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constant chest pain after stenting
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constant chest pain after stenting

I am 47 year old male, very athletic but unfortunately 4 months ago I had a heart attack/my left ventricle artery was 100% occluded/ and 2 regular metal stents were placed in my middle LAD. It was a big shock for everybody, especially for me, since my cholesterol was 170 at that time and even during my heart attack my blood pressure was 124/80. Plus genetically nobody has had or died of heart attack among my relatives. I do not eat fried or fast food so my diet was generally ok. My pain never stopped after that- I was experiencing constant chest pressure and shortness of breath but my doctor here did not pay any attention. He was saying that “etiology of my pain is not known but it shouldn’t be anything cardiac since my stress test was ok”.Last month I ended up in the emergency room with re-stenosis /one of the stents was clogged 99% and another stent was placed inside of those two. This time was Xience 5- drug eluted stent that went inside other two. The doctor started paying a little attention and even apologize that he did not listen to me.Since then/it’s been a little over a month/ I continue to experience the same problems. Every day I have pain- it doesn’t matter if I exercise or just sit in my office. The pain may start in the middle of the chest but moves to right or left, goes to back/upper part only/ and my shoulders/. Right above my breast bones hurt sometimes more and it is very tender to touch. Before I had my heart attack, I have never experienced anything like that- everything started after the stents were placed. Any suggestions or comments will be greatly appreciated- I can not function normally. I hope the stem cell science will advance much faster than we anticipate and will bring a new avenue and hope to people like us.
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Avatar_n_tn
i have the same pain you do. i had 2 stents in dec 09 and have had chest soreness ever since. its not heart related, i can exercise and it doesn't increase the pain. it is like the bones and muscles in my chest are always sore, some days more than others. i am very healthy, not overweight, eat healthy and take supplements. i quit the statins a month ago, thinking that may be the problem. chest xray showed no problems. ??????
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976897_tn?1379171202
This is something which research is trying to establish because there are so many schools of thought. Some believe the heart muscle is maybe damaged in ways not yet understood, others seem to think the muscle aches as it recovers, some believe it's the pressure of the stent against the artery wall and the list goes on and on.
I have six stents and dont have any of the pains described, so I could assume it isn't stent related. However, it is possible that our bodies react in different ways to stents. I had my first stent in feb 07 and this caused no discomforts whatsoever. I had 5 in sept last year and they seemed to pinch for about three weeks, everytime I inhaled it felt like someone was pinching my heart. I was told to drink lots of fluids and take things easy, then three weeks later they disappeared. I do know people who still feel the pinching, even years later, and some people who experienced restenosis within weeks. I wonder if the pain from stenting is due to how the procedure is actually done. All my stents were put into clean locations, i.e. the disease was completely removed before the stents were squashed into the artery wall. I can imagine that if a stent is simply forced against hard plaque into an artery lining, it will cause a lot of damage and probably inflame.
In my first stent (in the circumflex) there was only soft plaque which was removed and caught in a tiny net, then removed. My LAD which had the other 5 stents was rotablated from top to bottom.
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367994_tn?1304957193
Prinzmetal's angina are spasms and should be suspected by a cardiologist when the pain occurs at rest and/or in clusters, and in the absence of a positive treadmill stress test, as Prinzmetal's is exercise tolerant and can generally only be diagnosed after other forms of cardiac disease have been ruled out.  Has your doctor ruled the variant angina (spasms) out?

There could be small (micro vessels) coronary veins that stiffen and unable to relax and there isn’t yet an easy way to identify coronary microvascular disease. The best test so far, called coronary artery flow reserve or coronary vascular reactivity, requires maneuvering an ultrathin wire with sensors at the tip into a coronary artery. It measures blood flow and pressure before and after infusing into the heart medications that should cause microvessels to dilate. The smaller the change in pressure and flow, the stiffer the microvessels, etc.. Has there been an evaluation to rule out microvessel disease.
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1210142_tn?1266080631
I stopped the statin/Simvastatin/ for a month but unfortunately my cholesterol went up/the LDL/ and I started them again. Chest X-ray and CT scan were all normal. I am meeting pretty soon an internist- was told by my doctor that they can diagnose problems that are somehow difficult to understand. Will keep you posted.
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1210142_tn?1266080631
I spoke with the doctor about variant angina- he doesn't seem to believe this is the problem. Doctors sometimes are sceptical, they think they know a lot of things- in the reality you are the person who needs to find out what is wrong with you. Will keep you posted as I mentioned in my previous post. Thanks for the reply
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367994_tn?1304957193
Thanks for your response.  Keep us informed as you have an interesting and difficult to medical problem to  diagnose and the case can go into the archives for future reference for a similar condition..
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1210142_tn?1266080631
Just did lots of test after I met with the Internist. He stated that he could not find the cost of my pain. The only abnormal test was so called high sensitivity C- reactive protein- the results were 9.9...too high. The cardiologist told me that I have a heart disease/ he know already that/ and this test is a good indicator for people who did not have heart attack or disease to see if they are predisposed for this. Homocystine levels, 25 hydroxy D, CK- all those test were normal. Have no idea why the pain continues if the cardiologist thinks IT IS NOTHING CARDIAC...
