chest pain after stent

[lollynanda]

Had a stent placed in L main coronary artery (95% blockage) 2 months ago.  Prior to the stent I had been extremely athletic.  Even after coronary ischemic attacks which began just before the angioplasty, I passed stress test with flying colors. After the blockage was discovered thanks to a persistent PCP, and the stent inserted, I had chest pain afterwards.  Was re-catheterized, all the major arteries were given a clean bill of health, but was placed on a beta blocker.  Terrible reaction to the first one, put on a second one, and finally my cardiologist took me off that one as well.  Although I see some improvement, I still have chest "aches" on exertion.  All on the left side, below the heart,, in the side, sometimes in the back of the shoulder, and above the breast.  Can not walk at a normal pace.  Walk very slowly to control the pain.  Cardiologist suggested cardio rehab which will begin in a few weeks.  But have not heard of anyone else with such symptoms.  Don't know if I should risk walkin through the pain, or if it is a symptom that should be further pursued, and or tested.  All of my blood work, tests have come back normal so far.  Should I be concerned?  

[Coykendall]

....that you were stented with a left main blockage...that's what i had and it wasn;t even an option..left mammary bypass instead for  an 80& block...anyhow, I too have some pain, much like you describe and I think that the block is reoccurring after only 7 months...I feel worse and worse with each passing month...I'd be on your cardio team to make sure that the stent is holding up....

[lollynanda]

I had a very agressive interventionist, who is well known for stenting even the most daunting arteries.  Even so, when I spoke with his people, they are surprised they I still have discomfort after 2 months.  They had recatheterized me a few days after the stent placement, because I ended up in the ER with pretty intense chest pain, and the stent looked perfect.  However, the chest pain is not getting worse day by day, and in fact, over the past few days there is some minor improvement.  Just really shouldn't have any chest pain after 2 months. It's very discouraging.

[stripes4812]

Hi, I had a drug eluding stent (taxus) placed almost two months ago. I have pain when i take a deep breath, shoulder blade pain, especialy when i lie down. I have a dull ache in the center of my breastbone, don't sleep well, or at least not enough, and feel generally tired. I'm taking a beta blocker (cardensiel a french version, reduced from 5 mg to 2.5 mg) plavix 75 mg, enteric aspirin, crestor 10mg, as well as for my thyroid levoxyl .75 mg and cytomel .05 mg. I've been taking the thyroid meds for 35 yrs (the cytomel  for about ten). I'm 60 yrs old and had cardiac arrest, doctors said it wasn't a heart attack. I was resuscitated in the ambulance and i thought maybe it was the trauma of cpr and/or  shock (defibrillation) that caused the pain. After lowering the statin to once a day the pain is a little better. I read that plavix can also cause muscle pain, as well as beta blockers. I'm more tired than i was before the event. All tests, including a CT scan are negative. Some old spinal fracture showed up in the fifth vertebra. One dr said the cpr and shock may have aggravated it, as well as having to wear an external defibrillator for 11 days while drs. decided whether i needed an ICD or not. (I don't.) I used to swim a mile three or four times a week. Now i'm able to do a mile again, and walk for hours, but have to force myself. Afterword i'm very tired and just feel generally "dull" and not myself. I'm worried this is permanent and/or that it's a sign of another "event" waiting to happen. I'm not used to taking all these drugs and know that i may have to be on plavix for the rest of my life because of the risk of stenosis with the drug eluding stent. This is weighing heavily on my mind. I went from being an active fun-loving person who now looks at the world feeling on the fringe of all the fun.

[Tarheelguy1967]

I've had off and on pain since my first of five stents a few years ago.  I kept having to go back to the ER, because as I'm sure you've ascertained, it's very difficult to decide whether or not your symptoms are cardiac related or not.  My cardiologist put me on Ranexa, which supposedly helps w/ unstable angina.  I have honestly done much better over the last year, and I give credit to my cardiologist for continuing to help rather than "blow me off."  I am starting to have some difficulties again, but it was so nice to have a year or so of fairly symptom free times.  I recommend you continue to work with your cardiologist to figure out how to get over your symptoms.  Living w/ chest pain/pressure and stents is not an easy road, and I hope you get over the hump soon.  Good luck!

[lollynanda]

2 months ago, my cardiologist put me on Pravachol after taking me off the Lipitor.  I was concerned about the CoQ10 depletion effects with statins, so started taking CoQ10 a week or so before I started the Pravachol.  Almost simultaneously I noticed a decrease in chest pain with exertion.  Now, I don't know if it's just a coincidence, and that I suddenly started to get stronger, but there was a definite correlation there.  Suddenly I was able to walk at a normal pace, only felt challenged on the uphills. Shortly after that I broke my ankle, and had to attempt crutches with no cardiovascular strength. But within a week or two, I was able to do it!  I know there have been studies that have shown CoQ10 helps to alleviate regular muscle pain, but I wonder if anyone else has had this positive effect with chest pain?

