Coronary stent overview

Overview

A coronary stent is a tiny mesh tube that a doctor places inside a narrowed or blocked artery that supplies blood to your heart. The stent holds the artery open so blood can flow better. The procedure to place a stent is called angioplasty.

Yes, coronary stenting is one of the most common heart procedures done worldwide. Millions of stents are placed each year.

People who have coronary artery disease — a condition where fatty deposits narrow the heart arteries. It is more common in older adults, men, and those with risk factors such as smoking, high blood pressure, high cholesterol, diabetes, or a family history of heart disease.

Symptoms

Common symptoms

• Chest pain or discomfort (angina) – often feels like pressure or squeezing
• Shortness of breath, especially during activity
• Fatigue or feeling unusually tired

Symptoms in children

• Coronary stents are rarely placed in children. If there is a heart problem from birth (congenital heart disease), symptoms might include bluish skin, trouble feeding, or rapid breathing.

Symptoms in older adults

• Older adults may have different symptoms, such as indigestion, nausea, unusual fatigue, or shortness of breath without chest pain.

Causes

Main causes

• Coronary artery disease (atherosclerosis) – buildup of fatty plaque inside the artery walls

Risk factors

• Smoking or tobacco use
• High blood pressure
• High cholesterol
• Diabetes
• Being overweight or obese
• Unhealthy diet (high in saturated fats, salt, and sugar)
• Lack of physical activity
• Family history of early heart disease
• Older age (men over 45, women over 55)

When to see a doctor

See a doctor urgently if:

• If you have chest pain that does not go away or happens with shortness of breath, nausea, or sweating – call your local emergency number immediately.
• If you have new or worsening chest pain and you have known heart disease, seek urgent care.

Book a routine appointment if:

• If you have risk factors for heart disease and have not had a checkup recently
• If you have mild chest pain that occurs only during heavy exertion and resolves quickly with rest
• If you have been prescribed a stent and have questions about the procedure

Diagnosis

The need for a coronary stent is usually determined after tests show narrowing or blockage in the heart arteries. The most common test is a coronary angiogram, where a thin tube is threaded into the heart arteries and dye is injected to see blockages on X-ray.

Tests that may be done

• Electrocardiogram (ECG/EKG) – checks your heart's electrical activity
• Stress test – records your heart while you exercise or take a medicine that makes your heart work harder
• Echocardiogram – uses sound waves to create a picture of your heart
• Coronary angiography – the key test that shows blockages and guides stent placement

What to expect at your appointment

If your doctor finds a blockage that can be treated with a stent, it is often placed during the same angiogram procedure. You will be awake but given medicine to help you relax. The doctor makes a small cut in your groin or wrist, guides a thin tube to the blockage, and expands a tiny balloon to open the artery. Then the stent (a mesh tube) is placed to keep the artery open.

Treatment

The main treatment for a narrowed coronary artery is to open it up and keep it open. A coronary stent is the most common way to do this. After the stent is placed, you will need to take certain medicines to prevent blood clots and manage cholesterol. Lifestyle changes are also a key part of treatment.

Self-care at home

• Take all medicines exactly as prescribed – do not stop without talking to your doctor first.
• Quit smoking if you smoke – it is the single best thing you can do for your heart.
• Follow a heart-healthy diet – low in saturated fats, salt, and added sugars, and high in fruits, vegetables, and whole grains.
• Get regular physical activity – aim for 30 minutes of moderate activity most days, but check with your doctor first.
• Manage stress with relaxation techniques or talking to someone you trust.

Medical treatments

After stent placement, you will be prescribed medications to prevent blood clots from forming inside the stent (antiplatelet medicines) and often medicines to lower cholesterol, control blood pressure, or manage diabetes. Your doctor will tell you which ones are right for you. It is very important not to stop these medicines without talking to your doctor.

When is surgery considered?

If you have severe or widespread blockages that are not suitable for stenting, your doctor may recommend coronary artery bypass graft (CABG) surgery. This is a more invasive procedure where healthy blood vessels are taken from another part of your body and used to create a new path for blood to flow around the blockage.

Living with this condition

Most people can go back to normal activities within a week after getting a stent. You may feel tired at first, but that is normal. You will need to avoid heavy lifting and strenuous exercise for a few days. Your doctor will tell you when it is safe to return to work.

Lifestyle tips

• Take your medicines every day as directed – never skip doses.
• Keep all follow-up appointments with your doctor or cardiologist.
• Watch for signs of a blood clot in the stent: chest pain, shortness of breath, or feeling unwell. Contact your doctor if these happen.
• Carry a list of your medicines and allergies with you at all times.

Diet and exercise

Eat a heart-friendly diet: plenty of vegetables, fruits, whole grains, lean protein (like fish and chicken), and healthy fats (like olive oil and nuts). Limit processed foods, red meat, and sugary drinks. For exercise, start with gentle walking and gradually increase as you feel better. Cardiac rehabilitation (a supervised program of exercise and education) is highly recommended.

Mental health and emotional wellbeing

It is very common to feel anxious, worried, or down after a heart procedure. Talking about your feelings with your doctor, a counsellor, or a support group can help. If you have thoughts of harming yourself, call your local emergency number or a crisis helpline immediately. You are not alone.

Prevention

While a stent itself is a treatment, you can take steps to prevent future blockages from forming in your other arteries. Eating a healthy diet, staying active, not smoking, and controlling blood pressure, cholesterol, and diabetes all reduce your risk of needing another stent or having a heart attack.

Screening programmes

Regular health checkups to monitor your blood pressure, cholesterol, and blood sugar levels can help catch problems early. If you have a family history of heart disease, talk to your doctor about when to start screening.

Complications

If left untreated

• If a blocked coronary artery is not treated, it can lead to a heart attack, which can damage the heart muscle.
• Untreated coronary artery disease can also lead to heart failure or an irregular heartbeat (arrhythmia).

Long-term outlook

Having a coronary stent is very effective at opening blockages and restoring blood flow. Most people live active, full lives after their procedure. By taking your medicines and making heart-healthy choices, you can greatly reduce the risk of future problems. Your healthcare team will help you stay on track.

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