What tests are done to check stent is ok?

[DizzyD]

Hi all i had a stent fitted 16 May 2023. As of yet i have not had follow up check up with cardiologist. I attended cardiac rehab clinic once, a few weeks after stent procedure...no follow up after that, just phone calls from rehab nurse.On several occassions i told rehab nurse (on phone) sypmtoms that emmerged about 2 wks after stent ie discomfort over entirs front of chest, tight band feeling under breasts, breathlessness. My right hand was constanlty massarging under breasts and middle of chest.

I read some posts on this forum about post stent issues and was reassured when i read that these symptoms would resolve given time.

However, my symptoms remained to this day. They ease off when i lay down. Hot water bottle also helps ease the discomfort. Lol I walk around with it tied to my chest.

I am pushing for post stent follow up.

Question is in what way can stents go play up, what tests are done.

Thank you in advance

Have a rewarding day

[Hidden]

Good question, I've wondered this myself and it would interesting to see the answers

[Teddy2022]

Hi, I had a stent fitted after an NStemi in Feb 2022. Just had one follow up about three months later with a cardiologist. I had to chase this up myself. He did an echocardiogram which was normal. I was then signed back to my GP who was asked to monitor bloods/BP as per standards. I have had no further pains etc but beginning of this month on another CT scan for something else, an aortic ascending aneurysm was picked up. I am back as an urgent referral at the cardiologist clinic in less the 2 weeks. Not the news I was wanting as it’s a very serious condition.

Hope this helps

[DizzyD in reply to Teddy2022]

No it's not the news you wanted but what a blessing that CT scan picked aneurysm up. Correct me if I'm wrong, I think they can rupture. So pleased you got a urgent referral. Sincerely, hope everything goes well for you. If I were in your shoes I would want to sleep for whole of the two weeks.

Take care lovely.

[Teddy2022 in reply to DizzyD]

To be honest the way I am feeling I want to go to sleep and not wake up at all 😢

[DizzyD in reply to Teddy2022]

Although my heart issues are not as scary as yours I know exactly how you feel and emphasis with you. Nothing I say will alter how you feel but over the past year I have literally wanted to die at times rather than wake up. I would yell at a power far greater than myself for allowing me to wake up each day but I'm still here...awake. Keep talking Teddy I will listen to you and hold your hand wherever you are. You so kindly replied to my post for a reason. So glad you did. You will get through this scary ordeal, you will survive....just take it one day at a time YOU MY FRIEND ARE NOT ALONEMuch love and hugs where ever you are.

[Teddy2022 in reply to DizzyD]

Thank you so so much DizzyD you are my friend too. What a kind lovely reply. Love and hugs back from your friend Angie x

[DizzyD in reply to Teddy2022]

Good day to you Angie, great to hear back from you yesterday. Thank you for accepting me as a friend...i feel truly honoured. I really understand where you are at....fear of things to come,.but we cant write the script for our future outcomes can we? I just hope you are feeling a little bit less fearful today and you can somehow mamage to open the door to " peace" in you mind. Think it was Martin Luther King who said "If the world was going to end tomorrow, I would still plant apple seed today". Nuture seed of belief that you are going to get through your very scary ordeal one day at a time. You are not alone precious. Love and hugs. Your friend Jay

[Happyrosie]

I can give you my husband’s history. Stents 2003. Four years later he had angina when going up hills - the artery between two stents had closed so he was re-stented. Then There’s the annual gp follow-up. Then last year he felt some possible heart issues and had an echo-cardiogram. No probs. So it’s just back to annual reviews.

So my belief is that no checks are done unless there are symptoms. Whether your symptoms warrant investigation don’t t know,

[Sljp0000]

Hi, I had 4 stents February '23 in 3 arteries after failed bypass surgery a few months before. I get alsorts of random pains still. I do have other problems and I simply don't know what is what. My GP and my surgical hospital have pushed for a cardiologist appointment where I had my stents. I've been given a telephone appointment next week. I hate telephone appointments. All my cardiologists have string accents and I struggle to understand them. I'm hoping he might agree to another CT Angiogram or MRI stress tests but I doubt it. I really want to know everything is OK so I can relax and get on with life but I have a niggling feeling my a-typical angina is creeping in again.

