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1210142 tn?1266077031

constant chest pain after stent placements

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 left artery. 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 on the top of those two. This time was Xience 5- drug eluted stent that went on the top of the other two. The doctor started paying a little attention and even apologize that he did not listen to me.Since then/it’s been only 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 universal
I have been reading all your post and surprisingly, I am also a patient with constant chest pressure and light headedness. I am post op 2 stints placed 4 months ago. I have been changed to so many different medications, I can't keep up with them. I just went to my cardiologist this week and told him he has to do something, I just want to be myself again. Never had the first symptom of anything prior to my heart attack.  The blockages were 80 and 90% with no heart damage. They did tell me I had other small blockages.  I have had negative echo showing no CHF. I have had a negative chemical stress test. My cardiologist has decided to do another heart cath this week to see if there is anything else going on.  I get so out of breath just walking up the stairs. I am going to cardiac rehab and they will not let me advance because my heart rate jumps up to 20+ from a resting heart rate too quickly. So if any of you have any insight what so ever, PLEASE fill me in. I am only 46 and desperately want to get back to myself.  THANKS!!!  
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Avatar universal
I had an MI 1 year ago and 2 stents put in at the time, one of them due to creating a tear during placement of the first stent.  they were also placed in an artery which I later found out had nothing to do with heart attack.   The entire experience soured me on interventional cardiology.  Later learned that stents do not decrease mortality unless they are used during a heart attack to save a patient.

I would say, get a second opinion on the need to stent, avoid if possible.   I would also recommend that she go on a strict diet which supports her vascular system.   This will enhancing nitric oxide production (which relaxes the vascular system) and support endothelial health.   This can be done in large part by strictly reducing saturated fats and greatly increasing quality plant foods, especially green leafy vegetables.   If she can go cold turkey on all animal products and junk food of any sort all the better.  A side effect of a good diet will be lowering lipids and blood pressure and often a decrease in angina.   Ensure sufficient magnesium as well as it helps relax the vascular system.    A small amount of grape or pomegranate juice or red wine daily is helpful too.  Also, unless the doctor prohibits, she should try to walk at least 20 minutes everyday.    
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Avatar universal
I know this is quite an old post but was wondering if any of you guys can give advice from past experiences etc.. My mum is 50 years old and had a heart attack 2 months ago. One of her arteries was 100% blocked and one other was 50% blocked. She had one medical stent in the 100% blocked one and they said she can come back in 6 weeks later to have the other stent in the 50% (they didn't believe it was too serious). Anyway, a few days later she had chest pain and left arm pain, was rushed into hospital and they decided to do another angioplasty and stent the other main artery (this time they did a blood flow measure and found out that it was actually 80% blocked as oppose to the previously thought 50%). They also put a stent in a smaller artery that was 80% blocked.

A few days later again, she was rushed back into hospital with more pains. They did a trophin level test which came back positive so they did another angioplasty. They found that they had cut one of the main arteries when they did the previous angio. They then stented this. Therefore all in all, she has 4 stents.

After this she was still having pains and was rushed into hospital another 4 times with more pain. They have said its not the heart. They have done a ct angio, nuclear stress test, numerous ECGs, ecco's perfusion test all have come back clear. They said the pain that she is experiencing seems to be costa condrotis (not sure of spelling :)). She has also had 2 treadmill tests- one she did 9 mins and all was clear then we got one another with a different doctor who didn't look at her history. She lasted 10 mins however, her ECG during this test was a slightly unusual. He said you might need to have another angio so we showed the results to the cardiologist who did her stents and he said the fact that she lasted 10 mins with no pain, the ECG is insignificant and he said that it is likely to be slightly unusual due to her having 4 stents and 3 angios.

They said the pain is Costa condrotis and we have rejected the next angiogram to see how things work out. I was wondering if any of guys could give your opinion on this. My email address is ***@**** if you want to get in contact with me or just post back on here- would really appreciate all of your advice just so we get idea- thank you :)

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1210142 tn?1266077031
That's what I thought too:) Thank you very much. It gives me an additional reasurance to focus on the food versus supplements. Thanks again
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Avatar universal
The study you refer to, from the Fred Hutchinson Cancer Research Center in Seattle, looks like a serious piece of research.

Add to that the Italian study earlier this year, published in the May issue of the New England Journal of Medicine, which found that fish oil did *not* protect at all against cardiovascular disease.

