What not to do after getting a stent?

Angioplasty and stent — heart — discharge

Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary arteries. A coronary artery stent is a small, metal mesh tube that expands inside a coronary artery.

When You’re in the Hospital

You had angioplasty when you were in the hospital. You may have also had a stent placed. Both of these were done to open narrowed or blocked coronary arteries, the blood vessels that supply blood to your heart. You may have had a heart attack or angina (chest pain) before the procedure.

What to Expect at Home

You may have pain in your groin area, arm, or wrist. This is from the catheter (flexible tube) that was inserted to do the procedure. You may also have some bruising around and below the incision.

The chest pain and shortness of breath you likely had before the procedure should be much better now.

Self-care

In general, people who have angioplasty can walk around within 6 hours after the procedure. You may be able to be up and walking earlier if the procedure was performed through the wrist. Complete recovery takes a week or less. Keep the area where the catheter was inserted dry for 24 to 48 hours.

If the provider put the catheter in through your groin:

• Walking short distances on a flat surface is OK. Limit going up and down stairs to around 2 times a day for the first 2 to 3 days.
• Don’t do yard work, drive, squat, carry heavy objects, or play sports for at least 2 days, or until your health care provider tells you it is safe.

If the provider put the catheter in your arm or wrist:

• Don’t lift anything heavier than 10 pounds (4.5 kilograms) (a little more than a gallon of milk) with the arm that had the catheter.
• Don’t do any heavy pushing, pulling or twisting with that arm.

For a catheter in your groin, arm, or wrist:

• Avoid sexual activity for 2 to 5 days. Ask your provider when it will be OK to start again.
• Don’t take a bath or swim for the first week. You may take showers, but make sure the area where the catheter was inserted does not get wet for the first 24 to 48 hours.
• You should be able to return to work in 2 to 3 days if you do not do heavy work.

You will need to care for your incision.

• Your provider will tell you how often to change your dressing.
• If your incision bleeds or swells up, lie down and put pressure on it for 30 minutes.

Angioplasty does not cure the cause of the blockage in your arteries. Your arteries may become narrow again. Eat a heart-healthy diet, exercise, stop smoking (if you smoke), and reduce stress to help lower your chances of having a blocked artery again. Your provider may give you medicine to help lower your cholesterol.

Most people take aspirin together with another antiplatelet medicine such as clopidogrel (Plavix), prasugrel (Efient), or ticagrelor (Brilinta) after this procedure. These medicines are blood thinners. They keep your blood from forming clots in your arteries and stent. A blood clot can lead to a heart attack. Take the medicines exactly as your provider tells you. Do not stop taking them without talking with your provider first.

You should know how to take care of your angina if it returns.

Make sure you have a follow-up appointment scheduled with your heart care provider (cardiologist).

Your provider may refer you to a cardiac rehabilitation program. This will help you learn how to slowly increase your exercise. You will also learn how to take care of your angina and care for yourself after a heart attack.

When to Call the Doctor

Contact your provider if:

• There is bleeding at the catheter insertion site that does not stop when you apply pressure.
• There is swelling at the catheter site.
• Your leg or arm below where the catheter was inserted changes color, becomes cool to touch, or is numb.
• The small incision for your catheter becomes red or painful, or yellow or green discharge is draining from it.
• You have chest pain or shortness of breath that does not go away with rest.
• Your pulse feels irregular — very slow (fewer than 60 beats), or very fast (over 100 to 120 beats) a minute.
• You have dizziness, fainting, or you are very tired.
• You are coughing up blood or yellow or green mucus.
• You have problems taking any of your heart medicines.
• You have chills or a fever over 101°F (38.3°C).

Alternative Names

Drug-eluting stents — discharge; PCI — discharge; Percutaneous coronary intervention — discharge; Balloon angioplasty — discharge; Coronary angioplasty — discharge; Coronary artery angioplasty — discharge; Cardiac angioplasty — discharge; PTCA — discharge; Percutaneous transluminal coronary angioplasty — discharge; Heart artery dilatation — discharge; Angina angioplasty — discharge; Heart attack angioplasty — discharge; CAD angioplasty — discharge

Images

• Coronary artery stent

References

Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718 pubmed.ncbi.nlm.nih.gov/25260718/.

