I am sorry to keep bothering people with this question, but every day I learn more and more and get nervous more and more almost to the point of panic! I saw my cardiologist yet again (its usually at least once a month) and we're considering yet another cardiac cath in a couple of weeks. This one will be my 5th cath since May 2005. The prior caths, all but one required more drug eluting stents in the same artery. ( I think this is called rethrombosis?) Anyway, I even went to the FDA site to read about these stents, and they're not even sure about them! I am sooo nervous!! The more caths I get the more risky they are. What if they find another blockage??? I don't want to keep getting the same stents that seem to be causing the problem. But if I dont get the stent...then what?? Is there anyone out there who has had drug eluting stents and what is your opinion on them. Good or Bad I need to hear something.

I have one stent in the main trunk of my RCA...it is drug eluting.
I haven't had any problems and it has been in for exactly 2 years.

Pwarbur,
An option for you is to ask your cardiologist to angioplasty and blockages he finds, whether IN a stent or elsewhere.

After 5 stents, perhaps saying enough is enough might be reasonable.

Before the age of stenting, I had a neighbor with a "bad heart" and every year or so my mother would say that "Jockey had another baloon procedure on his heart"...he went on for 15 years like this when his emphysema eventually killed him, so plain vanilla angioplasty DOES work.

Another option for those who keep making new blockages is ATHERECTOMY where the plaque is carved out and removed.

What levels of LDL do you have? What drugs?

What are your symptoms? I have a completely blocked LAD (collateral vessels have provided a natural bypass. And a branch (circumflex) about 70% block. The RCA artery (98%) was implanted with a drug-coated stent 2 years ago.

You should be alerted that many stent implants may not be necessary. If you don't find relief from symptoms (angina, SOB, etc.), the continued intervention should be questioned as whether or not it is the correct treatment for you.

The guidelines recommends a stent implant not be done on a 70% or less blockage. The intervention cardio who did my RCA stent, and then a short time later wanted to do the 70% when I had no symptoms.:mad: I asked what that would do for me. He couldn't speak English very well so I never got an answer, just a shrug. No doubt in my mind he was after the money and didn't really consider my best welfare. MY opinion was somewhat validated after he moved out of state a month later.

I'm sort of turned off with foreign trained non-speaking or lightly speaking English doctors. A significant part of their professional life is communicating!! Hope you don't have a similar doctor and experiencing identical circumstances. A good doctor should be able to explain your condition and the expected results with treatment. If it doesn't make sense, or you can't understand his objective, find a good doctor.

Actually I have a very good cardiologist...or so I think. He is a young Jewish man (and quite good looking!!! must be the reason for all my heart probs. lol ) anyway, he is the one who does the cath but not the actual stent placement, I think the cardio who does the placement is from India or some place like that..and he told me last time, that I cant keep coming back every 6 months for a cath...but I cant help it if I keep getting blockages! I think the stent is causing them if you ask me. Anyway, my classic symptoms are arm and shoulder pain...and jaw pain. Sometimes shortness of breath but thats usually when I think about it...then I convince myself I cant breath. Sometimes my left arm gets a lil numb, but I wonder how much of that is circulatory cause it happens alot when I type. I dont have any chest pains as of now..just the pains. They are going to schedule me for another cath in 2 weeks..but I feel really uneasy about it and not sure what to do. My doctor pretty much leaves it up to me..cause everytime in the past I had these symptoms, I would get a cath and stent. The first 3 stents was 90% blockage, the second stent was a blockage between 2 of the 3 stents prior..dont know how much that was. And the last stent was 20% blockage on a bend in the same RCA. The last stenting hurt like hell and I havent been the same since. AGGGGHHHH

I guess I was lucky in that I had a wise, communicative, U.S. trained, highly rated cardiologist do my angiogram AND stent at the same time, with continuous clear communication with me...over ALMOST all issues.

I have also been reading that with stents, there is good evidence that angioplastying or atherectomying the distal end of the stent is a good precaution.

Pwarbur,
Is that arm, shoulder and jaw pain always WITH EXERTION?
Why not have another nuclear stress test before you do another angiogram? Find out the focus of the ischemia. IF it is again the RCA, seek out someone who can do an atherectomy. IT would seem yet ANOTHER stent in the RCA is asking for more trouble.

Highlight is that since you started with a 90% blocked RCA, evidence is good that you developed a collateral circulation that will save your life in case of total blockage.

And the last stent was 20% blockage on a bend in the same RCA
That's just malpractice, plain and simple.

QUOTE Lenin: at arm, shoulder and jaw pain always WITH EXERTION?
Why not have another nuclear stress test before you do another angiogram? Find out the focus of the ischemia. IF it is again the RCA, seek out someone who can do an atherectomy. IT would seem yet ANOTHER stent in the RCA is asking for more trouble.

Highlight is that since you started with a 90% blocked RCA, evidence is good that you developed a collateral circulation that will save your life in case of total blockage.


Quote:
And the last stent was 20% blockage on a bend in the same RCA

That's just malpractice, plain and simple.