The morale of these articles might just be that the subject of food intake and metabolism is more complex than anybody thought, and that the composition of the whole diet is likely to be more important than supplements, especially supplements that are self-prescribed with little understanding of how they might work.  Here is more info:  

http://www.health.harvard.edu/blog/fish-oil-friend-or-foe-201307126467

My personal suspicion is that genetics are going to turn out to be the key, and that the much-touted Mediterranean Diet may work best in genetically related people who have lived in the Mediterranean area for thousands of years.
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1210142 tn?1266077031
Has anyone heard or knows more about the connection between fish oil supplements and prostate cancer in men? The newest study has some data and sounds a little scarry! Thank you
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Avatar universal
Wow.  Thanks for the update.  What a detective story.  I hope there is some solution in the future for you.
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1210142 tn?1266077031
The last thing the doctors found was an alergic reaction to cobalt- my first bare metal stents are  made from cobalt. I am in Europe now and some doctors believe it is possible to remove those stents that cause alergic reaction even though it is very difficult and in the US doctors would never consider this. My chest pains are up and down and this is the most frustrating part. Lets hope your pains will get better but you have to really push to find out the cause of it.
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Avatar universal
Hi,  was reading Tony969 posts and wanted to join in since I am just had stents one week ago and also feel worse than before.   Like Tony969, I am also a Hodgkins Disease survivor and was treated with whole body radiation in 1978.

I am a 58 yr old male.  I have been experiencing chest pain (slight) for over 10 years.  I have had high BP controlled to 120/80 for over 5 yrs with 50mg ToprolXL and 40mg Monopril taken in split doses morning and night.  I also take 40mg crestor and 325mg aspirin daily. I have also suffered from pvc's.  

A year ago my cardiologist ordered a calcium scan which came out with a score of 97.  A stress test was ordered and nothing was found.  My ekg's / ultrasounds and enzymes have always been normal.  I wore a monitor which recorded approx 400 pvc's per day (doc said they are not concerned until over 1000).

Upon learning my calcium score, i started taking two 90mcg's per day of k2mk7 for 1 yr to present time.  Also added fishoil, flaxseed, haulauric acid, D3 and a multi.   The PVC's had pretty much disappeared which I attribute to the K2mk7 and was looking forward to a repeat calcium scan in July 2103 to see if my score had increased or decreased.

On April 23/24/25 2013 i started to experience bouts of chest and arm discomfort where my usual 120/80 bp would rise to about 180/100 and i would take some advill, a crushed aspirin and an extra 25mg if toprol and after about 2 hours i would return to normal.  After 3 bouts in 2 days, the last bout happened at night and i woke up sweating with the high bp readings and severe pain in my left arm all the way diwn to my palm.   It was about 5 am so I got up, dressed and drive myself to the hospital.  I was admitted......all day there.....chest xray / ekg / blood / ultasound were all normal but they wanted to do nuclear stress test.  By now the day was almost over and my cardio who came to the hospital looked over all the stuff and told his replacement to send me home once the result of the stress test came back since everything seemed ok.

At the very last minute, before being checked out, they decided the stress showed a possible blockage and said I had to stay for an angioplasty....It was now late Friday evening 4/26/13 and they transferred me to another hospital for the procedure where they could do it on a Saturday.  

I had the procedure done on 4/27/13 and ***4**** blockages were found..... 2 were 100 % and collaterals were formed and two were 70 and 90 and two stents were inserted.   After, my BP was now down to the 110/70 range, i felt well and went home.  Plavix was added to my drugs.

This great pressure lasted for 2 days and abruptly rose to the 135/90 range and started rising until i returned to the hospital 5 days after being released with readings back at 170/100 range....  Ekg normal / enzymes .29 and dropping (which they attrbuted to being "in there" for the angioplasty.)  A second angioplasty was done the same day and was expanded to include the kidneys....  Stents were found to be open and no further blockages or kidney problems were found.  They added a nitrate to my meds and sent me home with constsnt pressures of 133/85........much higher than I had for years (120/80) and even higher than the 110/70 when the stents were out in.