Dangas GD, Mehran R. Coronary angiography and intravascular imaging. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 21.

Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Thorac Cardiovasc Surg. 2015;149(3):e5-e23. PMID: 25827388 pubmed.ncbi.nlm.nih.gov/25827388/.

Kumbhani DJ, Bhatt DL. Percutaneous coronary intervention. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 41.

O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;127(4):529-555. PMID: 23247303 pubmed.ncbi.nlm.nih.gov/23247303/.

Recovery — Coronary angioplasty and stent insertion

Before you leave hospital, you should be given advice on:

• any medication you need to take
• improving your diet and lifestyle
• wound care and hygiene advice during your recovery

You may also be given a date for a follow-up appointment to check on your progress.

You may have a bruise under the skin where the catheter was inserted. This isn’t serious, but it may be sore for a few days. Occasionally, the wound can become infected. Keep an eye on it to check it’s healing properly.

Your chest may also feel tender after the procedure, but this is normal and usually passes in a few days. If necessary, you can take paracetamol to relieve any pain.

Activities

Your hospital team can usually advise you about how long it will take to recover and if there are any activities you need to avoid in the meantime.

In most cases, you’ll be advised to avoid heavy lifting and strenuous activities for about a week, or until the wound has healed.

Driving

You shouldn’t drive a car for a week after having a coronary angioplasty.

If you drive a heavy vehicle for a living, such as a lorry or a bus, you must inform the Driver and Vehicle Licensing Agency (DVLA) that you’ve had a coronary angioplasty. They’ll arrange further testing before you can return to work.

You should be able to drive again as long as you meet the requirements of an exercise/function test and you don’t have another disqualifying health condition.

Work

If you had a planned (non-emergency) coronary angioplasty, you should be able to return to work after a week.

However, if you’ve had an emergency angioplasty following a heart attack, it may be several weeks or months before you recover fully and are able to return to work.

Sex

If your sex life was previously affected by angina, you may be able to have a more active sex life as soon as you feel ready after a coronary angioplasty.

If you have any concerns, speak to your GP. According to experts, having sex is the equivalent of climbing a couple of flights of stairs in terms of the strain it puts on your heart.

Medication and further treatment

Most people need to take blood-thinning medications for up to 1 year after having an angioplasty. This is usually a combination of low-dose aspirin and one of the following medications:

It’s very important you follow your medication schedule. If you stop your medication early, it greatly increases your risk of a heart attack caused by the treated artery becoming blocked.

The course of clopidogrel, prasugrel or ticagrelor will usually be withdrawn after about a year, but most people need to continue taking low-dose aspirin for the rest of their life.

You may need to have another angioplasty if your artery becomes blocked again and your angina symptoms return. Alternatively, you may need a coronary artery bypass graft (CABG).

Cardiac rehabilitation

Cardiac rehabilitation should be offered if you’ve had a heart operation. This programme aims to help you recover from the procedure and get back to everyday life as quickly as possible.

Your cardiac rehabilitation programme will begin when you’re in hospital. You should also be invited back for another session taking place within about 4 to 8 weeks after you leave hospital.

A member of the cardiac rehabilitation team will visit you in hospital and provide detailed information about:

• your state of health
• the type of treatment you received
• what medications you’ll need when you leave hospital
• what specific risk factors are thought to have contributed to needing the operation
• what lifestyle changes you can make to address those risk factors

Once you’ve completed your rehabilitation programme, it’s important you continue to take regular exercise and lead a healthy lifestyle. This helps protect your heart and reduce the risk of further heart-related problems.

Lifestyle changes

If you have a coronary angioplasty, it’s still important to take steps to reduce your risk of having further problems in the future. This may include:

• trying to lose weight if you’re overweight
• stopping smoking if you smoke
• eating a healthy diet with low levels of fat and salt
• being active and exercising regularly

Smoking and being overweight are 2 of the main causes of heart disease. They also make treatment less likely to work.

