is this usual?

[Nes71]

morning all, in April last year I had a hospital admission for suspected heart issues, in September I was told I have a significant narrowing in an artery, not a main one, they tried to start me in a whole heap of meds and suggested a stent, I wanted a chance to avoid all this so for 6 months I have been training regularly and eating well, I had my 6 month review yesterday and again they are insistent I have stent, due to risk of plaque breaking of, and complete closure, I have had only one bad epidsode in 6 months when I had to use my gtn spray, I am on aspirin but not taking all the other stuff, if I have stent I will have to start with it all, not sure it’s a journey I want to start- has anyone got any advice / suggestions? I am 52 female and in other wise good health

Many thanks

[Hidden]

It is my understanding that you cannot reverse plaque build up. It will likely only get worse. Taking statins will however stabilise what is there and hopefully prevent bits dropping off and causing blockages that potentially cause heart attacks and strokes as well as slowing further laydown. Lifestyle changes will also help slow further laydown but again will not reverse anything already there. But your health professionals have suggested tried and tested methods for reducing your ongoing heart disease risk such as stenting and medication, and if I were you I would be taking them up on their offer. Whilst medication and stents come with a small price to pay it is worth it to reduce the risk of major trauma further on in life at any time.

[Nes71 in reply to Hidden]

morning, thank you for your reply, and yes I know I can not reverse what is already there and there is a risk to break of, I did try statin at first but made me feel extremely sick, my cholesterol is ok, as is BP, so for me the concern is if some of it breaks off but researching stent surgery which also has its own risks so I am so confused, I took a friend yesterday to the appointment as got so confused last time, and was same advice as 6months ago, I don’t want to put myself at risk just trying to weigh up the options as seems everything comes with an element of it, I have been reading blogs on here since diagnosis and really appreciate peoples experiences and knowledge, thank you

[Hidden in reply to Nes71]

Nearly all medical interventions come with risk. However if the risks came anywhere near cancelling out the benefits they would not be recommended or used.

[Richard52]

hi

All I would say to you is, if I could wind back the clock 20 or 30 years then I would have changed my life style, I am 55 by the way. Trust me, take the stent at your earliest opportunity. I had a heart attack out of the blue in October 22, had a stent fitted on the day following a blockage, however on investigation they decided that I required a bypass, I am now 10 weeks post bypass. By the sounds of it your BP and cholesterol is ok then hopefully all you’ll need is a stent then take it. I personally would take 100 stents than a bypass operation.

[Nes71 in reply to Richard52]

thank you x

[Norton]

Hi Nes

I appreciate you must be feeling very confused and I suspect possibly scared

I didn’t have high blood pressure and my cholesterol wasn’t high and I didn’t have family history and I have never been overweight

I had a heart attack in November last year and stents inserted blew me away mentally these things don’t happen to me they happen to the people I have had the privilege of nursing for 40 years

You say you don’t want to put yourself at risk, if the cardiologist has recommended a stent and you decline whilst that is absolutely your choice you are putting yourself at risk, they wouldn’t recommend a procedure that does have risks (all procedures have an element of risk) if they didn’t believe it would be beneficial to you

A lot of medication can make you feel yuk at the beginning with some perseverance the side affects often disappear and if they don’t or they are intolerable to you there are different medications that can be tried.

Just a suggestion why don’t you with your friend make a pros and cons list that is personal to you and include affect on your mental health for both pro and con then phone the cardiac nurses at BHF obtain BHF literature and discuss your concerns.

Your concerns are real and you are making a big decision however there is support out there for you to make a very informed decision and support you along whichever road you choose

Good luck keep posting with any more questions lots of people on here who have personal experiences and willing to share them

Let us all know how you get on.

[Nes71 in reply to Norton]

thank you so much I like the idea of a list will do that x

[Chappychap]

There is almost no evidence that stents prevent heart attacks (in fact there's precious little evidence that even bypass surgery prevents heart attacks). What these surgical interventions are brilliant at is removing or reducing the symptoms of angina, and if a stent is inserted during a heart attack it may very well save your life by opening up a completely blocked artery. Heart attacks used to be mainly fatal, they're now mainly survivable, the number one reason for that improvement is stents being fitted during heart attacks.

