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Doctor insights on: Exercizing After A Cardiac Stent In The Lad

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Can stent be used to open 100% blockage in an artery such as LAD during cardiac catheterization procedure. Cons and pros please. Thank.

Can stent be used to open 100% blockage in an artery such as LAD during cardiac catheterization procedure. Cons and pros please. Thank.

Yes, if needed: Total blockage may occur suddenly - this is what causes a heart attack. Then the goal of the procedure is to get the blocked artery open asap (<90min) to save otherwise dying heart muscle. If the blockage is chronic, then it should be opened if the supplied muscle is alive and the patient's active lifestyle brings out symptoms. Stress scanning may be helpful to determine this. ...Read more

Dr. Ihab Ibrahim
2 Doctors shared insights

Stenting (Definition)

In general, a stent is a metal tube used to keep a vessel open. Stents can be placed in a huge number of places, including blood vessels, bile ducts, even in the colon ...Read more


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Can only Plavix be taken after coronary stenting? I have erosive gastritis, take Protonix (pantoprazole) 40mg and a DES in LAD post heart att. Need 3 more DES or BMS.

Can only Plavix be taken after coronary stenting? I have erosive gastritis, take Protonix (pantoprazole) 40mg and a DES in LAD post heart att. Need 3 more DES or BMS.

There may be options: Plavix (clopidogrel) is a platelet inhibiting drug. The purpose of the medication is prevention of future myocardial infarction and death following acute coronary syndromes and prevention of stent thrombosis. There are other medications besides Plavix (clopidogrel) that are platelet inhibitors ...Read more

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Is it possible to take only Plavix (clopidogrel) and not Aspirin after coronary stenting? I have erosive gastritis and DES in LAD after heart a, need 3 more stents.

Is it possible to take only Plavix (clopidogrel) and not Aspirin after coronary stenting? I have erosive gastritis and DES in LAD after heart a, need 3 more stents.

Anti platelet Rx: We use dual antiplatelet therapy for at least 6 months to minimize stents occluding after placement. Usually either aspirin or plavix (clopidogrel) is continued later if no contraindication to that. The erosive gastritis is a significant problem and the appropriate step (s) in this case need to be considered with risks and benefits to the treatments by those with the most information about the patient. ...Read more

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I had a DES placed in my LAD 30 days ago. How long does it take for the endothilial cells to cover the stent cage in this type of stent?

I had a DES placed in my LAD 30 days ago. How long does it take for the endothilial cells to cover the stent cage in this type of stent?

Atleast 1 year: In order for struts of stent to be fully endothelialised and before one can even consider altering dual amtiplatelet therapy, a full 12 months ought to pass. There are other features such as lesion length, and angulation that may warrant even longer DAPT - discuss with ur interventional cardiologist. Data suggests outcome curves continue to diverge, so benefit upto 18 months post DES for dapt. ...Read more

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Husband has artherosclerosis, stent in rca in nov, 2012, left main 60%, LAD is 70%, on medications, ef43%, feels fine, is it ok to gym and do weights?

Husband has artherosclerosis, stent in rca in nov, 2012, left main 60%, LAD is 70%, on medications, ef43%, feels fine, is it ok to gym and do weights?

Check: Sounds like he has a cardiologist
range of activity can be guided by last stress test.
No smoking
weight loss and graded exercize are reasonable.
Common sense: if it hurts stop!
if tired - rest. ...Read more

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3 weeks ago, stent placed due to 95%+ blocked lad. Since then, I often feel a bit of pressure or pinching like feeling. Not pain...Just discomfort. Is this normal?

Yes: Yes it's very common to have a pinching pain in your chest after a stent is placed. However, the pain should be stable, if it changes, get to an er otherwise I would call your cardiologist and follow up as an outpatient. ...Read more

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Can tofrinal be used in cardiac patients (2 stents in lad) for ocd, anxiety, depression?

Can tofrinal be used in cardiac patients (2 stents in lad) for ocd, anxiety, depression?

I'll let MDs reply: On the rx issue, I must allow mds to reply. But - whatever they say, i'll strongly recommend that you also look into techniques that will help with all of the symptoms, including the cardiac ones. Any of the following: mindfulness meditation, stress reduction, relaxation exercises, yoga and/or targeted cbt will help a myriad of symptoms and probably make you feel more alive and happy too. Best! ...Read more

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What % of narrowing do you need for a stent as I've got 60% of mid LAD and been dishcharged from cardio? Put on statins asprin ect.

