You complained of severe chest pain (angina) and/ or shortness of breath. There was significant blockage of one or more coronary arteries. Doctors thus decided to go for a cardiac surgery to relieve your blockage of the coronary arteries.
You have undergone coronary angioplasty, which is a medical technique used for the purpose of widening up any stenotic (narrowed) or obstructed coronary blood vessel (arteries), when you were in the hospital. By this we mean that we have carefully identified the stenotic coronary artery in your body and have removed the blockage with the use of a catheter. In most of the cases, we put a Stent which is a metal tube in the obstructed artery to keep it open.
Fig.1. Schematic procedure of Coronary Angioplasty and the metal stent put inside the blocked coronary artery to open.
You may feel pain in your groin area, arm or wrist from where the catheter (flexible tube) was inserted to carry out the surgical procedure. You may also experience some bruising around and below the incision.
The chest pain and shortness of breath you had before the procedure should be much better now.(2)
Self care instructions:
Do's and don'ts after Angioplasty:
Though it takes a week or less to recover completely, people who have coronary angioplasty are able to walk around within a day after the procedure. Keep the area where the catheter was inserted dry for 24 - 48 hours.
You can walk for a short distance on a flat surface BUT STOP immediately if you have chest pain, nausea or dizziness. You should limit going up and down stairs up to 2 times a day for the first 2 to 3 days.
Take your medications on time.
Drink plenty of water to help your body get rid of dye.
For first few days, if you feel that you are about to cough or sneeze, keep gentle pressure where the incision was to prevent it from re-opening.
DO NOT do any heavy work, drive, squat, lift anything heavier than 10 pounds (~ 4.5 Kg) or play sports for at least for the first week.
DO NOT take a bath or swim for the first week. Taking shower is admissible, but make sure that it does not wet the area where the catheter was inserted for the first 24 - 48 hours.
You may resume your work in 2 - 3 days if strenuous activity is not part of your job.
There is swelling at the catheter site or bleeding at the catheter insertion site that does not stop even after you apply pressure.
The colour of the limb where the catheter was inserted changes, or becomes cool to touch or is numb.
The area surrounding the catheter becomes red or painful, or yellow or green discharge is draining from it.
You have chest pain or shortness of breath that does not go away with rest.
You have irregular pulse rate -- very slow (fewer than 60 beats), or very fast (over 120 beats) a minute.
You feel dizziness, faint, or you are very tired.
Your cough contains blood or yellow or green mucus.
You have chills or a fever over 101℉.
Counting Your Pulse
Every time your heart beats, blood is forced through certain blood vessels called arteries, causing them to expand then contract. You can count the rate of your heartbeat by feeling certain places on your body where arteries are close to the skin. One place that your can feel your pulse is on the wrist. Hold your arm with your palm up facing you. Bend your hand slightly away from you. Place your index and middle fingers of your other hand on the thumb side of your wrist, about 2 inches from the center of the wrist. Apply gentle but firm pressure for the pulsation. It may take practice to take your
pulse. Sometimes it is easier on the opposite wrist.
Most people recover from coronary angioplasty and return to work within a week of leaving the hospital.
We want to check your progress after you leave the hospital. During the follow-up visit, we shall examine you, make changes to your medicines (if needed), do any necessary tests, and check your overall recovery.
We advise you to use this time to understand your health conditions and prepare all the questions you may have about activities, medicines, or lifestyle changes, or to talk about any other issues that concern you.
It is EXTREMELY IMPORTANT that you take your blood thinners as prescribed to prevent any blood clot formation. During your therapy you MUST take your medicines every day. DO NOT miss even a SINGLE pill. In any circumstances if someone (even may be a doctor) advises you to stop these medications, you MUST call us first.
Do not do any rough sports such as jogging, or tennis for 3 days after your procedure.
Do not bend, squat and lift anything heavy for at least 2 days.
