3 Years After Angioplasty, 47-Year-Old Lifeguard Develops 95% Blockage At Old Stent Site

Navi Mumbai: A 47-year-old lifeguard from Vashigaon, who had undergone angioplasty three years ago, was rushed for treatment after worsening chest pain led to the detection of a critical 95% blockage in the right coronary artery at the site of his previous stent.

Rajaram Joshi, who has diabetes, hypertension and ischemic heart disease, had been experiencing intermittent chest discomfort for around eight days. He initially continued with his routine, but sought medical help when the pain intensified and was accompanied by sweating and breathlessness.

At NewEra Hospital, his blood pressure was found to be 195/120 mmHg and an ECG showed fresh changes. Coronary angiography revealed severe narrowing at the earlier stent site. Doctors performed a repeat angioplasty and inserted a drug-eluting stent to restore blood flow.

Dr Gaurav Surana, Consultant Cardiologist, said the patient's symptoms were an important warning sign given his previous cardiac history.

"Patients who have undergone angioplasty should not ignore new or worsening chest pain, particularly when it is accompanied by sweating or breathlessness. In this case, the change in symptoms, fresh ECG changes and very high blood pressure indicated the need for urgent evaluation," Surana said.

He said the 95% narrowing was found in the right coronary artery at the site of the earlier stent and attributed the recurrence to factors including uncontrolled blood pressure and cholesterol.

"Stent-related narrowing can occur again, particularly when underlying conditions such as diabetes, hypertension and high cholesterol are not adequately controlled," he said.

The repeat procedure was completed in about half an hour. Joshi was kept under observation in the ICU before being shifted to the ward after his condition stabilised. He was discharged after a further 24 hours of observation and was advised to rest for 15 days before resuming his routine activities.

Surana said patients who have undergone angioplasty should remember that the procedure treats an existing blockage but does not eliminate the underlying risk of heart disease.

"Any new or recurring chest discomfort should be assessed promptly rather than being dismissed as acidity, tiredness or routine discomfort," he said.

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