A coronary artery disease or CAD occurs when there is a build-up in the arteries. In such conditions, it can interrupt the flow of blood to your heart. Plaque causes narrowing or blockage which can result in a greater risk of having a heart attack. Symptoms could include chest pain, discomfort in breathing and shortness of breath.

Cardiovascular diseases are the leading cause of death globally, according to World Health Organisation, it takes an estimate of 17.9 million lives each year. More than four out of five deaths are due to heart attacks or stroke. The most important behavioral risk factors are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. If you have CAD your doctor might suggest using a stent to treat it. It’s a procedure called Coronary Angioplasty in which the doctor will insert a stent into your coronary arteries. A stent is a small tube made up of metal mesh that is designed to support your artery walls and prevent plaque from blocking your blood flow. It helps the blood flow more freely to your heart. During angioplasty, a thin tube known as a guiding catheter is inserted through the groin or wrist and is then moved towards the site of the blockage. A small balloon at the tip of the balloon catheter is inserted through the guiding catheter near the blocked or narrowed area of the coronary artery. When the balloon mounted with the stent, is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened (dilated) to increase blood flow to the heart. Once the plaque is compressed and the artery is opened sufficiently, the balloon catheter is deflated and removed. The stent will remain as a permanent implant in the coronary artery.

Your doctor may use a bare-metal stent(BMS), Drug-eluting stent (DES), or BioResorbable Scaffold (BRS). A drug-eluting stent is the most common type of stent used lately. The new and improved versions of drug-eluting stents are considered safe and effective in most cases. They have ultra-low strut thickness that promotes early vascular healing, the variable strut width, and variable crown design ensure adequate radial strength. However, BRS is a next-generation bioresorbable technology with a low strut thickness of 100 microns which fully resorbs naturally in the artery within 2-3 years, thus restoring the vessel to its true form and nature.

In this blog, you will learn more about Drug-Eluting stents and their benefits.

So what is a Drug-eluting stent? 

DES is a standard metallic coronary stent that has a polymer coating and an antiproliferative drug. It allows drug elution into the coronary wall for weeks and months after stent implantation. It releases medication directly into your artery which helps the scar tissues from forming within the stent and narrowing your blood vessels again. That’s how Drug Eluting stents work you might need to take additional medications including blood thinners after the procedure. 

Benefits of Drug-Eluting Stent 

They can prevent plaque build-up, relieve chest pain, and promote good blood flow to your heart. They may also lower your chances of having a heart attack. 

As it’s a less invasive procedure than coronary bypass surgery, which is recommended to people who have more than two narrowed arteries. So most people recover within few days of inserting the stent. A stent helps you get back to your regular schedule faster. In contrast, coronary bypass surgery takes six weeks or more to recover. 

With Benefits, Drug-Eluting Stents even have risks: 

Like any medical procedure, coronary angioplasty or stenting do involve risks, including: 

• Bleeding or clotting 
• Damage to your blood vessel
• Infection 
• Kidney damage caused by the dye 
• Allergic reaction to the anesthetic, dyes, or other material used 
• Scarring of your blood vessels 
• Heart attack and stroke, which is rare

If you form scar tissue after stenting, the doctor may need to repeat the procedure. In case you have chest pain report to your doctor immediately as it could be a sign of serious complication. 

There are also few other things you should consider before getting a drug-eluting stent.  

For patients with a history of bleeding problems, a drug-eluting stent might not be a good option. Apart from this, you might need to take blood thinners for the rest of your life to prevent your blood from thickening and causing the risk of clots in the stent. Your doctor would give you additional information on what to expect before and after angioplasty. 

How to live with a stent? 

Having a stent doesn’t mean you have to live differently. But you will have to take extra care of your heart by eating right and healthy. Be active and take your medications. Follow few precautions such as: 

• Take your blood-thinning medication this would prevent heart attack and stroke. After stenting, you will take aspirin plus another antiplatelet for at least 6 months. If you are at a high risk of bleeding your doctor with shortening the duration of these medicines. Work with your doctor to decide how long you will be needing the medications. The decision depends upon your risk of having a heart attack, risk of bleeding, and your preferences about taking the medicines. 
• Stent identification card- Your doctor will provide you with a stent identification card that you can show to your health professionals so that they know you have a stent.    

Protect your heart health

You can lower your risk of developing blocked arteries or having a heart attack by practicing healthy habits. Common risks for heart disease include high cholesterol, high blood pressure, and being overweight. All of which can be managed with a healthy lifestyle. For example, having a balanced diet and regular exercising can go a long way towards keeping your heart healthy and strong. Smoking would put you at risk. If you are a smoker then now would be a good time to call quits. 

If you are diagnosed with CAD, to prevent complications follow your doctor’s instructions and treat it. Drug-eluting stents are a good option for patients with CAD but they are only one part of the solution. You may have to take statins, aspirin, or other medications. 

Follow your doctor’s advice and take their prescribed medicines and also follow their recommended lifestyle which will keep your heart healthy. 

Heart disease often involves a problem with the valve, coronary arteries, or muscles all of which causes the heart to not function normally. The common heart disease among patients is CAD which arises from a build-up of plaque on the inner surface of the arteries. In the worst cases, it blocks the artery. Stents are instered to open the blocked artery and restor the blood by increasing the lumen area of the artery which got compromised due to plaque formation,it becomes even more important in the emergency like situation when patients suffer from the Heart Attack as due to thrombus a blood flow is totally stopped or compromised leading to the death of cardiac muscles due to lack of oxygen this need a immediate action to remove the thrombus or clot with help of medicines or angioplasty.

The idea of cardiovascular stents revolutionized the treatment of coronary-related diseases. Since then, stents have been used in coronary and peripheral procedures for decades. Let’s take a look at newer kinds of stents, their evolution and understand why better stents are needed.­­­­­­­­

What is the function of stents? 

The main purpose is to open the blocked coronary arteries which occurred due to plaque formation. A stent is a tiny mesh tube inserted into a blocked passageway to keep it open, it restores the flow of blood. It is usually needed when plaque blocks blood vessels. Commonly used heart stents  are made up of materials like stainless steel,cobalt chromium or platinium. It can be coated with medication to facilitae optimal healing.

Evolution of early stents

The first used stents were successful at reducing the risk of restenosis following angioplasty by about half, from 20% to 10% in the 12 months following the procedure. The first generation of stents was called bare-metal stents (BMS) as they were mostly fabricated from metal. These permanent frameworks are made from chrome steel and cobalt-chromium alloys for balloon-expandable and Nickel-titanium for self-expanding stents. This revolution was considered the turning point in the field of angioplasty however it had its disadvantages of increased risk of restenosis.

Stent developers started to coat bare-metal stents with polymers containing drugs that were aimed at inhabiting extra tissue growth at the site of the stent to reduce the rate of restenosis. These stents are called drug-eluting stents (DES). DES has been constantly developed by using several drugs.

DES has bought its advantage to overcome the limitation of BMS. Despite the influence in the clinical practice in vascular intervention, the major subject of the debate was incomplete endothelialization and hypersensitivity reactions to the polymer coating. The first-generation DES had all these drawbacks which had them failed. Due there coating material not being biodegradable or biocompatible their long-term efficiency was questioned. The potential risk associated with DES were late thrombosis and delayed healing.

The formation of a grume within the artery at the location of the stent is stent thrombosis. It is different from restenosis. Restenosis is the regrowth of tissue, it is a problem but it grows gradually so when it occurs there is time to treat it. In contrast, stent thrombosis tends to occur suddenly without warning, it commonly leads to the complete occlusion of the artery that then tends to produce a myocardial infarction (Heart attack) or sudden death.

In the youth of stenting, the matter of early thrombosis was recognized and successfully addressed by administering powerful antiplatelet or blood thiner for a couple of months after stenting. But within few years of the widespread use of DES the problem of late thrombosis was discovered. Late thrombosis may be a sudden thrombosis within the site of the stent that happens a year or two after the procedure. It is as catastrophic as early stent thrombosis. Hence the cardiologists started prescribing antiplatelet therapy for up to a year or for longer period of time. The strong use of anti-platelet drugs carried the risk. The problem of late stent thrombosis led stent developers to a challenge to develop a new type of stent that reduces this problem or eliminates it.

Researchers now believe that the polymer coating on DES may themselves increase inflammation and delay healing. Now several companies are identifying the problem and trying a general approach keeping this in mind.

Advanced stent technology  

Better durable polymers DES appear to cause less inflammation and also allow better healing at the site of treatment. These stents are referred to as second-generation DES, the newer stent design use cobalt-chromium which has greater radial strength per thickness and is radio-opaque, and thus allows thinner struts.

Bioabsorbable polymers

DES has been available for several years, they employ a polymer coating which is absorbed within few months leaving just the bare stent. These stents offer the benefits of DES for several months then they become BMS. This reduces the risk of late thrombosis. As compared to the first generation DES the risk of late thrombosis is reduced with both second-generation DES and bioabsorbable polymers DES. But there is no indication that bioabsorbable polymer performs better than the second-generation DES. They both still require very prolonged therapy and anti-platelet tests.

Bioresorbable stents

Bioresorbable stents also called as bioresorbable scaffold, biodegradable stent, or naturally- dissolving stent they are made from a material that may dissolve or be absorbed in the body. The main purpose of the bioresorbable stents is to overcome the drawbacks of DES and BMS. Currently, A metallic drug-eluting stent remains in the body as a permanent implant which can lead to an increased risk of complications year on year. It may pose a hindrance if the future procedure needs to be performed in the same artery. But on the other hand, BRS provides a temporary scaffold to the lesion to restore the blood flow, once the blockage is treated and healed completely BRS dissolves on its own leaving the artery in its natural state with no foreign residue. Hence providing both physicians and patients the room to explore further treatment, if required in the same blood vessel.    

We get to see all these extraordinary engineering in stent technology, it seems like sooner or later we might develop stents that would be able to eliminate the risk of both restenosis and thrombosis. But you need to make sure that before you agree to a stent talk to your doctor and explore options whether it will be helpful for you.

The news that one might be suffering from a heart condition that requires a heart stent can be stressful to process. It is important to understand the reasons why your doctor might have recommended a stent in the first place.

Arteries are blood vessels that carry out the function of circulating blood away from the heart to the rest of the body. They are shaped like tubes and the pumping contractions of the heart propel the blood through the arteries.

When a buildup of plaque i.e cholesterol, fat, and other substances collect in the bloodstream, it sticks to the walls of the arteries, and over time, this buildup narrows the arteries, limiting the amount of fresh blood that can be circulated to the body. 

Over time, people with narrowed coronary arteries may begin to notice symptoms such as chest pain. This buildup of plaque in the coronary arteries is a cause of coronary heart disease. People with this condition may be at a higher risk of many serious complications such as a heart attack or a stroke if they do not receive treatment.

What is Coronary Artery Disease? Coronary Artery Disease (CAD) is the most common form of heart disease. It occurs when one or more of the coronary arteries becomes narrow, thus restricting the flow of blood to the heart muscle. Without adequate blood, supply the heart becomes starved of oxygen and vital nutrients required for the proper functioning of the heart muscle which may lead to chest pain called angina. The process is often called hardening of the arteries or atherosclerosis.

Symptoms of CAD may include

Early warning signs such as

• A squeezing, suffocating, or burning feeling in your chest tends to start in the center of your chest but may move to your arm, neck, back, throat or jaw.
• fatigue
• pain
• dizziness

Symptoms in women are comparatively non-traditional:

• vague chest discomfort
• fatigue
• indigestion
• Anxiety
• sleep difficulties

If left untreated, CAD can lead to other serious problems such as heart attack, stroke, or even death.

When a coronary artery is narrowed by a buildup of fatty deposits called plaque, it can reduce blood flow, causing chest pain. If a clot forms and completely blocks the blood flow to part of the heart muscle, it can result in a heart attack.

Therefore if the artery is at risk of collapsing or becoming blocked, doctors may recommend inserting a stent to keep it open.

What is a stent?

A stent is a tiny wire mesh tube that your doctor can insert into a blocked artery passageway to keep it open. Its function is to open the blocked artery and post-treatments stents remain permanently in the body. Stents are made of either metal or plastic. Stents can also be coated with medication to help keep a blocked artery from closing.

How are stents used?

The stent is mounted on a balloon catheter. It is tracked through the artery to the narrowed segment/blockage which is then moved into the area of the blockage. The balloon is then inflated resulting in the stent expanding and locking in place, forming a scaffold that holds the artery open. The balloon is then deflated and withdrawn.

The stent stays permanently and improves blood flow to the heart muscle. Stents are used based on the features of the artery blockage such as the size of the artery and where the blockage is.

What are the advantages of using a stent?

• After balloon angioplasty or other procedures that use catheters, certain patients may experience a re-narrowing of the artery. Stents help to reduce the re-narrowing.

• Patients who have angioplasty and stents have less discomfort and also recover faster from these procedures as compared to patients that choose to undergo coronary artery bypass surgery (CABG)

How long will a stent last? Are stents permanent?

Commonly used metallic stents are permanent and stay in the body for lifelong.

Re-narrowing (Restenosis) of the treated coronary artery can occur in some cases and may require a re-intervention in the future. However, with the latest generation, the drug-eluting stents’ restenosis rate has reduced significantly.

Bioresorbable scaffold or stent is the latest innovation in the field of stent technology. Unlike metallic stents, they don’t stay permanently inside the patient body. Post healing, they dissolve naturally in 2-3 years thus leaving the artery in its natural state.

What happens after stent insertion?

Depending on the insertion site, there may be soreness, for which mil painkillers are usually given. Your doctor might prescribe medication to prevent clotting, and might want you to remain at the hospital overnight. This helps ensure that there are no complications. In cases of coronary events like a heart attack or a stroke, you might be asked to stay for a longer time. Depending on the severity of the cause of the stent insertion, such as a heart attack, recovery might take a while. Until then it is advised to take it easy for a couple of weeks, avoid heavy lifting, etc.

Are there any risks involved in the insertion of stents?

Like any other medical procedure, Stenting may also involve risk, but with the latest advancement in technology and the treatment procedure, it has been minimized significantly. One should discuss and understand with their Physician about the common risk factors which is involved with stenting.

Some of the common risk factors may include bleeding from the treatment site like groin from where the catheter was introduced, allergic reaction to dye or stent, re-narrowing of the artery or clot formation, etc

Insertion of a foreign body in your blood, there is a one in 50 chance of blood clots forming on the stent. Your physician may prescribe certain medications to lower the risk of blood clots. 

While a stent can result in remarkable improvement of your condition, it is not a cure for heart disease. You will need to address the contributing factors like high blood pressure, cholesterol, and being overweight as well. Eating a well-balanced diet, exercising regularly, even quitting smoking can lead to a heart-healthy lifestyle.

Disclaimer: This blog is only for awareness purposes. We do not intent to promote any medications given in the blog. Please consult your physician before taking any medication.

A heart attack can come with numerous apparent symptoms like chest pain and pressure or pain in the jaw, arm, or neck. However, in nearly 50% of all heart attack cases, those signs & symptoms are relatively missing. The signs and symptoms that do show up might be so mild and average that a patient may barely think about them by any stretch of the imagination.

More than 1.1 million individuals experience a heart attack (myocardial infarction) annually. Several of them when they get a heart attack it is the first indication of coronary artery disease. A heart attack could also be severe enough to cause death or it’s going to be a silent one.

A silent heart attack or a silent myocardial infarction (SMI), is a heart attack with minimum to no related signs and symptoms. Due to the lack of signs and symptoms, the affected person is unaware that they have suffered a significant cardiovascular event. Instead, the affected person will characterize reputedly minor symptoms like fatigue or mild chest soreness to ailments like the flu or indigestion.

Regardless of the lack of signs and symptoms, silent heart attacks are still heart attacks and may have a few extreme consequences, leaving behind scar tissue, weakening the heart, and growing the threat for a next, more serious heart attack.  Thus, it is vital to mention all potential signs and symptoms, even seemingly insignificant ones, to a doctor. Specifically, in case you also have contributing factors which include type 2 diabetes.

SYMPTOMS

Even though silent heart attacks strike men more frequently than women, the latter are equally at risk. For example, men could feel exhaustion or physical discomfort and chalk it up to overwork, poor sleep, or some general age-related ache or pain. Other typical symptoms like mild pain within the throat or chest are often confused with gastric reflux, indigestion, and heartburn. Also, in many cases, the situation of pain is usually misunderstood. Amidst, a silent myocardial infarction (SMI), a person will feel discomfort within the center of the chest and not a sharp pain on the left side of the chest, which many of them accompany a heart attack.

If you’ve got no symptoms or don’t notice the signs, a silent heart attack could also be discovered accidentally once you undergo tests for an additional reason. For instance, blood tests can show you’ve got tissue damage in your heart, and an EKG measures electrical activity in your heart. Heart damage can interrupt or delay several electrical activities. Finally, an echocardiogram, which is an ultrasound of your heart, also can show if there’s damage. A silent heart attack is as dangerous as the usual one. Simply because you can’t feel it, doesn’t mean it’s not serious.

Heart and vascular disease frequently go hand-in-hand with diabetes. People with diabetes are at a way greater threat for stroke, heart attack, and hypertension. Other vascular problems due to diabetes include inadequate circulation to the legs and feet. Sadly, many cardiovascular issues can go undetected and begin early in life.

Serious cardiovascular disease can start before age of 30 in individuals with diabetes. Type 2 diabetes (also called non-insulin-dependent diabetes mellitus) is the after-effect of the body’s inability to form or use enough insulin. One study found that individuals with type 2 diabetes, without apparent heart problems, ran an equivalent risk for a heart condition as people without diabetes who had already suffered one heart attack.

How Does Type 2 Diabetes Increase the Risk of Silent Heart Attack?

Having diabetes increases the danger of developing a wide range of ailments, a few of which directly impact the heart.  When it involves a silent heart attack, diabetics are particularly susceptible for a few reasons:

• Higher Risk of Heart Disease – Diabetic patients are at an increased risk of a silent heart attack in large part because the condition has already put their heart in a more precarious position overall. Additionally, to damaging levels of blood sugar, patients also are more likely to experience high cholesterol and obesity, all of which strain the cardiovascular system.
• Autonomic  Neuropathy – A significant side effect of diabetes is damage to the autonomic nervous system. The nerves of this technique are liable for controlling several bodily functions including breathing, digestion, and pulse.  Furthermore, nerve damage can reduce a patient’s ability to feel pain, including the painful symptoms related to heart attack, making the signs easier to miss.

Studies have shown that up to 16% of participants with Type 2 diabetes also are likely to have suffered a silent heart attack.  It’s a connection that can’t be ignored.  If you’ve been diagnosed with Type 2 diabetes, it’s important to know the risks related to the condition and to be cautious in maintaining and monitoring your health.

How can patients with type two diabetes prevent a silent heart attack?

The best way to one can prevent a silent heart attack is to take excellent care of themselves and also, keep proper control of type two diabetes.

• Maintain your blood sugar as normal as possible.
• Manage your blood pressure, with medication if necessary. The target for people with diabetes is under 130/80.
• Get your cholesterol numbers in check from time-to-timeby taking proper medications.
• Try to lose weight if you’re obese.
• Keep exercising regularly.
• Make sure you consume or eat a healthy diet daily.
• Quit smoking.
• Try calming exercises regularly to reduce your daily stress.

Lastly, it is important to check with your doctor when it comes to matters of the heart. In the end, it’s only the timely precautions and treatment that save your time and life. The more you are equipped with the knowledge, the safer you are.

Cardiovascular disease continues to be the leading cause of death and disability worldwide. According to the World Health Organization, more people die (around 17.9 million every year)  from CVDs worldwide than from any other disease. About 80% of these deaths are due to coronary heart diseases (eg. heart attack) and cerebrovascular diseases (eg strokes). For both men and women, heart attack remains one of the leading causes of death but they may experience the symptoms of the disease a little differently. It is not necessary that the most typical signs e.g pain in the left hand is what a woman would experience while she is having a heart attack. Aged women above 65 years are more likely to have a heart attack but unhealthy lifestyle habits can also expose younger women to CVDs. Understanding the female-specific symptoms could help an individual seek medical attention faster, which could prove to be life-saving.  Let us now take a look at some warning signs of a heart attack that every woman should know and shouldn’t be overlooked at any cost.

1. Chest pain/ Angina:

This symptom is the most common hint of a heart attack. A woman could experience pain in any part of the chest and not just the left side. It is usually a feeling of tightness and extreme pressure in your chest.

2. Pain in Back, Arms, Neck, and Jaw

This type of symptom is slightly abrupt and gradually increases. It can come and go anytime and anywhere including both your arms at one time, back, or even neck. This kind of pain may be extreme and can wake you up from sleep. Even the jaw pain could be either on the left or right.

3. Stomach Pain

A lot of times this pain is overlooked and treated as an acidic burn or maybe ulcer, flu, etc. But, it could be a possible warning sign of a heart attack for women. It feels like there’s extreme weight kept on your stomach. 

4. Shortness of breath and Nausea

This could occur at one of the most unusual times for instance while you are resting and there’s no physical activity involved. This may increase over time and also lead to stress.

5. Sweating

A woman may experience this even in cool places. A nervous, cold sweat without a possible reason can be taken as a sign of a heart attack. It is very different than your regular warm sweats after a good run.   

6. Fatigue

This feeling is natural when you have a lot of tasks to finish but when you feel the same at a time when you haven’t exerted yourself could be a cause of worry.

And, once you recognize these symptoms of a heart attack, it is important to treat the situation on an emergency basis and rush to your nearest healthcare provider. Identifying the symptoms of a heart attack can save your and other’s life. Ideally calling for an ambulance is the safest way to go about it. Self-driving may worsen the situation and put you in more danger.

Heart attack prevention

Now that we have discussed the symptoms of a heart attack, let us move towards three  key factors that can help prevent a heart attack.  

Quit smoking and limit alcohol

Smoking increases the fatty deposits in the arteries which increases blood clotting and affects the blood lipid levels. Also, nicotine is the primary reason to accelerate the heart rate and increase blood pressure. Drinking too much alcohol can also raise blood pressure, increase cardiomyopathy, stroke, cancer, and other diseases.

Physically active

Doing any physical activity like weight training, endurance training, or playing any sport can boost our heart health. Even a 30 mins brisk walk every day can do wonders to your heart. Studies say that people who have achieved even a moderate level of fitness are less likely to die early than those with a low fitness level.

Good nutrition

The most important thing for any human body is the quality of food that we consume. Making the right food choices and having a healthy mix of protein, carbs, and fats in your diet can keep your heart health on top. It is also crucial to managing a ratio of bad vs good cholesterol. Intake of vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils, and nuts; and limits intake of sweets, sugar-sweetened beverages, and red meats can boost your heart health.

Lastly, routine check-up and discussion about your risk factors with your healthcare provider before making any alterations is a must.  A heart attack is a serious and most fatal medical event that requires emergency treatment and any symptoms should never be taken lightly. Right know-how and awareness can improve outcomes and prevent complications in the future.