My patients, who have had a stent (that expandable mesh tube that widens a blocked artery for blood flow and stays that way) implanted after a heart attack, always have a question. Do they need to come back for a second stent or is the first one fine? To them I say, they are lucky that they survived and had the wake-up call. But the rest depends on how strictly they follow certain rules and stick to them for the rest of their lives.
All you have to do is modify your lifestyle, take your medication religiously and maintain certain standards. Yes, sometimes scar tissue can develop on the stent over time but these events are rare. So what should be the drill after stenting?
1) To start, make sure your low-density lipoprotein (LDL) or bad cholesterol stays below 55 mg/dL for the rest of your life to reduce the chance of plaque formation and dislodgement from the walls clogging arteries. When LDL levels are below 70 mg/dL, arterial plaques are smaller and more stable. Other factors like blood pressure, body weight and diabetes should always be checked. Anything that goes off the charts can be a risk factor.
2) Regular exercise helps lower blood pressure and speed up your recovery. But rest for two weeks after your angioplasty/stenting procedure. Then follow a graded cardiac rehabilitation program so that you can resume moderate activity in six weeks. Always do a warm-up and cool-down routine before each activity session. Do not carry more than 5 kg for 6 weeks. Begin light to moderate physical activity, such as walking a short distance or climbing stairs, two or three times a day. Endurance and resistance training must come next. If breathing and pain are felt, stop at the slightest sign of discomfort. Work with your doctor.
3) Adjust your diet. Switch to a low-carb diet immediately. Eat clean to prevent plaque buildup, so eat high-fiber fruits, vegetables, whole grains, nuts, and seeds. For protein, include eggs, fish with omega-3 or healthy fats, low-fat dairy, tofu, fruits and nuts. Avoid sugary soft drinks. Aim for five servings of fruit and vegetables (eat as a snack between salads and fruit) and you’ll manage at least three that way. Reduce salt intake as it helps lower blood pressure and prevent fluid retention.
4) Give up smoking and alcohol for good.
5) After angioplasty/stenting, you will be given anti-platelet drugs to reduce the risk of blood clots inside your stent, lipid-lowering drugs to control cholesterol and triglycerides, which cause plaque. You will be prescribed beta blockers and/or ACE inhibitors, which help control high blood pressure and prevent angina and heart attacks. Everyone has individual needs for medication. Do not neglect follow-up blood tests, echocardiograms and chest X-rays for the first year after surgery. You will better understand the workings of your heart.
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