When to seek medical advice

You should contact the hospital unit where the procedure was carried out, your specialist cardiac nurse, or your GP for advice if you develop:

• increasing pain and swelling around your wound
• a high temperature

You should be given a letter when you leave hospital of things to look out for.

Dial 999 for an ambulance – do not drive yourself – if you experience:

• any bleeding from your wound that doesn’t stop or restarts after applying pressure for 10 minutes
• severe chest pain that doesn’t ease – if you have been prescribed medicine for angina try taking this, but if it doesn’t help then seek urgent help
• discolouration, coldness or numbness in the leg or arm where the incision was made

Page last reviewed: 04 October 2022
Next review due: 04 October 2025

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8 Lifestyle changes to be adopted after Angioplasty

Understanding Angioplasty and Stent Implantation & How life changes after the procedure

The human body can withstand a lot of things. However as people age, their bodies also start becoming weaker. The years of wear and tear starts affecting the body. Sometimes, it becomes imminent for people to undergo several treatments, including various non-invasive procedures and invasive surgeries. And while your life can go back to the normal routine post any procedure, it can never truly be the same. You need to change your lifestyle to a great extent, to reduce any future incidents that can have a more severe effect on your body. For instance, people who go through an angioplasty and stent implantation have to make some radical lifestyle changes. This article explains what angioplasty is and how life is after angioplasty and stent implantation. Read on to find out.

What is angioplasty?

Angioplasty is essentially a minimally-invasive procedure. In this procedure, the interventional cardiologist removes the blockage from the artery for a smooth flow of blood, thus ensuring heart muscles get enough oxygen. Blocked and narrowed arteries can cause heart attacks, and angioplasty reduces the risk of heart attacks by restoring the proper blood and oxygen supply to the heart.

When a coronary angioplasty is performed, the interventional cardiologist inserts a thin catheter which is mounted with a tiny balloon into the blocked artery, via a small incision in the arm or the groin area. The balloon is inflated once the catheter is placed in the right spot, and this removes the blockage from the artery by pushing it aside radially. It thus allows the blood to flow once again.

Angioplasty as a treatment helps patients avoid majorly invasive procedures like bypass surgeries. As compared to bypass, an angioplasty is a relatively quick and painless procedure that allows patients to get back to their routine activities in just a few days.

What is a stent implant?

Most patients who undergo an angioplasty procedure also have to undergo stent implantation. A stent is essentially a small, latticed metal scaffold, which is introduced into the patient’s blood vessel, on a balloon catheter. Most modern stents have a drug coating on them for better clinical outcomes in the long run. The type of stent used depends on patient’s condition as assessed by the interventional cardiologist. The stent is chosen based on the location of where it is to be inserted and the condition of the narrowing in the patient’s coronary artery. The operator then plots the catheter into the blocked artery, after which he inflates the balloon upon which the stent is crimped. Upon balloon inflation, the stent starts to expand outwards towards the vessel wall. The balloon is then deflated and withdrawn and the stent then stays in its place permanently. It holds the blood vessel lumen open and improves the blood flow.

An Interventional cardiologist may insert one or more of these stents, depending upon the number of blockages. While Meril offers various DES stent that assists with early vascular healing, Evermine50 stent is a breakthrough in DES technology with clinically established drug everolimus with biodegradable polymer having Ultra-low strut thickness of 50μm and hybrid cell stent design

Lifestyle changes after angioplasty

The post-procedure recovery period can be indeed long, and the body can take its time to slowly and steadily regain its strength. It is essential that patients make steady improvements with every passing day, and adopt some additional, necessary measures. Here are some lifestyle changes to adopt after undergoing an angioplasty.