Stent: There is no benefit to stenting lesions that are not causing symptoms or objective evidence of myocardial ischemia. It sounds like you are being treated appropriately. Try to learn about popper diet, not smoking and exercise in addition to statin and Aspirin to help yourself. ...Read more

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Is it safe for a cardiac patient with 2 stents in LAD to use lithium.....also well controlled type 2 diabetic with oral med....sreatine 1.1?

Is it safe for a cardiac patient with 2 stents in LAD to use lithium.....also well controlled type 2 diabetic with oral med....sreatine 1.1?

Ans: I assume you are on your medications for the stents. Lithium is metabolized through the kidney so you kidney function is monitored and so far your creatinine seems ok. Now the diabetes can cause a problem for you and lithium if you kidney function is compromised due to the diabetes CSI be sure to keep your blood sugars as perfect as you can. Monitor closely. Your hardy issue is affected by the dm ...Read more

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My boyfriend is an avid triathlete and ended up with a 95% block in the LAD and had a stent placed. Why would he still have chest pressure and sob?

My boyfriend is an avid triathlete and ended up with a 95% block in the LAD and had a stent placed. Why would he still have chest pressure and sob?

LAD stent: Your friend should not be having chest pain and shortness of breath if the LAD block was stented successfully and it was the only problem. It is necessary to report these symptoms and be re-evaluated for other problems e.g. Silent heart attacks, congestive heart failure, failure of the stent, blood clots and other problems. It is wise to see the doctor frequently and meanwhile follow directions. ...Read more

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Should I get a stent, have bypass surgery, or try medicines for 100% blocked lad? If medicines, what are the most effective medicines for that. Thanks

Should I get a stent, have bypass surgery, or try medicines for 100% blocked lad? If medicines, what are the most effective medicines for that. Thanks

Need to see films: I would have to see coronary angiograms, echocardiogram, complete history and physical, pulmonary function test, hemoglobin a1c, cbc, chem 12, as minimum to advise anything. If the LAD territory is viable and the LAD vessel a good surgical target, and there is an internal mammary artery suitable, even if no other vessels require revascularization, no comorbidities would strongly advise lima-lad. ...Read more

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Which is safer in an average dose -klonopin or ativan-for a patient with cardiac disease -that is 2 stents in lad?

Which is safer in an average dose -klonopin or ativan-for a patient with cardiac disease -that is 2 stents in lad?

Both safe: Both drugs are safe for coronary heart disease. But they have somewhat different indications. You should use the one that best suits your needs. Let your provider help guide you. ...Read more

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If my lcx and LAD are less than 50% blocked (lcx due to stenting) but my ramus gets totally blocked, can this cause a heart attack?

If my lcx and LAD are less than 50% blocked (lcx due to stenting) but my ramus gets totally blocked, can this cause a heart attack?

Yes: Any coronary artery, including small branches, can cause damage to heart muscle cells if occludes (measured by cardiac enzymes). A heart attack from a smaller vessel is much less likely to cause death or significant disability. ...Read more

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If at LAD there is stenonis 80% at proximal, RCA there is long stenosis 60% at mid & stenting has not be done, whether AF ablation can be performed?

If at LAD there is stenonis 80% at proximal, RCA there is long stenosis 60% at mid & stenting has not be done, whether AF ablation can be performed?

1st things first: Ablation can be done but why wasn't the LAD addressed? If you're in an area with expertise to do AF ablation, there must be someone who can dilate your LAD - why was it not done? IT would make sense to do that first unless there is a good reason not to - (like a negative stress test?) ...Read more

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Mid LAD Shows chronic total occlusion with faint filling of distal LAD seen through collaterals, (LMCA, LCX, OMs, RCA are normal) Pls suggest Stent/Med?

Mid LAD Shows chronic total occlusion with faint filling of distal LAD seen through collaterals, (LMCA, LCX, OMs, RCA are normal) Pls suggest Stent/Med?

Cannot stent: You prob can't stent your mid-LAD as it is already 100% occluded. Good that you have collaterals to feed that downstream muscle. You should be on a statin med &#40;pravastatin, etc&#41; to prevent further atherosclerosis. Add a blood pressure med like Lisinopril if you have high BP. And use meds for angina, but only if you trigger it w/ activity. A daily aspirin is recommended. Any heart attacks? ...Read more

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Failed stress test. EF 33%. Poss. Blockage both RCA and LAD. Will be doing angiogram. What are chances this can be resolved with stent vs. Surgery?

Failed stress test. EF 33%. Poss. Blockage both RCA and LAD. Will be doing angiogram. What are chances this can be resolved with stent vs. Surgery?

