Chest Pain

Eight failed stents in a row!

i just had a heart attack again on the 19 of march 2016 they put a stent in me again to open up the flow this will be my 8th stent but now i am still having a lot of presure in my chest is that normal it is uncomfortible or is there something else going on  

Any recurrent chest pain after stenting indicates a very real risk of stent failure and you need to see your doctors immediately to get checked. Your symptoms are consistent with angina. Ask for another stress test or a 2nd opinion if your cardiologist refuses. You now have a long-standing and recurrent problem (stents) that fail! You can calculate the optimal treatment in your case here.


I'm 61 and on my last visit to my cardiologist, he wanted to do a heart cath to see if anything was going on in my heart.  I had been to the emergency room 2X in the prior two months with high BP 200/110 on one occasion and 180/100 on the other.  In both cases my heart rate had increased to 120-130 at rest.  The ER found nothing wrong with my heart.  My EKG was normal, as it has always been, and a contrast CAT scan of my chest showed no abnormalities. (BTW, my older brother is treated for the same condition with meds). At my last visit we agreed that I would continue losing weight (I've lost 21 pounds.  I'm 6'1" and 192 now), cut out the fatty food and exercise more.  We would check my blood work in 3 months and consider taking statins.  My HDL is 43, my LDL is 119, my total cholesterol is 180 and my triglycerides are in normal range.  It sounded like a great plan. Two days after my visit I went back to a local ER because my BP and heart rate jumped again.  Again, nothing was found wrong with my heart. The next day, my doctor's nurse called and said that my doc would really like to do a heart cath to see if I have any issues.  I agreed, mostly because I have a bicuspid heart valve, which has no stenosis and mild regurgitation.  There is no heart disease anywhere in my family and so I expected that he would find nothing. Prior to entering the cath lab, I specifically asked to be awake for the procedure and to talk to my doc before we started.  Neither request was granted as the technicians  knocked me out and I did not get to talk to my doc.  Two hours later, I woke up with a stent in my Circumflex Artery that I did not want nor agree to for 70% to 80% blockage and no chest pains or symptoms. So, now I'm on all the meds, my chest occasionally has pain that it never had before and I'm worried sick about a blood clot and restenosis.    

You certainly have every right to complain: no doctor should perform a procedure w/o a pt’s permission, and it is questionable whether you needed the stent. While you have proven coronary artery disease with hypertension and overweight as risk factors for future heart attacks and/or stroke, your weight loss and excellent cholesterol data would have been reasons for me to focus on getting your BP under better control, helped by continued diet and weight loss: so called "Optimal Medical Therapy" has proven to be just as effective (if not better)!

It is impossible to tell whether these new chest pains are a result of the stent procedure, but they do fail on occasion, so you may need to be re-evaluated to check whether this has happened if your symptoms persist! Please read this post about the subject:

Acid Reflux versus Angina Symptoms

HelloI'm a 39 year old female who has suffered from acid reflux for the last 7 or so years. The reflux cause me breathing difficulties, and was wondering if this, the breathing difficulties could cause any type of heart disease?Thank youRegards
Acid reflux (GERD) often produces breathing problems because of chronic aspiration of stomach contents. Patients with CAD usually have cardiac risks (that or course might be also present in a pateint with GERD). However, usually a physician can figure out what is what. That said, I have performed a coronary bypass operation  on many a patient where GERD was diagnosed instead of CAD.

Aortic Dissection Type B complications

My 78 year-old active mother was flown to an out of town hospital last week after she was diagnosed with Aortic Dissection Type B. She is being managed with medication in order to keep her blood pressure under control.  There was no surgical intervention. Tests (CT scans, blood work, sonogram) did not show that any of her organs or limbs were involved.  However, since this has happened her mobility has been affected in that she cannot walk very far. Both of her legs are weak from her knees to her hips and she can barely walk 20 feet without having to sit down.  This has greatly affected her quality of life and activity level.  We are wondering if this is some type of claudication as a result of the dissection, if it’s something temporary, something permanent, or something entirely unrelated.
Hi Carol,
Her symptoms (if new since the diagnosis of Aortic Dissection was made) should be re-evaluated for further treatment The initial therapy was correct but only for as long as no other complications occur. The dissection may well have 'cut off' the circulation to her legs and she should be re-tested!
Hope this helps,
Dr T

My stents failed within days after treatment for a heart attack

I had a heart attack 2.5 weeks ago. Next day 3 stents were placed in right coronary artery. Pressure became constant. Went in for more stents in left coronary and was told the right stents had totally closed up. Dr was not able to penetrate any of the 3. He did not place more in right side. So now I am on additional medicines. What can I expect as far as my recovery? Never knew I had heart problems until heart attack. Only other thing I have is hypertension. Dr said diet and exercise will reduce if not cure this problem along with additional arteries growing above blockage and trying to reattach to right artery below blockage. Have you ever heard of that happening?  