I hope you get some answers. Make sure your GP chases your follow up appointment. Keep telling them about your pains until you do.

All the best

Susie

[DizzyD in reply to Sljp0000]

Hi Susie you had 4 stents so totally understand why you need to know everything is OK so you can get on with you life with peace of mind. Hope your cardiologist agrees to CT angiogram or MRI stress test. Good luck lovely, I'll be rooting for you.Thing is, not long after having stent I felt great on a high so there I was shopping for groceries like a spring chick. Forgot about warning not to carry heavy stuff, and there I was struggling to carry really heavy bags of groceries (6 large milk, spuds etc) one in each hand, to car parked well away from store. Whoops! Few days later, chest discomfort started, was no longer feeling so great post stent..could be a coincidence but would like things checked out, due to persistent symptoms, but not only for peace of mind.

In not to distant future, I hope to be getting mini maze procedure to treat severe AFib which will be carried out by a cardiothoracic surgeon in Sheffield. For obvious medical reasons he needs to know stent is OK prior to me having maze procedure.

AFib has got so bad think he may do procedure pretty soon so not having follow up stent check could hold things up. Cardiologists in ACCU (recent admission) really concerned, I could go into permanent heart failure if afib is not treated pretty soon. Time is not on my side, hence the urgency for stent follow up. I suspect cardiologists in ACCU contacted surgeon in Sheffield ( I In Liverpool) re: urgency of my situation so I have a telephone consult with him on 27 March

Ohhh like yourself, for same reasons as you, I don't like telephone consults.

Sincere thank you for your most welcome reply. I now know CT angiogram is test to check stent out.

All things considered, have a prosperous day

Jay

[BaronFrankenstein]

I had a phone appointment the other week and I asked about follow up check before i return to work. She tried ronday i didnt need one simply because its been 3 months since i had my heart attack and stent fitted and i should be ok.

But i pointed out that I do a very physical job and shift work and I thinkni do need a check to see what my heart is like now. Ive been doing cardio rehab classes once a week and walking but i need some reassurance that my heart is good enough to return to my previous level of working.

She eventually agreed and said theyd order a stress test with a scan to chexk blood flows in my heart. I havent had that yet though but i need to return to work before thebend of this month as i stop getting paid sick pay.

[Barre01]

follow up seems all based around symptoms

[DizzyD in reply to Barre01]

On my discharge letter it states: stent follow up check in 6 months. Same stated in a letter from another cardiologist. I reported symptoms to cardio rehab nurse several times nothing happened. 6 month follow up is the usual protocol with or without symptoms.

[pasigal]

The only way to truly know how a stent is faring is another angiogram. Apart from that, an exercise or nuclear stress test can give a good idea about blood flow. At least that's what I understand. I've directly asked my cardiologist about this, too.

Now...I worry a lot about my 4 stents. The first 2 were placed in my LAD artery with no symptons, just near-total blockage. But then 8 months later I had cardiac arrest with a blockage in my circumflex artery, which was not highly blocked earlier (likely a piece of unstable plaque broke off). So, 2 more stents. Was the CA related to the earlier stents? That is my theory, as I never really felt totally "fine" after them -- i.e., opening the LAD somehow rerouted my plumbing, as it were, in a negative way.

[u2bnycpd in reply to pasigal]

Very true. Doctor explained the same to me. It's Amazing how little they can do other than opening a person up an rerouting blood vessals. And with that there is no guarantee of anything. The guy next to me in the hospital had by pass surgery and was there to have mote stents put in. All these surgeries make the hospital a ton of money. The motivation is not to find a better way but to continue with caveman medicine. Watch Dr Ekberg on YouTube and there's a very good Indian doctor in Flirida that also on there Dr Parjama or something like that.. these help you understand why your in this position and honestly what you can do to help your condition.

[pasigal in reply to u2bnycpd]

I think there is a lot we don't know about treating coronary artery disease. I agree with your point about "caveman medicine," although things are changing. The latest protocol is to stent only in very severe cases or if there is an active heart event. The next frontier is diet, I think -- but it's nearly impossible to do a true double-blind study on a significant population, so a lot of what we've been told is just guesswork.

The reason hospitals do stents/bypasses is that they work to treat the proximate cause, in a total population. It is VERY hard, if not impossible, to determine specific causes for coronary artery disease when there are so many factors. Why is it, for example, that everyone who smokes, is overweight and eats a "terrible" diet doesn't drop dead of a heart attack at age 50, while others who minimize those risk factors do? If it's genetics, what are they and how would you approach prevention?

The YouTube doctors are also in it for the money, don't forget. Very few of those guys have ever undergone rigorous scientific review of their work (and I'm not just talking about heart disease). I think there are some promising directions, but most don't stand up to scrutiny -- hence why hospitals tend to stick with critical care treatment options like stents/bypasses, followed up by a standard cocktail of meds, to circle back to the OP.

[DizzyD in reply to pasigal]

When it comes causal factors of CAD doctors focus on patients lifestyle far too much and ignore vital information that does not fit their narrative. January 2020, after reviewing my entire thyroid medication history along with thyroid test results, endocrinologist actually told me that I had been over treated with levothyroxine for over 30 years which had more than likely damaged my heart. How right he was!Further research on my part revealed CAD is caused by hyperthyroidism, but seeing I had no thyroid over treatment of levothyroxine, made me hyper, wired for years, always on the go etc...I looked like a stick insect. So I did have hyperthyroidism induced by levo medication.

Every cardiologist I have seen I always say, "I have CAD because my heart has been damaged due to being over treated with levothyroxine for 30 years" Ohh their sceptical look days a lot. They are not interested in the least as to causal factors...but they love to put onus on people's life style an blame the individual so to speak.

It is not mentioned anywhere in my medical records that I was over treated with levo for more than 30 yrs but it does mention that I did smoke many years ago. ✓✓✓✓✓✓ lifestyle box is not a definitive causal factor.

Dr Kendrick is excellent book to read. He blows many causal factors of heart disease out of the window.

How come cardiology depts are now overwhelmed with more people than ever, from every walk of life, presenting with heart problems since 2021?

How come with the vast array of medicines there are more sick people?

Sorry gone on a rant...!

[DizzyD in reply to pasigal]

If I have to I will get a private CT angiogram. Going by your experience I totally understand why you worry about your 4 stents. I am not medically minded in anyway but I do have a very inquisitive mind and I trust my intuition. If you suspect your CA was related to earlier stents then you are more than likely correct. Docs not going to admit this are they?For every action, in this case medical procedure, there is bound to be a counter reaction somewhere else in the body similar to your analysis, rerouting the plumbing, which could have negative effects of positive ones. So sorry yours was negative!!!

When I was having PCI test to investigate extent of blocked coronary artery, cardiologist told me blockage was 50% an asked me what I wanted to do. I told him to go ahead and fit stent. Later findings, blockage was 80/85%.

By rights, if blockage was 50%, under NHS guidelines he should not have gone ahead with stent because blockage got to be 65%. Well at least I didn't have to wait until I had a HA in order to have stent fitted.

[Paula233]

As well as the advice given by other people, I would keep pressing your GP about your symptons. The GP might run some tests or refer you to a cardiologist.

