Can a heart stent get blocked again? A cardiac surgeon explains

A heart stent can sometimes get blocked again after the initial procedure. This can happen in several ways, such as tissue growing inside the stent (restenosis) or a blood clot forming inside it. Modern stents have reduced this risk, but it still exists. Symptoms of a possible blockage include chest pain, breathlessness, unusual fatigue, and discomfort spreading to the arm, jaw, or back. Some people may experience symptoms similar to those they had before the stent procedure.

A blockage can occur at different stages after the procedure, from hours to years later, depending on factors like the stent type, medication adherence, and overall heart health. People with diabetes, high cholesterol, uncontrolled blood pressure, kidney disease, or smoking habits may have a higher risk of complications. The risk may also be higher in those with complex blockages, multiple stents, or a history of previous restenosis.

Antiplatelet medicines help prevent blood clots, so missing doses can increase this risk, especially in the early period after the procedure. Patients should follow their prescription and contact their doctor if they miss a dose, never stopping the medicines without medical guidance.

Treatment for a blocked stent depends on the cause and severity. Doctors may use techniques like widening the narrowed area with a balloon, inserting another stent, or using specialised methods to remove or manage the blockage. In some cases, bypass surgery may be recommended. If the blockage causes a heart attack, emergency treatment is essential.

To reduce the risk of another blockage, patients should take prescribed antiplatelet medicines and other heart medications regularly, follow a heart-healthy diet, engage in regular physical activity as advised by their doctor, avoid tobacco, and control diabetes, blood pressure, and cholesterol. Maintaining a healthy weight and attending cardiac rehabilitation, when recommended, can also support recovery.

Regular check-ups with a cardiologist are important, even if the patient feels fine, to monitor symptoms, blood pressure, cholesterol, and medication use. Any new chest discomfort, breathlessness, or reduced exercise tolerance should be reported promptly, as sudden or severe symptoms could indicate a heart attack.