I dont understand how i now have more chest discomfort / higher bp / and more drugs than just 2 weeks ago and AFTER having stents placed which should have helped me!
I have more discomfort now than before.
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1210142 tn?1266077031
Sorry for the typos, too much work:)
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1210142 tn?1266077031
Thank you:) The doctor prescribed a new medication for chest pain- Ranexa- red good things about and will give it a try. It is a little more expensice though I anticipated but if it helps- it's worth the money. I have read all about different diets, have watched countless presentations, can see the points but does not mean I do agree with them. I have excluded red meats from my diet/even though I am not sure if I should do this 100%/ but I will stick with fish and poultry for sure. Lots of countries in the world consume tons of meat/particularly fish/ and have longevity that is 5-10 years longer than US. I am just tired of this propaganda, stupid advirtisements, false diest, etc. Use your judgment but never become obsessed with things that promise to "work". I do agree with Ed on a lot of things and this "diet" is not proven to work on people with stents, like us.
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Avatar universal
Hi, Tony.  Glad to hear from you.  Sorry you're still having difficulties.  Just wanted to say hi.
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976897 tn?1379167602
He doesn't mention what happens to arteries which have stents. I think a stent holds arteries open, which means they cannot contract. I take it that this means they are unable to expand further also? Another problem with arteries is scar tissue formation, which he doesn't mention. As far as I know, nothing removes this.
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Avatar universal
Granted Dr E does not do as good a job explaining the mechanisms as I would like.  But the diet he advocates helps with NO production and dramatically affects lipids levels - both of which are helpful for cardiac patients   I went on a plant based diet very close to what he and Neal Barnard and other vegan advocates recommend and my lipids dropped like a stone.  LDL is consistently around 60 and TC is about 120.  I took myself off of my low dose statin for two weeks and retested after consulting with cardiologist and lipids barely moved up.  An older Ornish study also showed benefit using a plant based diet, but Ornish also advocated exercise and stress reduction.  In both cases, Ornish and Ess, some patients who underwent  angiograms which indicated either no progression or some reversal in blockage, unlike the controls which showed progression.  I would like to see studies with larger numbers of patients, including substantial numbers with stents.   Dr Ess is supposed to have a paper coming out soon which decribes the results of about 200 patients who followed his approach compared to patients with a similar profile who did not.  He touched on the results briefly, but there was not enough data there to satisfy me.    The Ornish and Esselstyn papers can be found using google scholar if you are interested.  If nothing else, I am a firm advocate of doing one's  homework as I have learned that my doctors will not tell me all that i want or need to know..  
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976897 tn?1379167602
I watched the presentation with great interest, but I am left asking some questions which were not answered really. For example, in the first part of the presentation he repeatedly states "heart disease is reversible" and yet this hasn't happened in any of his patients that I can make out. What he later says is "so what's happening with these patients, well nitrous oxide is increasing and making the arteries dilate, allowing more flow past the blockages". So to me the word 'reversible' is misused. The disease is still there. Another thing is he doesn't mention the involvement of white cells fully, in particular macrophages. These critters break open the lipids to reveal the raw fat inside, and fat is sticky. Nitrous oxide will not stop this being sticky and attracting further problems. I simply don't understand all the mechanics behind it. He also stated that within hours after eating a bad diet, the arteries were affected? really? The liver produces lipids mostly when we are sleeping, so how can the food be digested, turned to lipids and then sent into the blood stream that quickly, along with lowering nitrous oxide levels? Again, no real explanation. As far as I know, the human body can happily digest meat and fat. Eskimos managed it with no issues and no heart disease. We can go on blaming omega this, omega that, but it seems every year there's a new blame.Sorry for being so pessimistic but I have friends who have eaten nothing but fruit and veg since their teens, and they have heart disease.
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4612161 tn?1357163528
MEDICAL PROFESSIONAL
You should consult your physician about your pain especially since you have multiple stents and have had restenosis.  The pain you are having may be angina.  The tender rib pain is unlikely to be cardiac, however if you have pain similar to the pain you had prior to the stents you should definitely see your physician.  If your vessels are unchanged, it is possible you need more aggressive medical management for angina.
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Avatar universal
Try Dr Esselstyn's approach.  It has helped me..   I had two Xience V stents placed last Sept.  

go to minute 50 and watch about 10 minutes worth if you don't want to watch the entire presentation.
http://www.youtube.com/watch?v=J6pLRdawBw0


  
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1210142 tn?1266077031
Thank you Ed. I do take Ubiquinol on regular basis- the problem is with the chest pain,,,have you heard about Enhanced External Counterpulsation or EECP?
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976897 tn?1379167602
apart from nitro, I don't know what they can do with microvascular disease. I recently read a report here in the UK that research in Europe has just revealed huge benefits from taking COq10. After 5 years, survival rates in the group taking COq10 against placebo was 50% up. They discovered it seems to improve the heart in many ways. Perhaps it would be worth looking into this a bit more. I think there are different types of COq10 and I'm not sure which is the one that has the benefits for the heart.
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1210142 tn?1266077031
Hello everybody. It has been a long time and chest pain is still here. 4 angiograms did not reveal anything. Now the doctor thinks it is a microvascular angina/syndrome X/. Please, give me all possible ideas for treatment from prospective and expirience- need to see what my options are. Thank you in advance
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Avatar universal
I had a similar scare last year at age 49 with BP that shot up within a year. They sent me in for chest x-rays, EKG and everything was ok but they put me on .1 mg Clonidine for BP. Scared as heck I started on a plant based diet 10 months ago and haven't looked back. In 2 months I was off the Clonidine and Lisinopril with a baseline BP of 115/65. On your case I think this diet would be perfect as it will reverse the blockages and eliminate the need for stents and/or bypass surgery. Most importantly it will reduce your cholesterol to less than 150 which is where heart attacks cease to exist. I'd recommend reading "Prevent and Reverse Heart Disease" by Caldwell Esselstyn. It has literally changed my life for the better.
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Avatar universal
Hello Tony,

Hope by now you are doing better.  A thanks goes out to j2iron. In addition to the "Prevent and Reverse Heart Disease" book, I watched Esselstyn's DVD, "Forks Over Knives and listened to Campbell's "China Study."  I'm convinced, we can control our cholesterol levels.  But, I'm not convinced its the only player in cardiac artery occlusions?.  I'm beginning to think that in some cases  it may be more related to the worst types of LDL i.e. LP(a).

