates though so contacted GP who said take only 1 as both were same but with different names.

Normally I expect they would - the rehab team covered it with me during their "before you go" visit. But, I guess, at the moment they're under as much strain as the rest of the medical world.

Which is understandable but doesn't help you much as the patient!

I was self funding too. Procedure cancelled previous week due to consultant being ill (Covid) Told it would then be February some time. Then following Monday told it might be possible for Friday, admission previous evening but no guarantees. Covid test arranged for next day.Phone call Thurs morning to say angioplasty would go ahead but to wait to be told of admission time. We live an hour away from hospital and got a further phone call at 3.45 asking me to be there for 5p.m.

After procedure and consultant discharge waited over 2 hours for discharge letter and meds. No explanations or advice re do’s and don’t. Glad its been done though but not the best experience. The procedure was fine. It was all the stress and uncertainty surrounding it.

That's a side of it I didn't have to experience.

Private van-sized taxi with special blue flashing lights (but, disappointingly, no siren because there were no other cars around), seen straight away, and bedded down with free meals & lots of beeping tech until they could do the angioplasty the next morning.

Although, that was pre-Covid.

Meanwhile, the thoughts of "am I dying?" kind of blanked out any stress over anything else :D

Got a call from cardio rehab nurse this afternoon (nobody told me to expect this) Her exercise advice contradicts that of consultant. No exercise classes due to Covid but I had already visited BHF exercises online. Phoned back 10 mins later as her records showed I had been given 2 packs of blood thinners and was worried I had been taking 2 a day since discharge. Hadn’t had 2 packs given and wouldn’t have taken 2 anyway. I am just going to go it alone with help of my wife and this forum.

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