[lildip]

I'm happy to have found someone whose symptons were like what I'm experiencing.  May 18, 2008 I had a  drug eluting stent put in the right artery for 95% blockage.  On plavix, asprin, zocor as well as other drugs for other reasons.  I keep having periodic jaw aches, chest pain discomfort, and sometimes when I lay on my left side in bed the jaw starts aching again.  I haven't taken any nitro yet, but wonder if I should just to see if the discomfort goes away.  After the first sex the jaw started aching and the ache lasted 4 to 5 hours.  Do you think I should consult my doctor?  Sounds like a stupid question, but I haven't known anyone who had this situation and i do not want to go thru the angiogram again if this is just a typical or normal event after stent is put in.  I haven't dared do anything again, and trying to treadmill walk produces the same "jaw ache"  after 3 minutes at 1.5 mph.

[Jeff5038]

I have had almost the exact same symptoms.  I was a pretty active cyclist until I had a heart attack about a month ago (while riding).  I had a stent placed in the left anterior decending artery due to a 98% blockage.  All other arteries were normal.  I was told that I had insignificant heart damage, but since then I have had minor aches and twinges in my chest, throat and jaw.  The past few days, I have been getting a pain in neck just right of front center.  The pains usually last less than a minute, but reoccur quite often.  They are not big enough that I have taken my nitro yet, but quite concerning none the less.  My cardiologist didn't seem too concerned and said they are probably nothing.  Is it normal to have mild pains after a heart attack or stent?  If so, do they typically go away after some healing time?

[lildip]

I plan to call the cardiologist if this continues on because  I don't want to end up like tim Russert or George Carlin.  I don't know their circumstances, but I hate asking about something if I haven't given it enough time.  In my case, (the right artery 95% blockage) the Dr put 2 stents saying while he was already there he might as well put the second one in .  I guess that was because the blockage was so tight that he felt it'd be safer to extend the opening with the second stent.  A cardiolgy technician told me stent can collapse within 30 to 90 days after the procedure, and that "any pain or discomfort" requires looking into, and to use the nitro if it stays any lenghth of time.  Minor periods of time maybe par for the course at first.  I didn't see the Dr to ask him about it because he was on vacation, but I also didn't think to ask him of any possible side effects.  When I contact the office, I'll post any remarks he has to say about it.

[ranger275]

Well, being 45 at the first of two heart attacks, I feel better knowing my symptoms are not alone. I have three stents. Two in the widow maker and one in the back. I have pains all the time. Don't know when to get seen or not. I sweat here and there. Laying in bed is oainful in the arm pit, middle chest, jaw and at times the left arm. When I get excited or angry it gets worse. I am on Liptior, Niaspan, Plavix, Zetia, Metorpral, Asprin and Lexeprel. When I run the impact causes such pain in the chest and left area I have to stop. Nitro is a temp fix at best.

I am called a challenge and am down about this.

[toby45]

Wow! This is eerie to suddenly come upon this thread. Had a heart attack at 45 in Jan '08, with 100% blockage of the LAD. They stented it.

I had a rod like pain about the size of a 4" pencil to the left of my sternum - my cardiologist said it was nothing extraordinary.

Had a lot of travel and work stress in Sep/Oct and I started getting intermittent pain traveling up the neck to the left side of my jaw. The pain also radiated to my left arm pit. These were some of the same symptoms I had during the heart attack.

Went to ER with the pain as it seemed to last longer and was growing in intensity. They did an angiogram and found everything was ok - and have suggested my heart and blood vessels are fine...

I've given up on complaining anymore - they say I'm okay, but the pains are there. I'm exercising 45 mins/day and ignoring the pain as no one seems to think it's serious. But I know that they're not phantom pains!

I am completely exhausted after exercise every day - feel like I hit the wall, and my legs "shake from the inside". I'm on Plavix, Niaspan, Lipitor, Asprin, and Metoprolol.

Seems several of you are in the same boat. I'm just glad to know I'm not alone in these post stenting pains. Doc says Stents don't hurt. Not sure what to do at this point.

