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Angioplasty and Stent Placement are life-saving medical procedures for patients suffering from heart attack or severe coronary artery disease. When the blood flow gets blocked due to accumulation of fat and cholesterol (plaque) in the arteries of the heart, doctors insert a small mesh tube i.e. stent in the arteries to open them. But, there is a big myth in the society and in the minds of many patients that “once a stent is placed, then one can never have a heart attack again in life.”

Senior cardiologists completely reject this and clearly warn that a heart attack can occur again even after a stent is placed. Stenting is not a permanent cure for heart disease, but only a procedure to open a blocked artery. If the patient is careless about his lifestyle and medications, a blockage inside the stent or in another artery of the heart can occur again, leading to a fatal attack. Let us know from the doctors what are the reasons for a second heart attack after a stent is placed and how it can be prevented.

Why can a heart attack occur again even after a stent? 3 main reasons

According to cardiologists, three main conditions are responsible for recurrence of heart attack after angioplasty:

1. Stent Thrombosis (blood clot in the stent)

In the first few months or years after a stent is inserted, a blood clot can suddenly form inside the stent’s mesh. This is called stent thrombosis. It is a medical emergency. If the patient skips taking blood thinners (such as aspirin or clopidogrel) even for a day, the stent can clot and the patient may immediately suffer another serious heart attack.

2. In-Stent Restenosis (re-formation of blockage inside the stent)

Over time, the body’s natural recovery process can cause new tissue to form at the stent site or cholesterol to build up again. Although modern drug-eluting stents (DES) have a very low risk of re-stenosis (less than 5%), if diabetes and cholesterol remain uncontrolled, the stent’s path can gradually become blocked again.

3. New Blockage in Other Arteries

A stent is placed only in the specific artery or part of the artery that is currently 70% or more blocked. However, the human heart contains many other arteries, both large and small. If the patient continues to smoke, eat an unhealthy diet, and does not exercise even after the stent is placed, new plaque can begin to accumulate in other arteries, and after one or two years, the blockage ruptures elsewhere, leading to a heart attack.

5 golden rules to prevent a second heart attack after a stent insertion

If you or a loved one has undergone angioplasty, strictly following these 5 rules prescribed by doctors can reduce the risk of a second heart attack to near zero:

1. Never skip blood thinners: Take your doctor-prescribed antiplatelet drugs and statins at a strictly prescribed time. Do not miss a dose or stop taking your medication on your own without your doctor’s written permission.

2. Say no to smoking and tobacco immediately: Smoking and tobacco use increase the risk of blood clots forming inside a stent by a factor of 10. Smoking should be completely avoided after stenting.

3. Strict control of diabetes, BP and cholesterol: Keep your blood pressure (BP around 120/80), sugar (HbA1c below 7) and bad cholesterol (LDL below 55 mg/dL) under control with strict diet and medicines.

4. Heart-Healthy Lifestyle: Avoid saturated fats, junk food, refined oils, and excessive salt in your diet. Include fresh fruits, green vegetables, oats, and nuts in your diet. As per your doctor’s advice, take a light walk or exercise for 30 minutes daily.

5. Regular follow-up and stress management: Schedule regular checkups with your cardiologist every 3 to 6 months and have an ECG or ECHO test done periodically. Avoid excessive stress, as stress can cause arterial dilation.

Do not ignore these symptoms even by mistake

If you experience chest heaviness, pressure, pain in your left arm or jaw, sudden excessive sweating, or shortness of breath after a stent is inserted, these could be early signs of a clogged stent or a second heart attack. In such a situation, rush to the nearest cardiac hospital without delay.