Post NSTEMI chest pain'

[Hugiebear]

I had NSTEMI a year ago and have suffered constant chest pain ever since but never pre heart attack. I had seven stents inserted and suffered a dissection during the procedure. Cardiac MRI showed nothing conclusive but did show improvement in LV function. I am now 80 yrs old and apart from the pain have made steady progress. I have just had a telephone consult with my third cardiologist [ dont ask ! ) whose diagnosis is coronary artery disease and presence of seven stents. He is going to try me on a new tablet , and review in two months. Are any of you worse than before you started following NSTEMI ?

[AlfredV]

I was told I should be up and back to normal within a few weeks of having a stent placed. The reality was that I had periods of chest pain virtually every single day for a little over a year afterwards. My only saving grace is that I know from experience what a heart attack feels like, and this pain was different, but just as debilitating. I sought answers but didn't get any. Fortunately it slowly cleared up.

Hopefully things start to ease up for you soon.

[Hugiebear in reply to AlfredV]

Thank you Alfred V. Its good to hear you have improved and I hope you stay well. We are very lucky to be offered these procedures but Im sure it would help us all if we were kept more informed. Thanks for yhour reply.

[Hugiebear]

I was the same re troponin levels and GTN spray although occasionally I did get some relief from the latter. I do think patients should be warned about pain after stenting as its the not knowing that really gets me down. However, in spite of it all its good to be alive. Thank you for your post.

[pasigal]

i have had on and off chest pain in the past year after HA + 4 stents. I've also gone to A&E a few times and had troponin levels checked. It's very, very frustrating. For me it's noticeable when I take a deep breath, kind of at the very end of the breath. It's in the center around the breastbone. I'm sure my cardiologist thinks I'm a hypochondriac. It's not exactly angina as it doesn't get worse than a dull ache, but it's really unsettling. It could also be related to reflux but I kind of doubt it.

[Hugiebear in reply to pasigal]

Thanks for your response. My pain is centred just below my collar bones and is pretty much all day. However, I am having two or three better days each week and dont feel so ill as I have done. I get a lot of back pain with it which is very tiring .The tablet Im going to try next is ranolazine ( ranexa ) so heres hoping for a good result. I also have reflux but I seem to be able to tell the difference in the pains. Hope you improve soon.

[AlfredV]

This is interesting as my story is very similar to yours. Same artery with a 95-99% blockage. I wonder if there is something specific about accessing that artery that makes the ensuing problems more likely? The GTN spray has never worked for me, if anything I'd say it results in more pain, which I know sounds bizarre.

[Hugiebear in reply to AlfredV]

I had partial blockage in three arteries all of which are stented. We know the body will try to reject anything that shouldnt be there so I suppose it makes sense that there is a reaction to the stents, I live in hope that they will settle in and I can forget they are there.

[Karabiner]

Hugiebear, I've been round this tree before. I'm currently dealing with chronic pain following a third event. To keep the history short. STEMI in 2006, and no problems following two stents in LAD for 9 years. 2015 NSTEMI and a stent placed in LAD overlapping with previous 2 stents. That event set me up for several ED visits and ongoing on and off pain for nearly 18 months - eventually it seem to fade out. 2022 another STEMI - RCA - one stent. Last 6 months been dealing with multiple ongoing pains, chest, left arm, back, and neck. Been back into ED 5 or more times - always clear on ECG and Troponins. In fairness to cardiology team, they have bent over backwards to see if it is the heart - Exercise Stress Test, Repeat Echocardiogram, 7 day Holter Monitor, and repeat Angiogram - nothing abnormal! I don't get exertional angina, GTN has never worked, etc... I'm seeing a pain specialist next week. What I know from what I've read is that some folk are prone to post-surgical chronic pain syndromes, others to trauma initiated chronic pain syndromes. In some cases, pain perception is sensitized by traumatic events, and this is a result of the central nervous system being stirred up. Ongoing pain may not have anything to do with your heart, but that needs to be clearly ruled out first. I hope your symptoms improve and you get appropriate support. Pain perception is never "just in your head", but it might not be from the heart either.

[Hugiebear in reply to Karabiner]

Thank you for your reply. My goodness I thought I had problems! I agree with what you say about pain and how we each feel it. Its a pity no one has managed to invent a pain ometer, that would silence the ones who want us to believe its " all in our heads "! I really hope your health will improve and you stay away from MIs and stents. Good luck.

[Milkfairy Heart Star in reply to Hugiebear]

Oh I like the idea of a pain ometer!

I Iive with vasospastic angina. My coronary arteries are unblocked however my coronary arteries go into transient contrictions causing a lack of blood supply to my heart. It is very painful, the vasospasms can be severe and long acting.

This type of angina causes chest pain at rest rather than exertion.

It's difficult to diagnose.

When my coronary vasospasms were confirmed by specialised angiogram I felt vindicated.

I actually said to the Cardiologist who did the test ' so not in my head then?'

His response ' no not in your head, you have a physical cause of your pain'

Just as a thought there are some patients who have persistent chest pain following stents. There is a growing awareness that coronary vasospasms maybe responsible.

academic.oup.com/eurheartj/...

[Squash1961]

Hi BraveheartIt was interesting to read your theory behind your on going chest pain. I had a very similar episode, STEMI followed by a stent in the RCA. After which I had no pain, but within 12 hours of the angioplasty procedure, I had a stent thrombosis (blocked RCA where the stent was rejected) and was rushed down for an emergency procedure to clear the blockage. I assume this was quite an aggressive intervention.

This was 2 1/2 years ago, but I have had continuous chest and rib aches. Like yourself, everything has been ruled out and is not heart related. I did question whether there could have been damage from the procedures, but this was dismissed. My pain is worse when I twist (which indicates muscular damage) no pain during exercise.

The nerve damage you are suggesting. was that the eventual consensus of your cardiologist and GP? Also, how do you manage the pain?

Any advice would be appreciated

Thanks