After Percutaneous Coronary Intervention (PCI), I experienced chest pain, palpitations, and anxiety?

Mr. Li (pseudonym), 47 years old, experienced chest pain and dizziness two months ago. After being diagnosed with coronary heart disease, he underwent angioplasty and stent placement surgery. After the surgery, the dizziness was more severe than before the surgery, his resting heart rate reached 90-100 beats per minute, he had palpitations, and his mood became easily tense and depressed. He rushed to the clinic for treatment.

Why do some patients experience more discomfort after angioplasty?

There are several reasons for the recurrence of chest pain shortly after coronary artery stenting (commonly known as angioplasty). Common causes include new changes in other parts of the coronary arteries or changes in blood flow leading to arrhythmia. This patient's symptoms subsided after taking traditional Chinese medicine for two weeks. Mr. Li's experience is common among many coronary heart disease patients who have undergone surgery.

chest pain, palpitations, and anxiety after PCI

We can't help but ask: Are chest pain and dizziness really solely related to coronary artery stenosis, or are they just temporary discomforts caused by mental stress? Why do many people have stenosis detected in their examinations, yet experience no discomfort whatsoever?

In the past, coronary CT scans were the ultimate answer (the gold standard). Does narrowing always necessitate the placement of a stent?

According to past medical knowledge, if a patient's blood vessels were narrowed, leading to myocardial ischemia, a stent would be placed to improve blood supply to the heart. The usual method was to use techniques like coronary CT angiography and coronary angiography to assess the degree of narrowing. If the narrowing was 70% or greater, a stent would be placed. However, with advancements in medicine, it has been discovered that the elasticity of blood vessels varies from person to person. Some patients, even with 80% narrowing, do not experience myocardial ischemia, meaning they do not require a stent. To accurately determine when a stent is needed, the latest international standard uses fractional flow reserve (FFR) or CT-FFR as the basis for assessment. FFR directly measures blood flow through the coronary arteries, accurately determining whether a person's myocardium is ischemic and whether a stent is necessary; it is currently the internationally recognized gold standard. Using this examination, clinical findings have revealed that some patients, despite having 80% narrowing, do not experience ischemia and do not require a stent. Therefore, FFR has changed the fundamental concept of treating coronary heart disease.

Does inserting a stent solve all the problems?

Due to advancements in medicine, coronary heart disease is theoretically curable in Western medicine, but clinically it remains a difficult disease to treat, often recurring after treatment (including restenosis). While the lesions in coronary heart disease occur in the coronary arteries, the underlying cause is systemic, primarily affecting the heart but also involving the coordination of other organs, including the endocrine and metabolic systems. Current Western medical treatment for coronary heart disease mainly focuses on symptomatic and etiological approaches. Symptomatic treatment includes stent placement (note: not targeting the underlying cause) and the use of vasodilators to reduce myocardial workload and oxygen consumption, significantly improving symptoms (angina). Etiological treatment includes suppressing lipid metabolism disorders and endocrine imbalances, as well as comprehensive rehabilitation therapy. However, its effect on reversing existing lesions is slow and limited, though crucial for controlling disease progression.

If a stent is not needed, what would be considered a good option?

Clinically, it's common to encounter patients with no symptoms, yet physical examinations reveal coronary artery stenosis of 70%. Following the examination, they experience insomnia and anxiety, fearing a heart attack at any moment. In fact, this emotional state often exacerbates the cardiovascular burden, doing more harm than good to heart health. In such cases, patients require a comprehensive cardiac rehabilitation treatment, including traditional Chinese medicine, appropriate physical exercise, a healthy lifestyle, and maintaining an optimistic attitude. Traditional Chinese medicine has shown good results in the prevention and treatment of coronary heart disease, and some studies have even shown it can improve coronary artery stenosis. Perhaps the true essence of traditional Chinese medicine in treating coronary heart disease lies in the concept of "nourishment," encompassing both physical and mental well-being. Therefore, a healthy heart is inseparable from a healthy mind.

The essence of traditional Chinese medicine in treating coronary heart disease lies in the concept of "nourishment," which includes both health maintenance and mental well-being.