Nature of improvement after a stent - British Heart Fou...

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Nature of improvement after a stent

Cetus profile image
15 Replies

After a STENT, do patients typically experience a functional improvement in energy/power when moving around .... or is the improvement typically in reduced angina chest pain?

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In my case, my coronary PDA artery (posterior descending artery) was 80% blocked. Google tells me this artery branches off the RCA, and it provides about a third of the coronary blood supply to the Left Ventricle of the heart. I have seen marked improvment in energy when walking -- and also in my clarity of thinking.

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Cetus profile image
Cetus
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mjames1 profile image
mjames1

With severe five vessel disease, I had six stents placed but noticed no real functional difference afterwards.

That said I was somewhat asymptomatic prior, other than some intermittent chest pains that may have been angina and/or gastro related.

Going into the procedure I thought I might feel 10 years younger after in terms of aerobic capacity, but being In my late 70's maybe expecting too much. At least my heart attack risk is greatly diminished so they tell me :)

What were your symptoms before and how old are you? Glad you're feeling a lot better.!

Jim

Cetus profile image
Cetus in reply tomjames1

Thank you for the information. By the way, what is "five vessel disease"? Google isn't clear about it.

mjames1 profile image
mjames1 in reply toCetus

It means significant blockage in all five major coronary arteries.

Jim

Cetus profile image
Cetus in reply tomjames1

That sounds like they would give quite some difficulty! However you sound lucid and coherent in your post. Did you say you were just as functional before having stents fitted?

I had only a single stent in my posterior descending artery (80 percent blocked) and it improved my foggy thinking a great deal. I am now wondering if something else unrelated to stenting occurred by co-incidence that improved my cognition. Do you have any thoughts about this?

mjames1 profile image
mjames1 in reply toCetus

You can be quite symptomatic and dysfunctional with single vessel disease and asymptomatic with five vessel disease. Therefore, the saying, " the first symptom of a heart attack is often sudden death".

Jim

my husband had a big increase in feeling more energetic, being able to walk further and faster.

MountainGoat52 profile image
MountainGoat52

I think the answer here is that we are all different and stents will make a difference to us in various ways. I had a heart attack due to a blood clot in a severely narrowed right coronary artery. The clot was removed and a double length tent put in. I felt fit and well before the heart attack and regularly walked the hills and mountains in Scotland, so I wasn't expecting the improvements that happened.

The improvement in my cardio-vascular system had several effects. I took off 7kg in the first week, I found I could stand and chat with someone without having back ache and perhaps least surprising was that I walked up hills quicker with fewer stops. I did have bypass surgery a year later and the change it made was minimal, but as my surgeon told me, the investment there was for the longer term.

Cetus profile image
Cetus in reply toMountainGoat52

Was that 7kg due to fluid retention caused by a heart condition that the stent remedied?

MountainGoat52 profile image
MountainGoat52 in reply toCetus

Maybe. I won't know by what process it reduced as none of the medical team ever commented. I didn't have a heart condition, just partially clogged arteries, hence the clot. I guess the increased blood flow just made everything work better.

pete109 profile image
pete109

In my case, I had no symptoms at all before the stents, they were from tests for a problem with intermittent Hypertension, it's the associated meds and their side effects that cause the problems for me, bear that in mind when looking for signs of instant improvement.

Pundit999 profile image
Pundit999

I had an almost totally occluded LAD. So yes, there was a marked improvement in my exercise capacity.

If you have stable angina (where you do not have a heart attack but have pain when you exert), you should see improvement in symptoms but it all depends on how much the blockage is. If it is less than 70% or so, you probably won't feel a thing. Higher and you should see improvement in many cases.

Stents will not prevent future heart attacks in most cases. They improve your life though, in many cases: you can exercise more, have less or no pain etc. But all cases are unique.

It is great that a stent has improved your life much like it has improved mine.

mjames1 profile image
mjames1 in reply toPundit999

I had 95% occlusion in LAD and RCA and I was as asymptomatic. It's called compensatory collateral circulation and not uncommon. That's why the first symptom heart attack is often sudden death, ie no symptoms proceeding. And stent can prevent future heart attacks that's one of their main purposes.

Jim

Pundit999 profile image
Pundit999 in reply tomjames1

I also had extensive collaterals that allowed me to function normally for over a decade with the LAD blocked.

Let us agree to differ.

But it is generally agreed in the field that stents do not prevent heart attacks. Most heart attacks are caused by a sudden rupture of soft plaques and not a gradual narrowing of arteries through stable plaques which are stented.

nih.gov/news-events/news-re...

mjames1 profile image
mjames1 in reply toPundit999

But it is generally agreed in the field that stents do not prevent heart attacks

It's not one or the other. Yes, it's true that most heart attacks are caused by broken off plaque as opposed to a single large blockage. However, that doesn't mean you're not at a higher heart attack risk with let's say a 95% blockage of the LAD., as discussed. In such a case, stenting the LAD will reduce your heart attack risk, which is why they recommend stents (or CABG) in many such cases versus OMD. This isn't my opinion, but what I was told by multiple interventional, cardiologists and surgeons before I had my PVI's..

Jim

JohnWesterdale profile image
JohnWesterdale

Should there be more focus on ways to reduce deposits? There was a look into reverse cholesterol transport for Trodusquemine. abdn.ac.uk/news/22656/ but there: en.wikipedia.org/wiki/Trodu... in that article: "Phase I clinical trials of trodusquemine have demonstrated good tolerability, but several planned phase II trials were halted due to financial difficulties of the developer.[4]". Not that it didn't work but someone put the brakes on development? Hmm. For near term, ratio of triglycerides/ HDL is supposed to compare tendency to form vs resorb arterial deposits. My HDL has always been below ,40... Looking for elevation strategies!!

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