These steps will help your catheter insertion site heal and prevent bleeding. We recommend you to take slow, easy walks during first 2 days of the surgery followed by a walking program. Slowly increase how fast and how far you walk each day. Since your artery is now open, this is the best time to start an exercise program. This will help keep your body weight checked, improve your cholesterol level and help prevent other arteries from blockage.(3)
1. Dress appropriately. Wear clothes that fit loosely and are made of cotton or nylon. In the summer wear light colors which reflect the heat. In cold weather wear layers of clothes, as you warm up a layer can be removed before you sweat too much. As you cool down a layer can be put back on. Wear shoes that go with the sport. They should not feel uncomfortable in any way. If you buy new shoes, buy then in the afternoon when your feet may be the biggest.
2. Avoid extremes of heat or cold. The heat the body produces balances body temperature and the heat it loses. In hot weather the body temperatures goes up, blood vessels become larger, and blood moves to the skin's surface. As you sweat, heat leaves the body and the skin and blood is cooled. Just as hot weather expands blood vessels, cold weather narrows them. As the blood vessels get smaller, the heart must pump harder to move the same amount of blood through the smaller vessel. This can cause your blood pressure to go higher. Cold weather also decreases how much air the lungs can exchange, which reduces the amount of oxygen going into the working muscles. Do not exercise outside in very hot or very cold weather, i.e.; if it is over 80 degrees F., or less than 30 degrees F. (including the wind chill factor), or greater than 70% humidity. In the summer when it is hot and humid walk in the early morning or late in the day, when it is cooler. In cold or bad weather, walk in an enclosed area such as a shopping mall or long hallway.
3. When you exercise against wind, slow down or exercise for a shorter period of time than is normal for your. Wind makes you work harder and makes the body feel cooler than it may be.
4. Each exercise session should begin with a warm-up-stretching and 5 minutes of slow walking. End with a cool-down of 2 minutes slow walking then stretching. If you stop after a workout without cooling down, the muscles get stiff and blood tends to pool in the veins, which can cause light-headedness or even fainting.
5. Do not eat large meals or drink alcohol before exercising. Eating too much puts added strain on the heart. Alcohol, marijuana, and/or cocaine increase the heart rate. They may also hide symptoms that are telling you to stop. Over-the-counter decongestants can also cause your heart rate and blood pressure to increase during exercise and should not be taken while exercising.
7. Persons with claudication (leg pain or cramping with walking) need to walk as far past the start of the pain as possible and may need to alternate short bouts of walking or cycling of 1 - 10 minutes with equal rest periods.
After a week, you can follow following exercises.
Check out this link for cardiac exercises:
Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems.(4)Enroll for these programmes for improving the cardiac health condition.
Quit! Research suggests that tobacco use and second-hand smoke are the primary risk factors of cardiovascular diseases. Globally around 10% of cardiovascular deaths are attributed to tobacco use. Need help quitting, call - the National Tobacco Cessation Quit Line, 1800-22-77-87 To know more about the health benefits of quitting.
Abstinence is the best policy Alcohol is high in calories and known to increase blood pressure. Talk to your doctor to know more about how much alcohol can be consumed.
Lowering stress levels are important when recuperating from a cardiac surgery. Stress can increase blood pressure. Incorporate a daily routine to relax and rejuvenate try to listen to soothing music, chant, read a book or meditate
It is crucial to maintain ideal weight as being overweight or obese is recognized as an important risk factor for cardiovascular diseases. To find out your ideal weight and Body Mass Index (BMI) go to thislink. A healthy, low fat diet combined with a regular exercise regime is the key to lose and maintain weight.
Post-surgery can be a challenging period to manage emotions. Patient may experience anxiety, anger, and depression to name a few. It is important to find an emotional anchor - either a family member or a friend who can help you cope with the feelings.
Reduce the intake of tea, coffee, colas and chocolate especially later in the day. Lowered caffeine intake is known to induce a better sleep during the night
Blood Pressure management
Maintaining a normal blood pressure of lower than 120/80 is important to lower the risk of further cardiovascular complications. Exercise can help to maintaining normal blood pressure
Blood Glucose management
Diabetic patients are at a risk of developing complications, post cardiac surgery. Keep your blood sugar in constant check by maintaining a balanced diet and a prudent lifestyle. Normal fasting glucose range is 70-100mg/dL and for diabetics it is 70-130mg/dL. After meals for non-diabetics it should be less than 125mg/dL and for diabetics, it should be less than 180mg/dL.