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976897_tn?1379171202
Hi Tony, I think personally that Kenkeith could be right with regards to the variant angina. Cardiologists worked very hard on restoring my LAD and my EF is 70%, yet I was suffering lots of discomfort. My discomforts always appeared during exertion, but nuclear scans, EKGs, Echo scans etc all revealed no problems. I even had a lung function test. In the end, my latest cardiologist prescribed nitrates which did nothing but give me headaches. He felt sure that there was nothing wrong with my heart, it was due to spasms of the arteries. I visited my local Doctor stating I couldn't tolerate the nitrates, and to be honest they did nothing for my condition. He started me on calcium channel blockers which have given amazing results. All pains have stopped and I was still getting short of breath. However, over the last 24 hours I have noticed a huge improvement with that. I can now run upstairs and talk normally.
When cardiologists are at a loss, this is a good thing to investigate, or at least try medication for it, to see if things improve.
You know, before my MI events, and stenting to the LAD it never used to spasm. I had 5 angio procedures and never did that vessel spasm at all. Even bypass surgery had no spasm present. On the 6th angio procedure when they stented the LAD, it went nuts. So I assume it is having spasms due to the stents.
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1210142_tn?1266080631
I don't know....every muslce on the chest hutrs...like it is coming from the bones. I don't think it is a variant angina, most likely muscular or God knows...naturophat prescribed some calcium and magnesiim so today I will start taking them and I am meeting another internist in about 3 weeks. The previous one told me that "etiology of my pain can not be discovered"- very sad but true...
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976897_tn?1379171202
It seems a bit of a coincidence that everything started after stenting though. I had never had a spasm and never had one been seen during my 5 previous stenting procedures or bypass surgery. Yet, on the 6th angio procedure, stenting my LAD, my artery went nuts. I too felt all kinds of aches and pains that I thought were my chest bones. I was very shocked when it all went away with calcium channel blockers. Maybe it is bone/muscle related, but the timing was just a bit odd to start occurring.
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237039_tn?1264261657
I am surprised I didn't see this before.  I have for a long time complained that the chest pains I have started after the first stent and I wondered if my body was rejecting it.  As soon as they finished the procedure with the first stent in 2004 I was still lying on the table when Igot the most incredible pain in my chest.  So much so, I screamed.  The doctor turned around and looked at the monitor then me and said "it's probably your back".  What?!   Let m know how you are doing. Ally
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1210142_tn?1266080631
It is possible to be my back- I have had back problems in the past. The coincidence though is something that worries me. Will see how calcium and magnesium do for me and after I meet with the internist and naturopath, will have more information. Thank you for the input though.
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1210142_tn?1266080631
Just a bried follow up after a few months. Today is 08/31/10 and chest pain is still there. Nobody can tell me anything- the doctors are just puzzled. I noticed that when I walk up the hill I feel incredible tightness in the chest and have a feeling that my lungs are burning- as soon as I started walking dowhill the pain disapears. The problem is that my chest bones hurt every time when I am even sitting and I have to "massage" them to fill better even thoug it does not help very much. I am pretty sure it is stent related  and somehow the artery/ies/ is a little damaged but who am I to guess...Any advise or support will be appreciated.
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976897_tn?1379171202
Have you had a recent stress echo test to see if your heart is working properly under exertion?
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1210142_tn?1266080631
Not recently but the last test was very good. The doctor is shure it is not cardiac related. I had an angiogram in April and the stent was wide opened.
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976897_tn?1379171202
I saw a Cardiologist back in November who said my problems are no longer cardiac related. Another Cardiologist said that it was due to spasms. I visited my regular Doctor who agreed with me that this is angina and not caused by spasms. She demanded that my Cardiologist organise a lung test and echo stress test. The lung test was fine. For the stress echo, they slowly injected some agent into my blood stream to get my heart racing. I was soon suffering throat discomfort, shortness of breath, jaw ache, chest pains, nausea and dizziness. The images reveal an area of heart muscle near the bottom of the left ventricle not getting enough oxygen for exertion. Maybe ask for a stress echo to see if your heart is coping properly under stress?
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237039_tn?1264261657
I went back to the ER this past April with chest pains that were the very same type pain I had with my heart attacks.  It turned out to be heart spasms.  My cardiac enzymes were good, the echo I am not sure of as I didn't care to ask.  The cath showed a new blockage that would need bypassing, but it was flowing at around 50%.  So they concluded that the chest pains I had been having several times a day every day were from the coronary artery spasms or prinzmetal angina.  This is rare, but it was treated with a calcium channel blocker.  It took some trial and error to find the right med and combination of meds, but the spasms have settled down quite a bit.  And I use a long acting nitro and quick acting nitro. That's my case, but may not be in yours.  Take care, Ally
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1210142_tn?1266080631
Thank you very much. When I see cardiologist next time, definetely I will talk to him about stress echo test...
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237039_tn?1264261657
Please keep us posted and take care!  Ally
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1210142_tn?1266080631
What is the name of the test exactly? Is it a nuclear stress test or...? I look for echo stress test on the Internet- they don't mention to inject anything, that's why I am curious what is actual name? Also what kind of calcium channel blockers did you take? Thanks again
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