After Your Angioplasty

Summary

This video gives patients the guidelines for both short-term recovery and long-term secondary prevention of heart disease. It instructs patients on what to do immediately following angioplasty, what symptoms to be aware of, and when to call the healthcare team. It also shows them how to reduce their risks of further heart disease and live a healthier life. The chapter format of this video breaks information down into segments your patients can absorb as they're ready to deal with them. The long-term risk reduction chapter is something they can watch repeatedly to help them modify their lifestyle.

This home video guide is also available in a shorter version called Recovering From Angioplasty, for your patients to view in your facility.

Details

Coronary artery disease:

• fatty deposits called plaque can build up on the coronary artery wall and block it
• angioplasty uses a balloon to compress the plaque in your arteries and open blocked areas
• a stent may be used to act as a scaffold and keep the artery open

First few days at home:

• tiredness for a few days is normal
• take it easy
• no lifting, pushing or pulling anything over ten pounds for a week
• no driving for the first two days
• limit trips up and down stairs for a few days
• in general if you feel tired, stop and rest

Short term complications:

• catheter insertion site should be checked daily
• call doctor if site is red, swollen, warm to touch or draining; if you have a temperature over 100 degrees; or if you have swelling, numbness or weakness in the leg
• temporary bruising is normal
• small amount of blood at insertion site, let your doctor know
• heavy or forceful bleeding, go to the emergency room

Chest discomfort:

• may mean the artery has become re-blocked
• take nitroglycerine as directed or call for an ambulance
• directions for taking nitroglycerine

Medication:

• aspirin daily is common
• if have a stent will be taking a special blood thinning medication until new tissue grows over the stent
• other heart medications may be continued, follow your doctor's instructions
• don't double dose to make up for a missed dose
• let doctor know about all medications you're taking - prescription and over-the-counter

Personal care guidelines:

• showers are okay, but no baths for first few days
• no lotions or powders on insertion site

Returning to normal activity:

• many patients return to regular activity within a week
• pace yourself
• begin by taking short walks and gradually build up
• exercise indoors on very hot, cold or humid days
• many patients return to work within one to two weeks
• microwaves and metal detectors are okay after a stent
• keep a list of all medications you take with you

Signs of blocked arteries:

• restenosis (re-narrowing of the artery) is possible, or a new blockage may develop
• chest discomfort, shortness of breath and fatigue indicate a narrowing
• if symptoms return, stop what you are doing and rest and let your doctor know

Treatment for restenosis:

• another angioplasty or stent
• coronary artery bypass surgery
• medication

You can reduce your risk of more heart damage by controlling certain risk factors.

Controllable risk factors:

• smoking
• high cholesterol and triglycerides
• high blood pressure
• diabetes
• excess weight
• stress
• inactivity or lack of exercise

A cardiac rehabilitation program can be a good place to start. In addition to supervised exercise, many cardiac rehab programs offer education on how to control risk factors.

Smoking:

• makes your heart pump faster
• constricts your blood vessels raising your blood pressure
• robs your cells of oxygen
• contributes to the build-up of plaque

If you aren't successful on your own, ask your doctor about getting some help like individual counseling or a smoking cessation program. Some people find nicotine replacement methods or medication helpful.

Cholesterol and triglycerides:

• fatty substances that exist normally in your blood
• too much of either can increase your risk of atherosclerosis
• LDLs (low density lipoproteins) form plaque in your arteries
• HDLs (high density lipoproteins) help remove clogging LDLs from your blood
• triglycerides contribute to plaque build up

Cholesterol goals:

• LDL level of less than 100
• HDL level of 45 or more for men, 55 or more for women
• triglyceride level of less than 200

Ways to lower cholesterol:

• change what you eat
• limit alcohol to one drink a day
• regular exercise may also lower your cholesterol level and raise your HDL
• medication

High blood pressure:

• heart is working harder than it should to pump blood
• damages the artery wall, making it easier for plaque to build up
• goal is a reading of 130 over 85 or less

Controlling blood pressure:

• medication
• control your weight through healthy eating and exercise
• reduce sodium (salt) intake
• limit alcohol to one or two drinks a day

Diabetes:

• contributes to the build up of plaque on the artery walls

Controlling diabetes:

• diet
• exercise
• medication

Excess weight:

• makes your heart work harder than it should
• develop a weight loss plan with your doctor
• regular exercise will help you lose weight and keep it off

Stress:

• constricts your blood vessels and raises blood pressure

Exercise:

• can help reduce every risk factor
• cardiac rehabilitation program can be a safe place to start exercising
• aerobic activities like walking, swimming, biking, jogging
• build to 30 to 60 minutes of exercise a day, three to five times a week