It is important to eat the right kind of food for a healthy heart, mind and body. For a speedy and long lasting recovery we advise you to combine positive dietary and lifestyle changes with the medical care. Post-surgery, many patients experience poor appetite. To boost your appetite, consume small portions of food about 7-9 snacks/meals throughout the day. Nausea is another common complaint that could be caused due to medications. Take the prescribed medicines on full stomach. Consult your doctor if nausea persists.
A day's meal comprises of several food items. Generally, all food items can be classified into six major groups (5) as shown in the Healthy Heart pyramid.(6)
Immediate Diet Plan
Include lots of fresh, seasonal, local and if possible organic Fruits and Vegetables in your daily diet.
Add plenty of Whole Grains (whole wheat flour, brown rice, whole beans).
Choose foods high in Good Fat such as olive oil, peanut oil, fatty fish, walnuts, flaxseeds. If you do not eat fish, talk to your doctor about taking fish supplements.
Instead of whole milk, choose low fat or skim milk.
Say NO to all Sugary and Refined foods (cakes, pastries) and do not add any sugar to beverages.
Avoid Unhealthy Fats such as Cholesterol, Saturated and Trans Fat. Stay away from egg yolks, cream, butter, ghee, coconut, deep fried items, whole milk, dalda, vanspati.
No Carbonated, Caffeinated and Alcoholic beverages.
Curb Salt intake, as it can increase blood pressure. Don't add salt while cooking and reduce packaged food consumption.
Don't Consume foods or vitamins which are high in Vitamin K. You do not have to avoid these foods, just eat normal amounts.
Foods High in Vitamin K:
Sample Diet Plan:
Below is a sample Diet Plan for a patient who has undergone angioplasty. Make sure to check the correct portion sizes for each food item by going to these links.(8), (10)
Talk to you doctor or dietician about any restrictions on fluid or water intake. Do not add SALT or SUGAR while cooking or as seasoning. For cooking, use only Olive Oil.
- 1 Cup lukewarm water with 1 Tbsp. freshly squeezed lemon juice and 1/2 tsp. honey
- 1 Cup Dahlia, porridge made with Skim Milk OR 1 Moong Dal Dosa(Recipe)OR 1 Ragi Dosa(Recipe)
- 1 medium Apple OR medium Orange OR 1/2 Cup pomegranate seeds
Early Morning Snack
- 1 Cup boiled Sweet potatoes, sprinkled with lemon juice OR 1 Cup Brown rice Poha with low fat yoghurt
- 1 Cup Coconut water (discard the malai")
- 2 dried apricots and 1 whole walnut OR 2 dried figs and 2 almonds (unsalted)
- 1 large bowl of Salad (carrots, cucumbers, beets, tomatoes and onions) (Dressing is important , use - Olive oil, lemon juice and pepper) - 1 Whole wheat/Multigrain phulka OR Jowari Roti - 1 Cup Palak Dal OR Rajma - 1 Cup of Buttermilk
Mid Afternoon Snack
- 1/2 Cup Mixed sprouts OR Chole salad (Recipe) - 1 Cup Green Tea (no milk added)
Early Dinner Snack
- 2 Ragi Biscuits OR 2 Unsweetened Oatmeal Biscuits
- 1/2 Cup Brown rice with 1 Cup Mixed vegetable sambar OR 1 Cup Brown rice Khichadi with 1 small bowl Raita - 1 Cup cabbage curry OR steamed Cauliflower curry OR Karela curry - 1 Cup Buttermilk
Late Night Snack
- 1/2 Cup cubed Papaya OR Musk melon
Life Long Instructions:
It is never too late to adapt a healthy lifestyle.
Maintain a balanced diet and perform regular physical activity.
Eat foods that are low in saturated fats and cholesterol.
Avoid foods high sodium content.
If overweight or obese, loose the extra kilos and maintain a healthy weight.
Quit smoking and cut down on alcohol. Check your blood pressure and blood glucose regularly.
Eat Right and Exercise your way to a Healthy Heart.