[Qualipop]

I had HA and two stents done 5 years ago when they also found two 64% blockages that were not stented. I have bad breathlessness and have been trying to find a non invasive way of checking those two part blockages. They really prey on my mind and I'd love to know if they've got worse or not. As for the original stents, I've had echo scans which show blood flowing well and heart muscle good but they don't actually check the stents. They won't do an angiogram just to check. Although they do hundreds the risk is just to o great for simply a check. GP has referred me back and I'm hoping for a CT angiogram as I can't manage a stress test - whenever I get to see someone!

[wischo in reply to Qualipop]

The echo should tell you the health of your heart and show anything sinister. Of course they will not do a routine angiogram just because you want one and even though it is relatively safe it is madly expensive and time consuming. As for the heart disease debate I believe it is all related to genetics and rarely hits anyone with no history of family disease irrespective of their lifestyles. As in some people go bald, get cancer and other genetically inherited conditions so do people with a family history of heart disease, hence the emphasis on lifestyle as genetics is well known but not really understood by the medical profession. Hope you get your CT angiogram soon.

[Qualipop in reply to wischo]

After several years of complaining about being breathless and being constantly told it was muscular ( I have spinal disease) I rang 111 and went to the urgent care centre. The very first doctor to ask about family history was a very young ( they all seem young to me now LOL) newly qualified doctor who immediately recommended an urgent stress test. My paternal grandfather, the youngest of 13 siblings was the first and only one to live past 50. It was called dropsy back then. I remember him being terrified of his upcoming birthday. My mum died after 3 heart attacks but I don't think hers was hereditary; she developed heart damage from having eclampsia in pregnancy with me and lived 45 more years with totally untreated heart failure. She died at 69.

My HA happened before the stress test was arranged- very luckily mild. I think all GPs should be taught to ask about family history as a matter of course, not just for heart but for anything important or life altering that isn't usually thought of as being caused by lifestyle. Maybe when genetic testing becomes more commonplace, it may happen so things can be caught earlier and maybe even prevented.

[wischo in reply to Qualipop]

Fully agree with you although even as they are aware of genetics been the main factor in heart disease I think they feel unable to help unless you have an event. No doubt the future will be more advanced and testing will be run of the mill and eventually better cures and devices will be developed to eradicate our type of problems. In the meantime we just have to put up with what they have which is considerably better than your grandfather and his siblings and I know what most hearties including myself who seem to find it very difficult to be taken seriousely will say. Hard to imagine a muscular condition that makes you breathless?? the mind boggles.

[Qualipop in reply to wischo]

It's better now than when my mum had heart failure. She was never treated at all. Medicine improves constantly but will we even have a health service by then? No, don't answer that LOL.

[wischo in reply to Qualipop]

Ah probably go more like towards the private health insurance sector I think as I think you are much better to be able to have tests before things become an incident?. And the public health system is appalingly lacking in preventative tests as in enormously long waiting lists.

[Qualipop in reply to wischo]

For tests yes but would never want to go to a private hospital for surgery. Too many horror stories. We shouldn't have to b ut with the wait times on NHS, if you can afford it then do it. I've gone private ( without insurance) several times for my spine

[DizzyD in reply to wischo]

Hi wischo thank you your reply. Recent admission to a+e with most terrifying cardio symptoms never before experienced. One cardio doc was very comcerned about mew symptons and choose to focus on stent. She planned tests re stent. Later, a more senior cardio doctor over ruled her an focused on afib....sent me home.Why did the lady cardiologist focus on stent as being possible cause of new styptoms?

[wischo in reply to DizzyD]

No idea although Afib can cause some weird symptoms so good thing the more senior cardio had more experience!!. Would have been a good chance to see how the stent was doing mind you though honestly I despair when I hear such opposite views on a serious medical issue. Hope all is good with you now.

[Avagra]

I had. HA Oct’22 and a stent fitted to my circumflex artery with good results and have not seen a cardiologist since my treatment.They fix the plumbing and that’s your lot !

[u2bnycpd in reply to Avagra]

No idea what your writing. And that's your lot...what does that mean

[Avagra in reply to u2bnycpd]

It means nothing else happens regarding follow up etc !!!