Angiography: When the clinical indication for an interventional procedure in addition to medical therapy is present, one needs to first see the coronary anatomy to determine what is the best procedure for the patient. When multivessel disease is present in such a patient, often surgical intervention is preferable to stenting but not always. After the angiogram discuss the choices with your Dr. ...Read more

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Have you had any patients who got a sudden blocked LAD artery, MI, and SCA, and who survived despite stent failure (permanent total blockage)?

Have you had any patients who got a sudden blocked LAD artery, MI, and SCA, and who survived despite stent failure (permanent total blockage)?

Depends: Well sometimes these blockages happen slowly therefore the heart compensate and make collateral circulation which supplies the myocardium (heart muscle) which saves the patient. ...Read more

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My husband has CAD and had a stent placed in his lad. One dr. Says stay on plavix (clopidogrel) and the other says it doesn't matter. Why the controversy?

Stay on: The opinions are mixed. You need to stay on it for a year definitely. Occasionally stent thrombosis occurs late after stunting in a complex lesion. Only your cardiologist knows the complexity of your disease. ...Read more

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I am a cardiac patient with 2 stents in lad. Problems breathing in cold. Below 35 degrees and in heat. Is this common. Can it be med related?

I am a cardiac patient with 2 stents in lad. Problems breathing in cold. Below 35 degrees and in heat. Is this common. Can it be med related?

Problems: This kind of problem is not unusual but you should consult your cardiologist to see if something untoward is going on. There may be steps your cardiologist can take in evaluating and treating the symptoms. ...Read more

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Due to a heart attack in 2005 I had a stent to my LAD. I also have diffuse atheromatous disease to my RCA. So, what is the reason of Ramipril 1.25.

Due to a heart attack in 2005 I had a stent to my LAD. I also have diffuse atheromatous disease to my RCA. So, what is the reason of Ramipril 1.25.

Heart attack in 2005: Ramipril (& its family, the ACE inhibitors) have been shown to reduce the risk of heart attacks & vascular events (strokes) in pts who have had prior vascular events. Your greatest risk factor for another stroke or future heart attack is the fact that you (claim you) had one in 2005. To reduce future risk, you should take Ramipril & also aspirin, statin (RCA disease), & beta-blocker (an "-olol"). ...Read more

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Have relatively short 100% blockage in mid LAD &100% posterolateral branch of circumflex artery (both relatively small targets).Will stent help or ris?

Have relatively short 100% blockage in mid LAD &100% posterolateral branch of circumflex artery (both relatively small targets).Will stent help or ris?

Stent: There are technical factors in deciding whether stenting is possible and physiologic predictions of whether successful stenting will yield benefit. Your doctors including interventional cardiologist are best to advise you regarding your specific situation. ...Read more

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Have CAD stent cto LAD 17month ago. Cbc shows mpv12.4. read higher mpv could up risk for cv events. Take asp.81mg, no more effient. Am concerned. What todo?

Have CAD stent cto LAD 17month ago. Cbc shows mpv12.4. read higher mpv could up risk for cv events. Take asp.81mg, no more effient. Am concerned. What todo?

No new therapy: I believe your MPV is so close to normal range that additional therapy aimed specifically at that would not convert to any meaningful change in outcome. Certainly keep taking your aspirin 81 daily. Good luck ...Read more

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Can dual antiplatelet therapy (ASA + Plavix) last 3 months only? One stent Xience V on LAD.

No: With a Xience you need at least 6 months of DAP. No compromises on that PLEASE, until unless your doctors have told you something otherwise. ...Read more

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I had a major heart attack in aug 2012 with 100 percent blockage in LAD and one stent is inserted please give precaution?

I had a major heart attack in aug 2012 with 100 percent blockage in LAD and one stent is inserted please give precaution?

Follow up: Need monitoring and close follow up with doctor for care.Lipid management keep LDL close to 70 or below, anti platelet agents like Plavix (clopidogrel) for 1 year, ace inhibitor like ramipril, beta blockers and exercise program. ...Read more

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My 56 year old mom had heart attack, LAD was totally occluded, they put a bare metal stent in what is the outcome and her prognosis?

My 56 year old mom had heart attack, LAD was totally occluded, they put a bare metal stent in what is the outcome and her prognosis?

Type of stent: It depends upon the size of stent. Large stents stay open better than smaller ones. Typically for bare metals stents the renarrowing rate is between 1 in 10 and 1 in 20. ...Read more

Dr. Milroy Samuel
5 Doctors shared insights

Cardiac (Definition)

Cardiac translates literally to "heart, " and any place the term is seen, such ...Read more