Chest discomfort following stent common, with most patients unsure what to do

Chest discomfort following a coronary stent is common up to ten weeks after discharge, and most patients are unsure what to do about it. Most patients experience the benefits of PTCA and stent quickly, with reduction in symptoms and improvement in functional status; however, many patients experience chest symptoms post-procedure, writes Robyn Gallagher (University of Technology, Sydney, Australia) and colleagues in the European Journal of Cardiovascular Nursing. They therefore assessed the pattern and presence of chest symptoms in 129 coronary artery stent recipients four and ten weeks post-procedure. Patients were interviewed at cardiac rehabilitation or by the phone using a specifically developed questionnaire which incorporated the McGill Pain Questionnaire. Most participants were male, aged on average 60.5 years and received two stents, most often drug eluting. Two-thirds (68%) of patients experienced discomfort at some time during the 10 weeks post-discharge. Chest symptoms were recurrent, with 33% having symptoms on both occasions and occurred more often in younger patients. Patients described their symptoms as discomforting, using the words “dull”, “tight”, “sharp”, “pressing” and “flickering”. Symptoms were brief and/or intermittent (65%) lasting from a few seconds to a few minutes (63%). Most patients felt their symptoms were related to their stent (75%) and were unsure what to do. A small number (5%) interpreted their symptoms as ischaemic and presented to the hospital (4%). “Although symptoms tended to be brief and intermittent, the location and quality of these symptoms may overlap with existing chest pain guidelines, making it difficult for patients to interpret,” the researchers concluded. “Cardiac rehabilitation staff are in an ideal position to support and inform stent recipients about appropriate responses to these symptoms.” Reference...