Successful Coronary Angioplasty and Stent Placement in an Elderly Patient

Case Overview

An elderly patient visited Kamalakar Heart Centre after experiencing recurring chest discomfort, breathlessness and unusual tiredness. The symptoms had gradually worsened and started occurring even during simple activities such as walking short distances and climbing stairs.

Considering the patient’s age and symptoms, the cardiac team conducted a detailed evaluation to identify whether the heart was receiving an adequate blood supply.

Patient-identifying information has been withheld to protect privacy.

The Patient’s Problem

The patient reported:

• Tightness and heaviness in the chest
• Breathlessness during mild physical activity
• Excessive tiredness
• Occasional sweating and uneasiness
• Reduced ability to perform routine activities

Chest pressure, shortness of breath and fatigue can be symptoms of reduced blood flow to the heart and require prompt medical evaluation, particularly in elderly patients.

The clinical team reviewed the patient’s symptoms, general health, current medications and possible cardiac risk factors before recommending further investigations.

Diagnostic Evaluation

The patient underwent a systematic cardiac assessment that included:

Electrocardiogram

An ECG was performed to examine the heart’s electrical activity and identify signs of reduced blood supply or heart-muscle injury.

Blood Investigations

Blood tests, including cardiac biomarkers where clinically required, were conducted to look for evidence of heart-muscle damage. Troponin testing is commonly used when a heart attack or acute coronary syndrome is suspected.

2D Echocardiography

A 2D Echo was used to assess the heart’s pumping function, valves and movement of the heart muscle.

Coronary Angiography

Based on the patient’s symptoms and preliminary findings, coronary angiography was recommended. The angiogram revealed significant narrowing in a major coronary artery, restricting the normal flow of oxygen-rich blood to the heart.

Coronary angiography helps cardiologists identify the location and severity of narrowed or blocked coronary arteries and determine the most appropriate treatment approach.

Diagnosis

The patient was diagnosed with significant coronary artery disease caused by severe narrowing of a coronary artery.

The restricted blood flow was responsible for the recurring chest discomfort, breathlessness and reduced exercise capacity. Without appropriate treatment, the blockage could have increased the risk of further heart-muscle damage or a serious cardiac event.

The treatment decision was made after considering:

• The location and severity of the blockage
• The patient’s age and overall health
• Heart-pumping function
• Existing medical conditions
• Risks and expected benefits of available treatments

Treatment decisions for elderly patients should be individualized because physical strength, other medical conditions, bleeding risk and family support can influence recovery and long-term care.

Treatment: Coronary Angioplasty and Stent Placement

After discussing the findings and treatment options with the patient and family, the cardiac team recommended coronary angioplasty with stent placement.

Coronary angioplasty, also known as percutaneous coronary intervention, is a catheter-based procedure used to open narrowed or blocked coronary arteries. A stent is a small mesh tube placed inside the artery to help keep it open and maintain blood flow.

During the procedure:

1. The patient was given local anaesthesia and closely monitored.
2. A thin catheter was carefully introduced through an artery in the wrist or groin.
3. The catheter was guided towards the narrowed section of the coronary artery.
4. A small balloon was inflated to widen the narrowed area.
5. A coronary stent was positioned and expanded at the affected section.
6. Blood flow through the treated artery was checked before completing the procedure.

Once expanded, the stent remained inside the artery to support the vessel and help maintain blood flow to the heart muscle.

Post-Procedure Care

Following the angioplasty, the patient was shifted to a monitored cardiac-care area. Heart rate, blood pressure, oxygen levels and the catheter-insertion site were regularly assessed.

The patient remained stable and did not develop any immediate procedure-related complications.

The discharge plan included:

• Taking all prescribed medicines regularly
• Continuing antiplatelet medication exactly as advised
• Managing blood pressure, cholesterol and blood sugar
• Following a heart-healthy diet
• Avoiding tobacco products
• Gradually returning to physical activity
• Attending regular cardiology follow-ups
• Seeking immediate help if chest pain or breathing difficulty returned

Patients should not discontinue prescribed antiplatelet medicines after stent placement without consulting their cardiologist, as these medicines help reduce the risk of blood-clot formation inside the stent. The exact medicines and duration must be selected by the treating doctor according to the patient’s condition and bleeding risk.

Outcome

After treatment, blood flow through the affected coronary artery was restored. The patient reported relief from chest discomfort and an improvement in breathing and general comfort.

The patient was discharged in a stable condition with a personalized medication, lifestyle and follow-up plan. During follow-up, the patient showed satisfactory recovery and was gradually able to resume routine daily activities under medical guidance.

Conclusion

This case demonstrates the importance of not ignoring chest discomfort, breathlessness or sudden fatigue in elderly individuals. Early cardiac evaluation helped identify a serious coronary-artery blockage before it caused further damage.

Timely coronary angiography followed by angioplasty and stent placement helped restore blood flow to the heart through a minimally invasive approach. Continued medication adherence, risk-factor management, lifestyle changes and regular follow-up remain essential for protecting the patient’s long-term heart health.

Timely Heart Care Can Make a Difference

Kamalakar Heart Centre provides cardiac evaluation and interventional cardiology services, including ECG, 2D Echo, coronary angiography, angioplasty and stenting. For sudden or severe symptoms, the centre also provides emergency cardiac care.

Do not ignore recurring chest pain, breathlessness, sweating or unexplained fatigue.