Your good health: Heart stenting can lead to risk of infection or heart damage

Dear Dr. Roach: I am a 71 year old female diagnosed with coronary artery disease. My last calcium score was 801. My right coronary artery was 80% blocked and the left artery 25%. My cardiologist asked me to decide if I wanted to do an angioplasty or not. I have no symptoms, only shortness of breath on exertion. I also can’t breathe, like I’m suffocating, when I’m wearing a mask. I can’t decide what to do. My cardiologist seemed against getting a stent, not that he said that exactly, but he pointed out the risk of having a stent.

CM

A heart stent is a device placed in an artery of the heart after it is reopened, usually by a balloon, in a procedure called angioplasty. Stents help reduce the risk of the artery closing after the procedure. In people with stable coronary artery disease, opening a blood vessel may reduce symptoms, but despite numerous studies has not been shown to reduce the risk of heart attack or death .

You said you were asymptomatic, but shortness of breath is one of the main symptoms of blocked coronary arteries, which are the blood vessels that supply oxygen-rich blood to the heart muscle. It can sometimes be very difficult to determine whether or not a person’s shortness of breath is due to blockages in the artery, and exercise testing can help determine if this is likely. People can experience shortness of breath on exertion for many reasons, including lung problems, anemia, lack of exercise, or persistent symptoms after COVID infection.

While the decision is ultimately yours – it’s your body – it’s best if the cardiologist gives you a specific recommendation and the reasoning behind it. You cannot make an informed decision without being informed. A stent can improve your shortness of breath, but there are risks of bleeding, infection, and even heart damage from having a stent placed. This is not to be taken lightly.

If your cardiologist doesn’t think your shortness of breath is due to your blockages, a stent probably won’t help. Revisit with your cardiologist to get a clear idea of ​​the potential benefits and harms specific to your case, and bring a friend or family member to help.

Dear Dr. Roach: I take Antabuse to help me stop drinking. Should I be worried about alcohol in hand sanitizers?

L.W.

Antabuse is a drug that makes people very sick even if they drink small amounts of alcohol. It is no longer frequently used, but it remains an effective and proven option for the drug treatment of people with alcohol problems.

Hand sanitizers are made either from ethyl alcohol, which is the alcohol found in alcoholic beverages, or from isopropyl alcohol or rubbing alcohol. There have been case reports of people developing a reaction to alcohol while performing hand hygiene, after shaving and even inhaling fumes after performing hand hygiene. According to a study during the pandemic, out of 42 people on Antabuse who regularly used hand sanitizers, 20% had a reaction to ethyl alcohol-based sanitizer and 10% had a reaction to isopropyl-based sanitizer. Seven percent of people had severe reactions, but the rest were mild and self-limiting.

There is clearly a risk of developing symptoms even after the smallest amount of alcohol that can be absorbed through the skin or inhaled through the vapors. People on Antabuse who have a reaction to skin disinfectants should wash their hands rather than use disinfectants.

Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can email questions to ToYourGoodHealth@med.cornell.edu