By Erin Golden
Whether you’ve suffered from a heart attack or have chest pain or other symptoms due to blockages in the arteries that supply blood to your heart, an angioplasty can be key to keeping you healthy and improving your quality of life. A balloon that is inserted through a tube (catheter) is positioned into a blocked artery. The balloon is then inflated, pushing plaque up against the artery wall, which restores normal blood flow to the heart. Often, a stent (a small mesh tube) is put in place to ensure that blood can keep moving.
While the procedure typically doesn’t require a long stay in the hospital, it does require careful care in the days and weeks after you’ve returned home.
Recovery times after a percutaneous coronary intervention (also called angioplasty and stent procedure) can vary, depending on if the procedure was elective, how many types of blockages you had, what type of stent you had put in and where the catheter was inserted (the wrist or groin). When you can expect to leave the hospital and what you can — and can’t — do in the first few hours to days following your procedure will depend on these variables. Make sure to get a detailed plan from your doctor or the hospital staff.
All stents provide the same purpose: keeping your once-blocked artery from getting narrow after your angioplasty. But the two different types of stents — bare-metal or drug-eluting — come with different requirements after you’ve left the hospital.
Have a detailed conversation with your cardiologists about the type of stent you had implanted and what your medication regimen will be, advises Amar Krishnaswamy, MD, an interventional cardiologist in the Cleveland Clinic’s Department of Cardiovascular Medicine. The short version: patients who have bare-metal stents typically have to take aspirin and another type of clot-preventing drug for about four to six weeks after getting the stent. Drug-eluting stents, meanwhile, require at least 12 months' use of the same drugs — but they reduce the risk of arteries re-narrowing by about 15 to 20 percent. For bare-metal stents, meanwhile, the risk reduction is closer to 5 to 8 percent, he said.
Your doctor is likely to send you home with a prescription — or several prescriptions — for drugs related to your procedure and long-term heart health. It’s important to be upfront about other medications you’re already taking, because they can affect how your new drugs work.
Antiplatet medications, including aspirin, can be made more or less effective if other drugs — and even vitamins — are in your system.
People who are taking drugs for diabetes like metformin might have to change their routine for a few days, but it’s important to follow your doctor’s specific directions.
A cardiologist’s response to that question can vary widely, depending on the patient — making it particularly important to get a personal response, rather than searching the Internet.
The answer, said Dr. Krishnaswamy, “might be related not only to the stent procedure they have, but also the sort of diseases they may be facing.”
Immediately following your procedure, you need to limit strenuous activity and also avoid lifting, pushing or pulling heavy objects.
Going forward, talk to your doctor about your current level of physical activity and how you can modify it in the days and weeks after your procedure. That conversation can be a great time to see if a targeted, cardiac rehab program might be a good fit — particularly if you weren’t exercising regularly before.
Dr. Krishnaswamy suggests looking at the procedure as time to jumpstart other changes in your life. Talk to your doctor if you’re looking for help improving your diet and your exercise routine, or if you want help to quit smoking. Ask how your current lifestyle could affect the repairs you’ve just made to your body.
“Controlling this secondary prevention of coronary artery disease is going to be just as important of having that stent done,” he said.
Published August 6, 2014
Erin Golden is a journalist based in Nebraska.