chest pain after stent

[Stuart1958]

Hi...just read a couple of exchange on this topic.  Wow.  You guys have some experience!  Please help me if you can.  I'm posting this 2/19 and I had my (first) stent placed during heart cath on 1/30.  I'm a 53 yr-old guy who was very active, non-smoker, good BP and "fine" until mid-Jan '12 when I couldn't do 5min on elliptical without chest, neck, arm tightness...couldn't carry groceries in or clean up dog's paw prints without the feeling coming on. Went to doc next day, cardiologist next, heart cath in 2 days where they found a "Widow Maker" in progress.  99% in second diagonal artery and 90% is left anterior descending.  Metal stent placed in LAD artery, but could not get into diagonal and they "jailed" it with the stent placement since it was apparently out of play anyway.

My new cardiologist is surprised that I'm still experiencing chest pain to the degree I am given that my "artery is healthier than its been in years" and I should be feeling much better. I can walk 40+ mins on the treadmill with no prob, but if I do anything with a little degree of exertion (climb steps, mop up the dog's paw prints) the chest pain starts and works back into my arm/neck within under 2 mins.  Scares the beejeebers out of me.  I have nitro tabs, but have not taken the first one yet. I usually stop and calm it down before it becomes (in my mind) necessary.  

His advice this past Wednesday was to go ahead and attempt to exercise like I did before and take the nitro when necessary to "see how it works...and when I need to take it." (Please reference the "beejeebers" comment above.)  Guys, I've taken it to the wall with these little exertions so that seems enough in my mind to point to something being wrong/weird.

Can you help this rookie understand what's going on here, or give me some questions to ask next appt?  I'm having a hard time with the potential of being locking into first-gear like this for my remaining years.  Thanks in advance for your guidance.  Stu

[Stuart1958]

Thanks much, E.  I have an appt this coming Thursday and feel like I have to prod my doc by asking a bunch of  "How about this?" questions.  It seems extra testing is definitely in order given what you, F'caster have said and from what I've read. Thx again...all additional comments/perspectives appreciated!

[Stuart1958]

Thanks so much for sharing your experience - I appreciate your input into this.  Just coming up with the right questions to ask your doc is a chore in itself!  Stu

[ed34]

Well, I think it would be wise to first have more tests to establish which area is causing the problem. If the LAD is now fully open, then there must be another reason. I wouldn't even be willing to discuss any procedure until I know what the problem is. Otherwise, what will they bypass? you could have 4 grafts and still feel the same. I would ask for a nuclear scan, see if it shows the area causing the issue.

[Flycaster305]

Stuart, I had the same situation as you, but in a different time frame.  After multiple stents in both the LAD and RCA, I developed blockages in the first diagonal on the LAD and in the RCA, and I would experience angina symptoms that I fought for three years.  Drugs helped for awhile.  particularly Ranexa, but eventually angina with exercise wore me down, and I agreed to a triple bypass.  I wish I had agreed to this procedure earlier.  
I'd discuss bypass with your doctor.  

Stay in touch