Primary Angioplasty ( Room)

 

Long term course and care.

Heart attack or acute myocardial infarction is an injury to the heart muscle. After the heart attack the healing process starts and continues for 4 to 6 weeks. This period is very important to ensure that the healing happens to our benefit.

 

What can we do to help?

However normal you may feel, the first four to six weeks time, is the time to take it easy. The only way our heart can rest is, we ourselves not exert too much physically and mentally. It is generally recommended that we undertake only necessary physical activity during the first week. Beyond the first week, physical activity is gradually increased as per individual tolerance. You may start with 5 minute walk twice daily and gradually increase it by a minute every day. By the end of the first month you should be able to walk 30 minutes twice daily at an easy pace. If you have a smart watch that can monitor your pulse rate please do so and bring the data at your next visit.

 

Questions about stents

 

1 What are stents?

Stents are metallic mesh or tube that act as a supporting scaffold to prevent blocks from coming back.

2 What are drug coated stents?

Stents when coated with some specific medicines are even more effective in preventing blocks from coming back. Most of the current angioplasty procedures are done with drug coated stents.

3 is there any difference between different drug coated stents

All the currently available drug coated stents are extremely good with little difference between them. The stents that we use have undergone rigorous testing and approval by appropriate government agency. Please be assured that you have received the best stent available currently and that suits you.

4 Do these stents dissolve

No these stents do not dissolve. Our own tissues will cover them over a period of 6 to 9 months. After that period they stay as inert material with no consequence.

Previously absorbable stents were available. But they have been withdrawn from the market as the results with absorbable stents were not satisfactory.

5 What happens to the stents until they are covered by my tissues

Until the time that the stents are covered by our tissues (6-9 months) , the blood that flows through the vessel is exposed to the metallic stent. There is a natural tendency for the blood to clot. To prevent that from happening we recommend that you take two blood thinner medicines (DAPT) without missing even one dose. This has to be done for or at least one year or as long as you are told by your cardiologist.

What is DAPT?

The long form of DAPT is dual antiplatelet therapy. All patients of angioplasty stent procedure need DAPT. Usual recommendation for DAPT is up to 1 year. However it may be less or more as per your cardiologist. 

What are the medicines used in DAPT

1 Aspirin 75 milligram or 150 milligram ( ecosprin)

This is the first of the two medicines of DAPT. It is taken once daily after food

 

The second medicine could be one of the following three medicines

1 clopidogrel 75 milligrams plavix clopitab this is taken once daily after food OR

2 prasugrel 10 milligram prasudoc prasita this is taken once daily after food. OR

3 ticagrelor 90 milligram brillinta axcer. This is taken twice daily after food

 

What happens if I miss DAPT?

People who missed their dose of DAPT are most likely to develop clot inside the stent and therefore Heart attack. Even one missed dose can lead to Heart attack. So DO NOT MISS EVEN ONE DOSE of DAPT.

 

Can there be re blockages inside the stents

1 to 5% of stents will develop re blockages. This is called instent restenosis. 

 

What lifestyle measures can I undertake to prevent heart attack?

 

You can take care of yourself by doing the following four things

1 Sleep well

2 Eat well

3 Exercise appropriately

4 Learn stress management techniques like yoga meditation.

 

Have you collected your Angioplasty CD and report?

Please collect your Angioplasty CD and report from the cath lab reception. 020 4915 3278