Heart stents - questions, recovery times, expectations and recommendations

Silverburn55

Hi all,

First post, but its a biggie.

The back story:
Been cycling for 30 years, currently 51 years old. Do about 5-11 hours a week, covering 400km / 6-8000m climbing a week and done a few sportifs this year, here in Switzerland. I would consider myself fit, even though I carry a kilo or two more than I should. cholesterol, BP, all normal; Im fitter now that I was in my 30's.

The main story:
About a month ago, I returned from an Indian business trip, with a slight cough and tickly throat, but I tested negative for COVID. After a few days it cleared up, and I resumed training; I had 2 weeks sedentary to recover from, and a sportif to get into condition for. It mostly went ok, but I found I was getting a stitch and burning lungs early in the ride, which went away after warming up. I thought nothing of it; I am over 50, and the air was quite cold afterall.

However, I noticed I wasnt getting into threshhold; I just put it down to a drop in conditioning due to the business trip, and the fact I was doing endurance/tempo anyway for the event, so I wasnt really bothered. This went on for around 2-3 weeks.

Then Sunday happened. The warmup stitch didnt go away. And when I started the endurance hill repeats, I couldnt even get into Tempo never mind threshold. And there was a crushing pressure on my breastplate. Something was wrong. I turned round, and as soon as I dropped below 120bpm, I felt fine - I rode home anyway. 3 hours later, Im in A&E getting a stent fitted. Wow.

Dislodged clot from DVT from the flights? Clot from COVID*? Who knows. Now I need to look forward, and now I need some advice and re-assurance from those with similar experiences?

1. After the stent, my heart feels like a cricket ball in my chest and I have weird things going on in my chest; is this normal? Will it clear?
2. Im now on thinners, anti-cholesterol statins, etc. How will it affect my riding and my numbers?
3. And I guess the most important fear of all - will I ever be able to push my heart again? Can I ever climb alpine passes at threshold again?
4. Im now just massively nervous about pushing my heart too soon, and when Im fully recovered; how should I restructure my training?

*oh, and please dont insult me and embarrass yourself by claiming its the vaccine.

gethinceri

Did you ask your doctor all these questions?

Silverburn55

gethinceri said:

Did you ask your doctor all these questions?

Yes, but his answers werent inspiring; ranging from "I dont know" to "you should be able to get back to normal shortly".

leedsmjh

Hi, really sorry you are going through all of this.
I’m a similar age to yourself and had a number of stents late last year, though not in an emergency situation like it sounds yours was.

I had weird chest pains for a few months afterwards that I was told was the stents settling in. Beware that the meds themselves can cause chest pain through heartburn - if you suspect this, talk to your GP about a PPI like lansoprazole. It will probably take your body a few weeks to adjust to any meds. If in doubt, go to A+E.

If all this happened last Sunday then I’d be taking things very easy for a few weeks or a bit longer and build up slowly. Your heart has been through some trauma.

I’ve found the British Heart Foundation forum really useful and there are some on there doing marathons etc post cardiac-events. I was happily (though cautiously) back on the bike, though would never pretend to be capable of an alpine pass at threshold. Alas this has been derailed by an unrelated health thing for now.
Best wishes

Wheelspinner

I had a stent done when I was 48, (now almost 61), *very* lean and fit, cycling, tennis, swimming, golf, walking... but some family history of problems.

Post-op, I was back at work three days later all fine. Left the incision to heal as instructed, about 2 weeks IIRC, then eased back into exercise slowly. Did my first 50km ride at about a month, just low effort, and ramped it up steadily from there, no issues.

Mentally I was very nervous about pushing myself hard though. After a few months, one day I left home and told my other half I was going to give it a proper crack, and see what happened, and to half expect a call from the ambulance people. I rode my "usual" course hard enough that I had to pull over and nearly throw up, but other than that I survived the pressure fine. Never worried about it since really.

CAVEAT: I don't really do structured training, never have much. I ride or run or swim or whatever as hard or easy on the day as I feel like. Other than the HR bit below, I've no data to say whether I am measurably slower or less fit than I was before. Since I am not a professional athlete, it doesn't matter to me anyway.

Observations:

The drugs *do* have an effect on you long term. For me, I found my HR limit dropped noticeably, from around 165 down to low/mid 150s. Much above that and I just ran out of gas. I also feel a bit "sluggish" when taking them. Hard to describe, but it's as if my muscles just don't fire quite as quick as they do when I'm off them. It's still noticeable even now at almost 61. My GP is much the same as me - action man, had a stent etc, and his experience is pretty much identical to mine.

The statins are very effective at reducing your cholesterol, and the cardiology people all talk like you must never miss taking one or you'll fall over in minutes. In reality, the sensible advice to me has always been as long as my actual test numbers of LDL/HDL etc are "fine" then whether I achieve that with the statins or simply better diet/exercise habits, or combo of both, doesn't matter. I sometimes have a holiday for a couple months off the statins, just for a break. The difference in how I feel is small but significant (to me).

I *DO* take the aspirin daily though - that blood thinner effect is important I think for the actual function of the stent in hydraulic blood flow terms. I've occasionally also stopped it for a couple weeks and not noticed any change in how I feel at all.

With regards the immediate sensations post-op... depends I think on which type of stent they used. My specialist told me there are two basic types - one is "plain" mesh, the other has a coating to potentially minimise possibility of rejection by your body. He fitted the plain one for me, said his experience was fewer issues both short and long term with those offset any possible benefit from the coated one. Given I was otherwise very fit and healthy with no other conditions (diabetes, other circulatory issues etc), he also said his expectation was that I'd have *no* issues with it, and that I would be back to my "normal" levels of effort with little to no risk. (He did think my version of normal was everyone else's crazy hard work level).

The real outcome is that the measured level of what is normal for you - like me - may be different. The HR thing on the statins presumably impacts my actual performance measured objectively. I won't be as fast as I was at one time. So what? I still put in as much perceived effort as I always did, and enjoy it.