The Caldwell Esselstyn "Forks Over Knives" program is extremely effective in lowering cholesterol. After following this regime coupled with Linus Pauling's suggestion of Vitamin C (I use the calcium ascorbate form and L-lysine/L-proline) my LP(a), decreased from 167 to 22, and I saw a large 74 point drop in my cholesterol in 3 months.  

Tony, you may want to take a look at your LP(a).  This was a major player for me as it's a very bad type of LDL cholesterol. My cardiologist at the hospital did not even test for it.  I had an excellent Internal Medicine doc that mentioned it and I requested I be tested for it.  Docs sometimes don't like to check for it as some are under the impression nothing can be done to improve it but niacin has been shown to be effective. For me the Forks Knives and/or Linus Paul programs seemed to help.  I'm also on niacin. If the placebo effect is active player here, I don't care.  As long as the LP(a) and other bad cholesterol went down, that's what I want. If mind over matter is what did it... so be it.

I'm not completely without sleep associated angina attacks, by this I mean they never happen when I'm awake or exercising, but the incidence has decreased dramatically to only several times a month. I've decreased my stress levels, and I'm also following Dr. Sinatra's suggestions using CQ10, L-Carnitine, and D-Ribose.  

For religious and philosophical/creed related reasons, I take no medications. On the negative side, I do slip off the Forks Over Knives program more frequently then I should.  My biggest negative is cooking with olive oil and eating chicken, but these behaviors have negative consequences in my cholesterol levels. I also allow myself to eat Salmon once a week which is a Forks Over Knives no, no...

I never had a heart attack and attribute this to taking effective supplements the best of which I think for me include: Tumeric, Vitamin C,  garlic, wheat germ on cereal, and Hawthorn Berry among others.

I've not had a relapse or needed to go to the hospital and it's 2. 5 years.  However, I believe my life has and will continue to be negatively impacted severely by the implantation of a stent that was extended too wide for my artery.

I continue to be very distrusting of a medical industry that is driven by a  one side fits all mentality and pharmaceutical industrial complex that can and does pay its way out of its greed driven actions.
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Avatar universal
Hello Tony: I have been reading about your ordeal and I can imagine how frustrated you must be.  Have you read the book by Caldwell Esselstyn entitled "Prevent and Reverse Heart Disease?"  Esselstyn is a cardioolgist at the Cleveland Clinic and advocates a plant diet to get rid of angina and stop and/or reverse heart disease.  I mention this because he states that fats and oils that are in the normal american diet can irritate and inflame the endothelium and cause just what you seem to be experiencing.  The diet is brutal but the claimed results are interesting.  If you are interested, follow-up your reading with "The China Study" by Campbell,  the documentation is superb and the conclusions irrefutable.  And the best part, you can take control of your heart problems.  Good luck...j2iron
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Avatar universal
Just came across this thread - and I'm right here with you Tony and Kindred Spirit.  I'm coming up on my one year anniversary of mild MI and placement of 3 stents last May.  Since then, I've changed many of my behavior patterns (for the better) but I've never felt worse.  I had a severe arhythmia in Feb, palpitations all the time, wake up at night with a jolt and can feel my heart pumping hard, & irregularly.  The doctors say, 'hmm, don't know what that is' and push another med at me.  So now I've stopped the miserable plavix, no more statins, tried but quit the beta blockers too.  Hate it all, it didn't help my symptoms, I feel better off them.  But, I'm in constant fear of restenosis, or thrombosis so I do take xanex for the anxiety.  These palps are not the anxiety - they are far too dramatic.  And Kindred, I'd be interested in whatever class action suit you find or start.  I also did not give INFORMED consent.  I wasn't told about the need for plavix, I wasn't told about the possibility of bypass - the option was pushed on me like a fast car sales, while I was coming off the anesthisia from the cath, laying flat and extremely shaken it all.  (oh, and this was all 5 days after the MI cause I'd gone home from the hospital ama, was feeling absolutely fine but was called all the days later b/c my follow bloodwork showed small troponin and trace enzymes)  The guy who got a hold of me got a nice fat fee but never once called to find out if I'm still alive or dead.  So I continue to search for a doctor.  And a lawyer.  
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