I agree with that assessment. It is possible there are multible lesions that do not heal properly such as if one has diabetes, etc. A good evaluation with a scan to determine where there may be a deficit supply of blood notwithstanding the blockage. It may require a by-pass or other treatment to supply blood to the deficit area as it appears stents don't help very long if ever!

Actually the pains come WITHOUT any exertion whatsoever. They just come all by themselves. I try to rationalize any reason why I may be having these pains other than blockage issues..and if it werent for having the very same pains with past blockages and going away for a while after the stent placement..then I wouldnt be so suspicious about the pains now. For some reason tho...for the past week I have been getting pressure in my ears and feeling a little light headed when I stand after sitting for a couple of hours (my job requires just sitting and typing) that didnt use to happen before. And just today I was a little short of breath after walking and talking..but that went away. As I sit here typing, I am having a pain between my shoulder blades and that numbness in my left arm..but the arm numbness comes every time I sit here and type. The pain between my shoulder blades is concerning me somewhat but I am not sob right now. I cant run to the ER every time I get scared..but I never know when I should go or not. I dont think I will accept another stent..tho I need to know other options.

I agree with an earlier comment.... Get a second or third opinion. Life shouldn't be that tough.
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I had two eluting stents implanted more than two years ago, at age 66 and have returned to a full program of exercise, taking only 10/40 Vitorin and a teeny-tiny aspirin. I've passed three stress tests with a fourth pending.
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I've also followed a very fit wife walking through several European cities since the implants, mostly uphill as I remember it, and climbed to the top of a variety of cathedrals, monuments, hills and castles..... and we leave for Belgium in a month or so.
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:wave:

You do have the symptoms of a heart problem. Does an echo indicate a normal EF (55-75%) and no valve regurgitation.

Medication's side effect can cause the ear and light headedness discomfort.

I don't know or believe you should go to the ER everytime you are symptomatic, but you certainly don't want a continuation of the symptoms. It has to be very difficult to maintain some equilibrium in your emotional state from day to day. You should get some answers and help from a good doctor.

Ohhh I forgot to mention about the echo.. I have been diagnosed with MVP with reguritation. But I dont think that would cause the symptoms I have would it? I know it causes ectopic beats but as far as I know not the other problems. Did I mention that when I do water aerobics or some other activity like painting in my house, that I feel fine? I have no problems on exertion. So what do you think?

but the arm numbness comes every time I sit here and type

That REALLY sounds SO much more like a nerve pinch than an angina attack.

Do you have nitroglycerine lying around your medicine chest? Pop (or sqirt) one or two next time you feel the arm, jaw numbness/tingling and see if you get immediate relief. It will "cure" angina but not a nerve impingement.

I would glady accept that, but wouldnt a pinch nerve be constant pain instead of pain that comes and goes at various times? I would love for the pain to be anything but heart related, I can accept and live with anything but that. And its also random in my right jaw. I am embarrassed to say tho..I carry a big bubba keg of water to my job at night in my right hand. I noticed last night that it was pulling heavy on my right arm and the muscle was tight (not hurting) all the way up to the top of my shoulder. Do you think that it could radiate, later not at the time, up to my jaw? I dont get the pain at the time of carrying the heavy thing, but later and at different times of day. I do also have to admit that I have been carryin a heavy bag containing a portable tv on the left shoulder at the time when I carry the water in the right hand...I know it sounds pretty obvious that that is what should be causing my pain.. but I have been carrying these items for years and I only seem to have these two types of pains when I have blockages and they go away after stenting only to return 4-6 months later.:dizzy: :dizzy: :dizzy: :dizzy:

A "pinched nerve" is apt to recur at times when you bend something JUST RIGHT...sometimes the motion seems ever so slight.
Sure that carrying stuff can inflame the area and the inflammation causes later swelling which squeeezes the nerve til it hollers uncle.

Get hold of some nitroglycerine and see if it makes the pain go away instantly...if it DOES, then it probably IS your heart :(.

You doctor should have no trouble with prescribing a cheap "popper" for you...usually called NITRO-something. Better yet, ask for some of his "samples."

Yep, an upper vertebral nerve pinch can certainly radiate to your jaw. But that jaw pain, IF ON EXERTION, really is one of the hallmarks of angina.

Actually I do have some nitro spray, so next time I get the pains I will try it. But I was told...if the pain does not go away then its a heart problem. I dont know, I have always been confused about the nitro.:rolleyes:

Actually I do have some nitro spray, so next time I get the pains I will try it. But I was told...if the pain does not go away then its a heart problem. I dont know, I have always been confused about the nitro.:rolleyes:

It's more the reverse, Pwarbur. If the pain DOES go away with a nitro-spray it becomes much more likely your problem was angina. A spray of nitroglycerine won't do a thing to ease the pain of a muscle tear, ligament strain, or nerve inflammation.

I just got the results of my third six-month stress test. My two stents, both major, are doing fine. I passed with flying colors. Looking forward to entering my 70th year in August.

:wave: