Have you had Coronary Angioplasty and are wondering how long it takes to recover or get back to exercise? Or are you due to have one and want to know what to expect?
You may know Coronary Angioplasty by other names including PCI, PTCA or simply ‘stents’. Hopefully, you’ve been told WHY you needed to have this procedure done, WHERE the stents were placed and HOW to recover after. In case you were a little fuzzy while being told (or your hospital rushed you out the door!), I wanted to put together a little info to give you a summary of what you need to know.
What are the benefits of stents?
- To relieve blockages or narrowing of the arteries
- To improve your blood supply to the heart muscle
- Help to relieve angina symptoms, including chest pain and breathlessness
- Used as an emergency treatment for people that have had a heart attack or unstable angina (angina that comes on with less and less physical activity or even while you are resting)
Why did you have yours? Perhaps you were having chest pain and went to your GP, who referred you for some tests. These tests may have included an Angiogram, which is a test used to see if there are any ‘blockages’, which may then lead onto the next procedure, Angioplasty, where stent(s) are inserted.
What to expect in hospital
Every hospital is different, so I will give you an overall picture of what to expect but make sure you check with your own healthcare team or hospital.
You will be admitted to the hospital several hours before the procedure, usually having fasted (aka no food) for a few hours – this varies from hospital to hospital so make sure you get told how long to fast for!
You will be put into a gown, a drip may be put into your arm and you will have a range of tests – these could include blood pressure, ECG (electrocardiogram), heart rate, oxygen saturations, blood sugar levels, temperature and blood tests. You should have signed a consent form after having the procedure and its benefits and risks explained to you.
The procedure will take place in a catheter laboratory (cath lab) which looks similar to an operating theatre. You will usually be awake for the procedure but you may be able to ask for some medication to help you relax. The procedure time will vary depending what is found and whether or not you need stents. The below information is general information relating to those who had a stent(s) inserted during the procedure.
Immediately after the procedure
After the procedure is over, the catheters used to insert the stents are removed from your wrist or groin (depending on whether your wrist or groin was used).
Sometimes there might be a small amount of bleeding when they are taken out. A nurse or doctor will press on the area for a short while or they may put in a plug called an angioseal to stop any bleeding. An angioseal stays there and dissolves over a number of weeks. You may be able to feel a pea size lump where the angioseal is. After the procedure, you’ll need to stay in bed for a while. You will be told when you are allowed to get up and move around.
Expect to be checked on regularly, with a nurse taking your blood pressure, heart rate and oxygen levels to ensure you are coping well after the procedure. Your wound will be checked regularly for bleeding and bruising and you will be given something to eat and drink.
You should be seen by a senior nurse or your consultant who will give you information about what happened during the procedure, signs to look out for, how to look after your wound, returning to exercise, cardiac rehab if it’s available in your area and any other relevant information.
When you get home, check the area where the catheter was inserted. Expect to have some bruising, but if you get any redness, swelling or if the bruising worsens, contact your hospital. If the groin was used, avoid putting too much pressure on the leg used for at least 3-4 days and avoid exercise for at least 14 days. If the wrist was used, you can walk as normal but take a slower pace to your usual activities for at least one week afterwards.
Usually after an angioplasty you will need to take the following anti-platelet medications, as they can reduce the risk of clots forming inside the stent.
- Aspirin (often for life). Always take aspirin with food to protect your stomach.
- Clopidogrel or Ticagrelor (usually for 6 months to 1 year however sometimes shorter/longer period depending on your procedure).
Other medications that you may be prescribed include a statin, blood pressure medication and medication to slow your heart rate. These will vary depending what procedure you had and your future risk.
Returning to activity
Before you leave hospital, you should be told what you can and can’t do when you get home. The following is general information and is not to be taken as advice. Please check with your healthcare team before returning to exercise.
It’s best to avoid doing any demanding activities, such as heavy lifting or strenuous activity for two weeks. Most people find that they feel back to normal after a few days. However if you’ve also had a heart attack, it will take longer to recover and you may feel tired for several weeks. Please take things at your own pace and don’t put pressure on yourself to return to ‘normal’. Some people return to work after one week and others have several months off. Talk to your family, work and do what is right for you.
You can return to sex after one week if you feel ready. Talk to your partner about how you are feeling – your energy, your emotions and whether you feel ready. Generally it is safe to have sex with a stent. As with any exercise, a gentle warm up of a 10 minute walk beforehand would be beneficial to warm up the heart!
You shouldn’t drive for at least a week after having angioplasty – 4 weeks if you also had a heart attack. You can find out more from the DVLA here.
You should wait at least a week before flying – preferably longer. However, ensure you check with your doctor, your airline and your travel insurance to make sure that you are covered to travel. Ensure you write down the details of your cardiologist and GP and take your medical notes with you (or a summary of your health history, recent procedure and a list of your medications).
You will be able to exercise again but wait at least 2 weeks before returning to your previous exercise. Follow the below points to ensure your safety during exercise:
- Attend Cardiac Rehab if you can get referred. It’s an excellent resource and will help to teach you about exercise after a heart procedure.
- Always perform an long warm up to prepare the heart effectively for exercise. This means 10-15 mins of light activity before you start e.g. slow walking before you start faster walking/jogging.
- Wear a heart rate monitor to keep an eye on your heart rate and slow down if you feel short of breath.
- Keep the intensity low to begin with. By keeping it ‘easier’ than you would normally do, you will build a stronger aerobic base and will be able to perform exercise for longer.
- Avoid high intensity exercise or impact sport without first checking with your doctor and/or physio.
- Avoid holding your breath or lifting a weight so heavy that you need to hold your breath. This increases your blood pressure very quickly.
- Do not start exercising when you are very cold, very hot, have just finished eating or are feeling unwell.
- If you experience chest pain during exercise, slow down until it is safe to stop. Rest for 5 minutes. If you have a GTN spray with you, take a spray. If the pain does not go away with rest and GTN spray, seek help. For any new or changed episodes of chest pain, get checked by your doctor asap.
- If you feel dizzy, faint or unwell during exercise, slow down, stop, rest on a seat. If rest does not improve things, seek help.
- Ensure you are well hydrated – sip water throughout your exercise session.
- If you are diabetic, keep an eye on your blood sugars before, throughout and after exercise and adjust your medication and food intake accordingly.
Please ask if you have any questions at all. I specialise in helping people return to full fitness and health after heart surgery. I can develop a personalised programme specific to you, your condition, your surgery and you current medications. Let me know if you’d like us to create a programme for you. I can see you at my gym in East Molesey or work with you online.
Good luck in your health journey!
Yours in heart health,