Recovery After A Heart Attack And Stents

What is a heart attack?

A myocardial infarction (heart attack) is a cardiovascular condition that occurs as a result of damage to the heart. The British Heart Foundation¹ reports that approximately 100,000 individuals suffer from myocardial infarction in the UK each year. Heart attacks occur when a partial or total blockage occurs within our coronary artery, the artery responsible for the delivery of oxygenated blood to the heart’s muscles. Without this blood supply, the cardiac muscles become starved of the oxygen and key nutrients they require, causing them to become weaker and damaged. The American Heart Association² cites the following as some of the key factors that can increase the rate at which blockages build up within the arteries;

• Inactive lifestyle
• Diet high in fat and sugars
• High salt intake
• Age
• Obesity
• Medical conditions like high blood pressure and diabetes

Symptoms

Whilst the symptoms an individual may experience can vary from person to person, the symptoms below are those most commonly experienced by heart attack patients. If you experience any of the following symptoms, call 999 or 911 immediately.

• Pain, tightness, or squeezing sensation in the chest
• Pain that spreads to arms, back, neck, and jaw
• Feeling dizzy/loss of consciousness
• Feeling sick or experiencing indigestion-like pains
• Sweating
• Fatigue

Diagnosis

Once arriving at the hospital or medical centre, medical professionals will likely ask you questions about your symptoms before running tests as quickly as possible to help diagnose your condition. Here are some of the most commonly used tests.

Electrocardiogram (ECG)

An ECG is the most commonly used test to determine whether an individual is suffering from a heart attack. A painless electrical current is run through the body to analyse the heart's electrical activity, allowing doctors to assess how well the heart is functioning.

Blood Tests

Doctors may also take blood samples to assess if certain proteins and enzymes have leaked into the bloodstream as a result of the damage caused by the heart attack.

Cardiac Catheterization

A dye that is visible in X-ray scans is injected into the bloodstream before an X-ray image is taken, allowing doctors to identify the arteries that have become partially or completely blocked.

Treatment

The treatment options available to heart attack patients vary depending on the type of heart attack they have suffered and the severity of their condition.

Coronary Angioplasty

A process that allows the blocked or narrowed arteries to be opened back up without the need for open heart surgery. A balloon attached to a catheter is inserted into the bloodstream and guided towards the heart. Once at the site of the blockage, the balloon is inflated, allowing the blocked artery to become wider, and increasing blood flow.

Coronary Artery Bypass Graft

A form of open-heart surgery that involves redirecting the blood flow around the narrowed or blocked artery using a blood vessel taken from another part of the body.

Medication

If surgical procedures are deemed not appropriate for a heart attack patient, they may be prescribed various forms of medication. Examples include antiplatelets, which are designed to prevent the blood from clotting, and thrombolytics, which are designed to break down existing blood clots.

How is stent insertion performed?

Stent insertion is a procedure that will normally be performed once the balloon has been inflated during coronary angioplasty. Once inflated, a flexible metal stent is inserted into the same area the balloon was originally inserted (normally in the arm or groin). Once inserted, the stent is directed along the same route as the balloon. This procedure normally takes between 30-60 minutes and provides a more permanent way of improving blood flow through the narrowed blood vessel.

Recovery after a heart attack with stent insertion

The rehabilitation process can vary greatly depending on the severity of the heart attack suffered and the type of treatment utilised. Before leaving the hospital, ensure you have been provided advice on the medication you need to take, how to look after your wound, and how you can lead a healthier lifestyle going forward.

Recovery duration

The recovery time for coronary angioplasty and stent insertion depends on the type of surgery the heart attack patient has undergone. Those who have planned nonemergency angioplasty will likely be able to leave the hospital within 12-14 hours of the procedure and will likely have recovered after two weeks. Those who undergo emergency angioplasty will likely be required to remain at the hospital for longer after surgery for monitoring. The recovery process is also longer for emergency angioplasty patients, lasting between 6-12 weeks.

Medications

No matter the type of surgery, those who have suffered from a heart attack will be prescribed blood thinning medication to reduce the risk of further blood clots and heart attacks. Once prescribed the medication, ensure to follow the medication schedule given to you by your doctor, as failing to do so could increase the risk of further complications occurring. Alongside aspirin, those who suffer a heart attack are commonly prescribed either ticagrelor, clopidogrel, or prasugrel.

Regular activities 

Aside from strenuous activities like weightlifting, most patients who undergo planned angioplasty are able to complete regular daily activities such as going for a walk within two weeks of their procedure. Before being discharged from the hospital, ensure to seek advice from a medical professional on activities you should look to avoid.

Diet

Consuming a healthy and balanced diet after undergoing angioplasty is a crucial step toward improving and maintaining the health of your heart. Research³ has found that those who consume a healthy diet are significantly less likely to suffer from all forms of cardiovascular disease, including a heart attack. Here are a few ways we can help ensure our diet is as healthy as possible.

• Consume 5 portions of fruit and vegetables per day
• Choose whole grain products (brown bread and brown pasta/rice) over the white alternatives.
•  Avoid processed foods like red meat and fast food
• Avoid foods that have red labels on the nutritional information section of the packaging
• Reduce salt intake as much as possible
• Avoids foods high in sugar

Other activities after a heart attack with stent insertion

Work

The amount of time taken before an individual is able to return to work depends on their condition, the type of angioplasty undergone, and the patient’s job. For individuals who have undergone planned angioplasty, it is extremely common for them to be able to return to work within one to two weeks of their procedure. Those who have a particularly physically demanding job that requires regular lifting of heavy weights may require a longer period of recovery and should seek advice from their doctor before returning to work. Those who have emergency angioplasty will likely require a longer recovery period before returning to work, potentially lasting a few weeks or months.

