Q: My mother has been recently diagnosed with three blockages in one artery, which were treated by implanting Endeavour stents. After the procedure, she kept complaining of chest pain. Angiography was done to check for the pain and it was found to be non-cardiac and was treated as a gastric pain. She is fine now (on the 5th day post angioplasty) but the pain keeps reccurring off an on. What could this pain be? Is there any danger? Could you also comment on the quality of the stent used? What kind of rest does she need to take? When can she get back to work considering she is a principal of a high secondary school? She has been prescribed Plavix, which is a very expensive. Is there a cheaper and equally effective alternative to it?

A:Even with a successful deployment of stent, one can continue to have anginal chest pain because of involvement of the smaller blood vessels of the heart, the ones called capillaries and which can’t even be seen by the naked eye. Also there is a chance of the pain being non-cardiac in origin, that is related to inflammation of the lower end of the food pipe (oesophagitis) or it could be from the muscles and bones of the chest wall itself. It if is non cardiac in origin, then obviously it is very safe but if it is cardiac in origin then, one needs to take medicines and be aggressive about risk factor control. Regarding the quality of the stent, Endeavours stents are drug eluting stents made by a company called Medtronic and they are state of art stents and are of good quality. One needs to take rest for only couple of days after an angioplasty and thereafter one can get back to full gainful employment. Clopidogrel is a costly drug and is available under various names and one of them is Plavix. The cost is marginally different for various brands but essentially it’s a an expensive drug and has no substitute at this present moment in time.