[damaxwellguy]

i had heart attack Nov 29 2006 stent put in ..than on DEC 2007 i was taken off plavix and 3 weeks later had another heart attack on Jan 03 2008 another stent put in..than Jan 15 2008 a needless angeogram to tell me nothing blocked....that was the start of constant pain ,heart palpitations,flip-flops ,burning blood sensations in feet and hands,numbness with hands forearms and upper legs..wicked heart burn and just feeling like death most of the time.its been a year and i feel worse now than ever..doctors don't listen they seem in a hurry to get you in and out to make that big dollar..going to energy is another night mare
i could go on and on but ..bottom line is medical profession in Ontario ***** and I'm not important enough to be heard.

[Jack54]

I agree with Coykendall that stenting of the left main is not that common, especially in hospitals not in the NYC area! You are blessed with some of the best in the treatment of heart disease and CAD.

Having said that, the process of stenting any coronary artery is very traumatizing to that artery. The stent comes with a balloon inside of it. The doc inserts the stent into the middle of the blockage, then pressurizes the balloon to around 235 psig, for 8 seconds or more. (Your tire pressure is around 32 psig) Then the balloon is deflated and withdrawn. Did you experience severe angina when the inflation occurred? I have during two out of six stents.

The plaque or clot is smashed against the walls of the artery and held in place by the stent. This prevents the plaque from going (flowing) to the myocardium and causing an mi.

Your left main is probably 4 or more times bigger than your largest coronary artery, when it comes to diameter. It also comes directly off of the aorta. You could have just a wee bit of damage in this area that would not show on an arteriogram.

You just need to give it time to heal. I suggest light exercise for a while if it causes chest pain. Also, don't you have fast acting nitroglycerin? This is a must for all with CAD. It can prevent an mi! If it stops the chest pain, it is also a good sign that shows you are experiencing angina.

I think that you may be experiencing "referred pain" from either your left main or aorta. Arteries do not experience pain, but the heart muscle that they are "grooved into" surely can. I have had six stents and after each of them, I have experienced pain from my heart, but much different than angina. It feels more like an injury, which is exactly what I think it is.

Just my $.02 :) Hope you get better soon, and listen to your body. It will try to warn you of serious CAD developments.

[Adrian_Marcel]

I have 2 stents placed on 2 of my arteries 8 days ago and some minor chest pain just 2 days after that. The ECG didn't show anything abnormal. There was no pain since then but I still have some chest discomfort. Nobody seem to know exactly whether it is normal or not, but I feel a little better after reading this:
http://www.ncbi.nlm.nih.gov/pubmed/10372298
Good luck to every one

[yrr]

well thank God for the internet... I had a stent put in three days ago and had chest pain yesterday.... Doc said i have nothing to worry about unless it gets worse than when i first had my heart attack some weeks ago.... anyway, i believe yesterdays pain was set off by stress and am now feeling somewhat better.... I came on here on the wife's orders and reading all these answers has shown me i am not alone.... May all our hearts be soon well

[billben38us]

i had two stents put in two weeks ago.ive been very tired and easily fatigued.last few days been having more and more chest pains.today it was so bad i took three nitro pills.wondering if this is normal and if i should go back to the er.

[yrr]

Just a follow up to my last posting. Last week, which would be a week and two days since I had a stent put in i had a follow up appointment with my Doctor. I told him of the pain I had experienced in the chest post procedure and he told me there is a minority of patients who have this pain after stenting. It is not angina and nitro would not help. In truth this has now passed , something he said would be the case, and I feel better. Now I have to face lifestyle changes such as rabbit food diet and walking.... but at least i can tell the tale.

[captainmerrill]

My initial doctor told me I was imagining the chest pain I had.  He didn't even bother asking me about my genetics.  I left his care and went to the Cleveland Clinic.  Three months later after a quadruple by pass three stents six cathators and numerous tests I feel awful.  Still have chest pains I'm 53 and my 80 year old father in law is in better shape than me. My Dr sent me to cardio rehab and diet.  I will diet but not cardio I think that's a death sentence until someone can tell me what my heart attack symptoms are.  

[Ziggyzag]

I had a stent put in two weeks ago to a 50% narrowing artery.  I have never been overweight, never smoked, have always been pretty active, careful with diet, good HDL/LDL ratio, and an excellent fitness assessment result just the week before the severe chest pain which led to the discovery of the narrowing artery.  Now I am on 5 different drugs and advised not to do any strenuous exercises (no swimming or riding) for 4 weeks.  I am feeling pretty frustrated and am wondering whether it would be fine for me to attend indoor cycle classes after 2 weeks.

