Chest Symptoms Following Coronary Stenting in the First 10 Weeks of Recovery

BACKGROUND: 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. OBJECTIVE: To describe the pattern and characteristics of post-stent chest symptoms in cardiac rehabilitation participants. METHODS: A prospective descriptive study assessing the pattern and presence of chest symptoms in coronary artery stent recipients (N=129) 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. RESULTS: Most participants were male, aged on average 60.5 years and received two stents, most often drug eluting. Post-stent chest symptoms were common, experienced by two thirds of patients (68%) 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 (p<.00). Patients described their symptoms as discomforting and used the descriptors dull, tight, sharp, pressing and flickering. Chest symptoms tended to be 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%). CONCLUSIONS: Post-stent chest symptoms are frequent and recurrent out to 10 weeks post-discharge. 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. Cardiac rehabilitation staff are in an ideal position to support and inform stent recipients about appropriate responses to these symptoms.