Angioplasty and stent - heart - discharge

When You Were 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 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. Complete recovery takes a week or less. Keep the area where the catheter was inserted dry for 24 - 48 hours.

If the doctor put the catheter in through your groin:

• Walking short distances on a flat surface is okay. Limit going up and down stairs to around 2 times a day for the first 2 to 3 days.
• Do NOT do yard work, drive, squat, carry heavy objects, or play sports for at least 2 days, or for the number of days your doctor tells you to wait.

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

• Do NOT lift anything heavier than 10 pounds (a little more than a gallon of milk) with the arm the catheter was in.
• Do NOT do any heavy pushing or pulling with that arm.

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

• Avoid sexual activity for 2 - 5 days. Ask your doctor when it will be okay to start again.
• Do NOT 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 - 48 hours.
• You should be able to return to work in 2 - 3 days if strenuous activity is not part of your job.

You will need care for your incision.

• Your doctor or nurse 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 health care provider may give you medicine to help lower your cholesterol.

Most people take aspirin or another medicine called 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 doctor tells you. Do not stop taking them without talking with your doctor 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 doctor (cardiologist).

Your doctor 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 heart disease, such as

• Taking care of your angina
• Care after a heart attack

When to Call the Doctor

Call your doctor 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 - 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.

References

Kushner FG, Hand M, Smith SC Jr., King SB 3rd, Anderson JL, Antman EM, et al. 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (updating the 2005 Guideline and 2007 Focused Update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009;120:2271-2306.

Wright RS, Anderson JL, Adams CD, Bridges CR, Casey DE Jr, Ettinger SM, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 Guidelines for the Management of Patients with Unstable Angina/Non-ST-ElevationMyocardial Infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in collaboration with the American Academy of Family Physicians, Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons. J Am CollCardiol. 2011 May 10;57(19):e215-367.

Vandvik PO, Lincoff AM, Gore JM, Gutterman DD, Sonnenberg FA, Alonso-Coello P, et al. Primary and secondary prevention of cardiovascular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: AmericanCollege of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e637S-68S.  

Pfisterer ME, Zellweger MJ, Gersh BJ. Management of stable coronary artery disease. Lancet. 2010 Feb 27;375(9716):763-72.

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