The patient must quit smoking

Life after angioplasty strictly involves smoking cessation. Smoking can damage the artery lining and also cause fat to build up. This, in turn, causes the narrowing of the artery and hampers the blood flow in the body. Both active and passive smokers (people in close physical contact with active smokers) are highly likely to develop more severe heart conditions due to exposure to smoke.

The patient must take medications and consult the doctor in case of irregularities

After the angioplasty, the doctor typically advises the patient to take certain medicines which are meant to enhance heart recovery and regain body strength. As such, patients must be vigilant and ensure that they do not miss a single dose of their medication. Typically, the doctor may prescribe medicines which serve as blood thinners which are meant to ease the flow of blood, along with thrombolytics which dissolve clots, nitro-glycerine which widens blood vessels etc. The doctor may also prescribe pain killers so that the patient can manage the pain. When patients take these medications they may experience a few side-effects, which should be discussed with the doctor before discharge. Patients should immediately consult the doctor if they notice any discussed side-effects or have any doubts, so that the doctor can review and address issues immediately.

The patient must follow a healthy diet

Another critical lifestyle change after angioplasty one must adapt is following a healthy diet.. As such, some strict diet changes may be in order. Patients are most often advised to avoid unhealthy foods containing high levels of sodium, cholesterol, trans-fats and saturated fats, and so on. The diet should include foods rich in iron and essential vitamins such as green leafy vegetables, whole grains, fish, low-fat dairy, fibre, dry fruits, etc. Essentially, the patient must ensure that the foods they consume are nutritionally balanced as advised by a dietician or other healthcare professional involved in the treatment.

The patient must consider taking up more physical activities

One of the most common causes of heart problems is that most patients are physically inactive. As such, once the heart condition is cured through angioplasty or stent implant, patients must ensure that they increase their physical activities as per due guidance from doctors. You can start with low to moderate physical activities like walking short distances or going up and down the stairs twice or thrice a day. They can also consider light stretching exercises and aerobics. However, one must avoid all forms of strenuous workouts altogether, such as lifting anything heavier than 5 kilograms, for at least six weeks after undergoing the procedure. Patients must also consult their doctor before resuming sexual activity.

Obese patients must manage their weight

Weight management is another crucial lifestyle change after angioplasty that one mustn’t ignore, especially if one is obese. Weight management is directly linked to heart management. Cardiac arrests are often caused due to obesity which is why one must take the necessary steps to address their obesity. Weight can be managed by combining physical activities and maintaining a healthy diet. The patient must regulate the intake of calories. However, they must avoid crash diets. Instead, they can introduce nutritional foods like vegetables and fruits in their every-day diet, so that they can maintain their weight naturally.

The patient must take necessary steps to reduce stress levels

Stress of any kind is not good for the heart. Increased stress levels can aggravate heart conditions, cause blood pressure problems, and damage the arteries. These conditions, in turn, lead to surgeries like angioplasty. As such patients must take the necessary steps to reduce their stress levels. An excellent way to manage stress is to practice relaxation techniques such as yoga and meditation or take up hobbies that can reduce overall stress and assist in maintaining heart health.

The patient must limit alcohol intake

Life after stent placement should have no room for excessive alcohol. Patients must strictly limit their alcohol consumption. Excessive consumption of alcohol can lead to a wide variety of health complications – from increased blood pressure to strokes, irregular heartbeats and cardiomyopathy or heart muscle diseases. High consumption of alcohol also contributes to health issues such as obesity, fatigue, and strokes, all of which can trigger heart problems again.

The patient must go for regular follow-ups

Patients who undergo angioplasty and stent placement must ensure that they follow up with their doctors regularly. They should not miss any check-ups and also keep an eye on the cholesterol and blood sugar levels. They must consult their doctors if they notice even a small change or if they experience any sudden or inexplicable pains.

Final note: Angioplasty procedures do not involve any significant incisions as they are minimally invasive to the body. One can go back to their normal routine within 2 to 3 days after undergoing the procedure, depending on the doctors’ recommendations. However, patients who undergo this procedure must ensure they follow the above-mentioned lifestyle changes to lead a long and healthy life after stent placement.