Post-stent re-infarction: Two fatal mistakes – neglecting follow-up examinations and risk factors

Case: A patient who underwent stent implantation for myocardial infarction suffered another myocardial infarction less than six months later. The doctor said he made two mistakes.

Mr. Wang, 42 years old, a taxi driver, obese, with hypertension and hyperlipidemia, smoked one pack of cigarettes a day. Six months ago, he suddenly experienced chest tightness and chest pain while working and sought medical attention at this hospital. He was diagnosed with acute myocardial infarction and right coronary artery occlusion. He underwent stent implantation, the surgery was successful, the blood vessel was opened, and the patient was discharged after improvement. Six months later, the patient was hospitalized again due to chest pain. A coronary angiography revealed complete occlusion of the right coronary artery, and he was diagnosed with myocardial infarction again. Due to timely medical attention, the patient was successfully resuscitated.

Many patients with coronary heart disease have similar experiences to Mr. Wang. Although they successfully underwent coronary stent surgery and took medication as prescribed, improper post-operative procedures led to re-occlusion of the blood vessels.

1. The patient only took medication and did not pay attention to whether the laboratory indicators were within the target range.

After his first coronary stent surgery, Mr. Wang's symptoms disappeared, and he felt he was cured. He thought that as long as he took his medication on time, he would be fine, and he did not have regular follow-up appointments.

For patients with myocardial infarction, regular check-ups are very important. Firstly, they can check for adverse drug reactions, such as elevated transaminases caused by statins or bleeding caused by aspirin. Secondly, they can monitor whether biochemical indicators are within target ranges. For example, if a patient is taking statins but their LDL cholesterol remains above 2.4 mmol/L, which is below the target, then medication needs to be adjusted.

2. The patient only took medication and did not pay attention to controlling risk factors.

After being discharged from the hospital following his first myocardial infarction, the doctor told Mr. Wang that he must control risk factors, including reducing salt intake, abstaining from alcohol, quitting smoking, and exercising more. However, after being discharged, Mr. Wang disregarded the doctor's advice, making excuses such as driving a taxi every day, sitting most of the time, not having time to exercise; also, driving a taxi is very tiring, and to avoid drowsiness, he would smoke a cigarette to stay awake, and drink some alcohol at night to relax.

Everyone only has one life, and luck isn't always on your side. You can change jobs, but you can't gamble with your life. Risk factors that lead to blood vessel blockage after a myocardial infarction must be controlled, and medication must be taken on time.

In short, coronary heart disease and myocardial infarction are not simply a matter of getting a stent implanted and taking medication as prescribed. Risk factors that cause blood vessel blockage must be controlled to prevent tragedy!