Driving

Those who undergo coronary angioplasty and stent insertion should not drive for a minimum of 7 days after their surgery. If you are unsure if you are ready to begin driving again after this time period, contact your local GP for advice. If you drive a heavy vehicle such as a bus or lorry, you will need to contact the DVLA for health testing to ensure you are fit enough to drive.

Heavy lifting

Coronary angioplasty and stent patients will likely be advised on heavy lifting before being discharged from the hospital. In most cases, those who undergo the procedure will be told to avoid any activities that involve heavy weightlifting until their wound has healed to avoid damage. For most patients, the wound caused by the procedure should have healed within 7-14 days. Again, if you are unsure whether a specific activity is safe to do, contact your local GP for advice first.

Sexual activity

The amount of time a patient should wait after their surgery before resuming sexual activities depends on the type of angioplasty undergone. Those who undergo planned angioplasty should wait at least 3-5 days before resuming any sexual activity. As the recovery process is longer for those who undergo emergency angioplasty, they should not resume sexual activity until cleared to do so by their doctor. If you experience chest pains once cleared to resume normal daily life by a medical professional, avoid sexual activity alongside any strenuous physical activities and return to the hospital immediately.

Does stent insertion reduce further heart problems?

Stent insertion has been shown to be an effective method of improving the health of a patient's cardiovascular system and reducing the risk of further heart problems. Once inserted into the narrowed artery, stents widen the width between the walls of the artery, allowing an increased amount of blood to flow through. As a result, those who undergo the procedure are less likely to suffer from angina, a condition where patients experience chest pain due to a lack of oxygenated blood flow to the heart. Stents can also help reduce the amount of blood clotting in patients. A reduction in blood clotting combined with an increased blood flow can decrease the risk of a wide range of medical conditions such as heart attacks, strokes, and heart failure.

Cardiac rehabilitation

Cardiac rehabilitation is a programme offered to anyone in the UK who has suffered from a heart attack or undergone some form of heart surgery. Cardiac rehabilitation aims to help patients understand their condition, recover from their surgery/heart attack, and help prevent future cardiovascular complications. Cardiac rehabilitation programmes will normally consist of the following.

• Specialised exercise programme
• Lifestyle and dietary advice/education
• Emotional support
• Stress management

Statistics⁴ indicate that cardiac rehabilitation can be extremely beneficial to the long-term health of those that suffer from heart-related issues, helping reduce the risk of death caused by cardiovascular complications by 35%.

Healthy living

Research⁵ indicates that up to 80% of heart attacks could have been prevented by leading a healthier lifestyle, emphasizing how much our lifestyle choices can influence our risk of a heart attack. Furthermore, the American Heart Association⁶ report that leading a healthier lifestyle can significantly reduce the risk of a heart attack in patients suffering from a second attack. Below are some of the healthy lifestyle choices we can make to help improve our overall health and reduce the risk of heart attacks.

• Perform 150 minutes of aerobic exercise per week (walking, jogging, cycling, etc)
• Eat a healthy and well-balanced diet
• Drink 6-8 glasses of water per day
• Try to get at least 7 hours of sleep a night
• Practice stress management and relaxation techniques

Complications

Even though coronary angioplasty and stenting are considered low-risk procedures, there are risks and complications that can arise as a result of the surgery. Those at the highest risk of suffering from complications include having kidney disease, having had emergency angioplasty, being older than 50 years old, or having multiple blockages in different arteries. Below are examples of complications that can occur after coronary angioplasty and stenting are performed.

Artery Damage

in some instances, damage can be caused to the lining of the artery when the stent is first inserted.

Excessive Bleeding

Whilst small amounts of internal bleeding and bruising are common in coronary angioplasty patients, excessive bleeding can cause more severe issues and may require a blood transfusion.

Irregular Heartbeat

In some cases, stents can cause an irregular heartbeat to develop. If persistent, this could starve the heart and the rest of the body’s muscles of oxygen, causing serious damage that can lead to further health implications.

Further Cardiovascular Complications

Due to the potential damage to arteries and irregular heartbeat, further cardiovascular complications could occur after the insertion of the stent. For example, if the heart’s muscles become starved of oxygen as a result of an irregular heartbeat, the patient’s risk of suffering from heart failure or a second heart attack increases. 

Allergic Reaction

Certain individuals may suffer an allergic reaction to the stent or the dye utilised to identify the blocked artery. An allergic reaction to the stent or dye is very rarely fatal, with most individuals who suffer an allergic reaction either suffering from mild symptoms like a rash.

Summary

If you experience recurring chest pain or discomfort, book an appointment with your local GP as soon as possible. On the same note, if you or someone around you is suffering from the symptoms of a heart attack, call 999 immediately. Whilst it may seem daunting, coronary angioplasty is a painless and relatively quick procedure that can significantly improve an individual’s condition. If you have recently undergone the procedure, ensure to follow the advice given to you by your GP so you can make a quick and full recovery from the surgery.