Heart Attack & Coronary Artery Disease

Angina is chest pain from a partially blocked coronary artery — usually triggered by exertion or stress, lasts a few minutes, relieved by rest or nitroglycerin under the tongue. A heart attack is a complete blockage that kills heart muscle — pain is usually more severe, lasts longer than 15-20 minutes, doesn't ease with rest, and often comes with sweating, nausea, or shortness of breath. Any new chest pain lasting more than a few minutes needs immediate emergency evaluation — don't try to distinguish yourself.

Angioplasty (with a stent) opens a blocked artery through a small groin or wrist puncture — recovery in 1-2 days, back to normal in a week. Bypass surgery (CABG) creates new blood-flow paths around blocked arteries — bigger operation, 3-5 day hospital stay, 6-12 week recovery. Which is better depends on how many arteries are blocked, where the blockages are, and whether you have diabetes. Multi-vessel disease and diabetes often favor bypass. A good cardiologist explains both options honestly rather than pushing one.

Modern stents (drug-eluting) last well for most patients — 90%+ patency at 5-10 years. But stents don't cure coronary disease; the arteries elsewhere continue to narrow if the underlying risk factors aren't addressed. Post-stent patients need dual antiplatelet therapy (aspirin plus clopidogrel or similar) for 6-12 months, statins for life to lower LDL aggressively, BP control, diabetes control, no smoking, and regular activity. The stent buys time; the lifestyle and medications determine whether the next event happens.

Absolutely — and the evidence is very strong. Structured cardiac rehabilitation (supervised exercise plus education plus counseling) after heart attack, angioplasty, or bypass reduces mortality by 20-30% and improves quality of life. Yet in India, less than 10% of eligible patients enroll — often because it isn't offered, or because families don't know it exists. Ask your cardiologist for a referral to cardiac rehab; many hospitals now have programs, and community-based options are growing.

Return to activity is gradual and depends on the event and treatment. After uncomplicated angioplasty: walking within days, light activity in 1-2 weeks, most normal activities in 4-6 weeks. After bypass surgery: 6-12 weeks for full recovery, longer for physical work. Driving usually restricted for 2-6 weeks depending on procedure. Sexual activity generally safe once you can climb 2 flights of stairs without symptoms. Return-to-work timing depends on your job — office work is faster than physical labor.