The great majority of heart attacks aren't about plaque breaking off, moving along an artery, and then blocking an artery in a different location. That can happen, but it's relatively rare. The great majority of heart attacks occur when plaque bursts. Think of heart disease like acne of the arteries, and if one of the spots/plaque spontaneously bursts it releases a waxy, liquid substance into the bloodstream. That waxy/liquid substance instantly solidifies, but remains attached to the original plaque. As it solidifies it blocks the flow of oxygenated blood reaching the heart muscle, so part or all of the heart struggles to function and, if left long enough, will eventually die. Elective stents don't really prevent this, after all stents are measured in millimetres where as arteries are measured in metres, and we most likely have plaque scattered throughout.

Incidentally the evidence is growing that statins help stabilise our plaque, accelerating the natural tendency of the waxy/liquid contents to harden and calcify, making them less likely to suddenly rupture.

You talk about stents and medication as "starting a journey". The truth is that you (and indeed many people on this forum, myself included) are on that journey whether we like it or not. Heart disease/atherosclerosis is incurable and progressive. That means we've got it for life and left to its own devices it will just keep getting worse.

We do however have two (and only two) weapons in our armoury. Medication and life style changes. Personally I've chosen to double down on both of these, but I absolutely recognise that we're all free to make our own decisions. Our bodies, our choices.

Life style changes probably work best for people who can clearly identify when their heart disease likely has a life style related cause. Is that you? For example elevated blood pressure often responds well to the life style changes of reducing salt, exercising more, and losing weight. Elevated HbA1c scores often respond well to the life style changes of losing weight, exercising more, and reducing sugar and processed carbs. And pretty much every health metric responds well to stopping smoking!

But some people don't have such clear pointers towards obvious life style changes. Logically they'll either need to explore less obvious life style triggers for heart disease (such a gum disease or sleep apnea) or they'll be relying more on medication to keep them safe.

All I would say is keep an open mind about the best treatments for you, but it's probably time to accept that we're on the journey. What we have to do is make the right choices regarding the route.

Good luck!

[Nes71 in reply to Chappychap]

thank you, and yes I do have a healthy active lifestyle and luckily very few symptoms but when pain hits (handful of times in last year) it can be quite severe which I manage with gtn spray and aspirin, thanks for comments and sharing it’s really helpful x

[Cruiser25]

Hi Nes71,

I'm sorry you feel conflicted with regards your choices and predicament. I can only speak from my own experience and what was very clearly conveyed to me by the Consultant and Registrar (and the Sisters) when I was blue lighted in just over a year ago.

As Chappychap has said, stents really can save your life when inserted during a heart attack.....they definitely saved mine. My STEMI was a total blockage of my right coronary artery and needed two emergency stents to open. It is only by sheer luck it wasn't my LAD artery, because it it had been this that blocked, well I wouldn't be writing this!!! I needed far more work on my LAD, 5 more stents.My atreries were in a "shocking state" as they told me on my discharge!! My HA gave no prior warning, I've never smoked, been really fit, never overweight, active job and good lifestyle. I'd been on low dose statins for over a decade, (family history of cholesterol) and STILL got tagged. My family didn't know for over 2 hours if I would even make it!!! I would spare anyone that, It's easy for me as the patient as I know how I'm feeling inside, but I have to remember to tell my wife and son how I am, as I couldn't take it, knowing how they must have felt on that day almost 14 months ago.

What I'm trying to say is, you've been told twice, by a Cardiac Consultant, what their advice and recommendations are, but only you can decide. Just remember this ...I was lucky, really lucky, my body decided to wake me up to tell me I was having a HA. I had the cold sweats, pins and needles, nausea, breathlessness and finally crushing chest pain, I knew what I was having...easy to spot.... and they got to me in time. Ladies do not always present with the same, symptoms are more subtle, not as 'typical' so again you must decide and weigh up the pro's and cons. All I can wish you is good luck hopefully some peace in making your decision, I'm a convert, just tell me how high and how far you need me to jump and I'm there, the 'other' well let's not go there. Please take care of you.

[Nes71 in reply to Cruiser25]

thank you and I am glad to hear you are ok now x

[Nes71]

thank you x

[Nes71]

thank you and I am glad to hear you are doing so well a year on x