The right coronary artery is totally blocked, but its downstream portion is filled backwards from the Left coronary artery's major branch, the LAD.

Optimal treatment of coronary artery disease

I am having 90-95 % of block in both branches of LAD and 60% of block in RCA. Also have medically controlled normal diabetic,hpertension and cholestrol. Dr. sujested angioplasty; should it be cured by medication ? I have under gone EDTA  chelation therapy and took 20 days (twice a week-EDTA+VIT-C,etc;)  

Atypical exercise recovery chest pain

Hello Doctor, Im a 30y/o female in good health. Good wt, bp, chol, etc. I have worked out for over a decade. In the last year, I have had shooting pains up to my chin and faintness strictly during the Recovery phase of my workout. I run for a few miles, feel fine, but as soon as a slow to a fast walk, the pains start shooting up my chin. If i start running again the chest pain goes away, but I eventually have to end my workout, and the pain sets in again. I think sometime is wrong with how my heart recovers from cardio exercise.  Have you ever heard of this?
Hi Mary Ellen,
In absence of cardiac risks these chest pains are very unlikely to be caused by your heart. You can calculate your cardiac risks here.
Based on your symptoms (pain disappearing with exercise - not the other way around), I suspect a muscular skeletal issue, but this should be checked with your doctor.
Hope this helps,
Dr T

Please help me interpret these cardiac tests

Fibrous pericardium with granulation tissue with fibrinous exudate mild fibroblasia. There are mononuclear cell infiltrates with rare leukocytes and eosinophils What is organizing fibrinous pericarditis? What are the short term and long term implications? Thank you

Hi Amy,

These results mean you have had a pericardial effusion that was drained. Examination of the fluid only shows normal inflammatory cells, meaning you may well have had a viral pericarditis and this is your body's response. Prior to this you probably hace had a variety of symptoms that included chest pains, shortness of breath, fever, and decreased exercise tolerance.

(Image from: Causes of Pericarditis)

Sudden Chest Pain Years After A Pectus Excavatum Repair

I am a 30 year old male who had severe Pectus Excavatum repaired via Ravitch procedure when I was 15. The surgery was mostly successful and my chest has even greatly improved. About 3 months ago I experienced sudden onset of chest pain (about a 3-4 on scale of 1-10) while watching a movie which caused me to have a panic attack/palpitations. After extensive cardiac investigations including many ECG's, 24hr Holter, echo, stress echo and CTCA, all heart issues have been ruled out by my cardiologist. The only anomaly were 5 runs of SVES on the Holter, RBBB on all my ECG's and abnormal wall motion at peak exercise after the stress echo. The CTCA was ordered because of the 'rocking motion' that was viewed during the stress echo. Because the CTCA was normal with calcium score of zero, the wall motion abnormality was put down to compressed RV wall due to residual Pectus Excavatum. I apparently don't have any of the cardiac problems that can be associated with PE (eg MVP). The pain has not improved in the last 3 months. It is mainly situated down the left hand side of my rib cage, under my arm pit and can sometimes also be felt in my back. Pain to the left of my sternum is also common. I do not feel pain when the area is touched or manipulated. Exercise does not appear to make the pain worse, though I have ceased going to the gym and lifting weights. I'm still not confident in the diagnoses of non-cardiac chest pain but I am unsure of what other avenues I should be pursuing. Where to from here? Also, are wall motion abnormalities without the presence of heart disease of concern?

(From Mayo Clinic Medical Education Resources)

Hi Jamie,

All the tests have proven your heart to be OK. The "rocking motion" (the wall motion abnormality) is probably the result of a residual chest wall depression that is still pushing on your heart, however, w/o it causing any functional abnormality.

The Ravitch procedure includes removal of the deformed rib cartilages and a metal rod(s) to push the rib cage outwards and thus restore a normal chest wall configuration:

Chest Pains After Stenting

I am 59 old female and had heart attack three months ago with (%95 blockage) in left artery. I had a stent placed, however; still have some pain in jaw,lower back of the head, mid chest discomfort, heart palpitations. I have been at the Emergency  many times (3 times admitted to the hospital for the same symptoms) and been in many tests done which showed everything looking good without knowing a reasonable cause of the pain and my cardiologists want me to go the ER each time I have the pain (having the pain EVERY DAY).  

If your tests show the stent is working and the blood flow to your L coronary artery (+elsewhere) is now normal, it is not angina you are suffering from (unless you have other blockages that have not been treated). I assume you have had a stress test to confirm everything is well.

You may want to confirm this with your doctors, and/or ask for a second opinion. You may have coronary artery disease in other locations!

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