[ed34]

Personally I think it depends on which vessel the stent is placed into. If the stent is put
into the LAD in particular there seems to be a fair amount of discomfort. I had a stent put into my Obtuse marginal over two years ago and felt immediate benefits with no discomfort whatsoever. The stent is still patent. A few days ago I had five large stents
put into my LAD and I get a nasty pinching sensation when I inhale. It feels a bit like a
nasty stitch but deeper. If I cough it also gives a shooting pain. The pains shoot up from
what feels like my left lung to my left shoulder and neck. Paracetamol rids the discomfort and I've been told to drink lots of water and the stents should settle down after a few days. Time will tell. I was also surprised to hear that angina will probably be experienced for a while until the heart adjusts.

[kenkeith]

Usually, a 50% occlusion is not considered serious enough to stent (American Hospital Association and the American Academy of Cardiology recommendation), and seldom would a 50% lesion cause chest pains...but obviously there are exceptions...you are in better condition than most, and I am surprised you have difficulties.

Five years ago, I had a stent implant in a 98% blocked RCA, LAD is totally blocked but collaterized with grown vessels, and a 72% blocked circumflex that is not stented.  After the stent implant and release from the hospital for congested heart failure, there were no restrictions with discharged instructions, I felf very energetic and very active (mowed lawns on my 2 properties the day I was released).  Presently, I take a nitrate when going to the gym to workout and no problems.  Also, my medication is an ACE inhibitor for blood pressure control, a beta blocker (coreg) for bp and rhythm stability, and a med for cholesterol.

Follow your doctor's instructions, but it certainly differs from mine, and your general health appears good...much better than most.

[Ziggyzag]

Just discovered that it was a mid LAD 60% stenosis, not 50% as I originally thought.  On the ultra sound scan, it appeared that the plaque was unstable.  Problem of family history of coronary artery disease and hypertension, things I couldn't modify unfortunately.  Been going for long walks since release from hospital, but would really like to get back to my cycling training (and the gym) as I have registered for a longish ride just 5 weeks away.  

Don't know whether it is Lipitor, Plavix, Coversyl, or Somac that is giving me the congested sensation around the chest-throat.  Would anyone know what possible side effects these drugs might cause?

[SteveFlorida]

Now 5 years later, same very severe chest pain every day, after very large Drug eluding stent placed 9 mo after 2004 MI in osteum of LAD. Done at Cleveland Clinic Weston FL. The Cleveland Clinic interventionist just ignored me for no reason. Said it must be esophageal ulcers!... Later went to top Cleveland Clinic Gastero, who did extensive studies, said everything in esophageal area perfect and sent me back to Cardiologist who again blew me off for no reason... Cleveland Clinic intervention dept. could care less... Refused to look into it... Still now just as bad as first day. I have tried everything to no avail. Dozens of drugs, Renexa, all B Blocker brands, C Channel brands, Ace Inhib brands, hundreds of types of home remedies, supplements, best Co Q available, Chelation, Phosphitylcholine IV therapy, Stem Cell angioplasty in Bangkok Thailand with Theravitae (complete waste of $30,000.00). Nothing natural I took made me worse or better... but all drugs would actually make my condition worse, so I would search around, or stop them... Also complete IVUS of stent at Mt Saini in New York by top interventionist, and investigation of stent over and over, including extensive esophageal investigation, and aorta CT's... all super normal. Records sent to top 7 interventionists in USA, heads of departments at major hospitals: Current thoughts: Doctors at U of TexasAustin, and N Western U Chicago told me that they have documented thousands with severe pain like mine from Drug eluding stent. Johnson and Johnson blew me off when I contacted them, could care less... The Texas/Chicago study is on web. It involved 11 major hospitals and thousands of cases. Read it. Possibility now: one Florida top interventionist (and U Texas Drs also) recommended he gives Celebrex to many of my type of cases, of which he said there are far more than reported (and steroids perhaps cortizone or other steroids, if Celebrex does not work) to reduce severe constant stent caused inflammation. The Texas Dr's also try these remedies. Have tried all over the counter and natural inflammatories, hundreds... none work. Will now consider dreaded Celebrex, but he said to increase aspirin a lot when taking Celebrex, if not on Plavix. Now off Plavix for years. Local Cardio does not like the idea of celebrex, and especially no way to Cortizone, and I agree that Cortizone (steroid) not an option. Any one extensively investigate this as I have?

[oldie]

Are collateral growths detectable? By what tests please?

[oldie]

I've been searching the forums for months looking for someone with both thyroid and CAD problems. I sympathise entirely with you. I have the same symptoms. I take 100 levothyroxine but have increasingly low free T3 and would like to try cytomel but most posts on the thyroid forum have warned me off it because  of my   heart condition. What has been your experience please?