Training Progression after Angioplasty & Stent

I am 50 years old and have been strength training consistently since I was 14. I had chest pressure during cardio and went into get checked. I had 80% blockage of the LAD. I had a 90% blockage of a smaller artery off of that they ballooned but did not stent. They put in a stent 2 weeks ago and I started cardiac rehab. I did not have a MI and have no heart muscle damage I was a strength coach for 25 years so I would say i am not the typical cardiac rehab patient. The doc said to talk with cardiac rehab about my progression and I have but they do not really have any experience strength training. I began doing 1 set of 10 with a dowel of RDL, Press, Squat, DL, Row, Lunge, Curl. I have added weight and sets and most recently used a 35# bar. for 3 sets of 10, also adding in BP & triceps ext. At this point it is basically a little cardio circuit with a barbell. Is there any concern of the stent moving? If so how long before it is fixed in place? I have a check up at 6 weeks but it is with a different doctor than my cardiologist who performed the Angiogram. I am increasing the weight by 10# and will use a 45# bar tomorrow. Obviously some of the upper body exercises will limit the weight progression. I plan to split up the circuit and use 2 barbells. I will then use a lighter weight for the upper body exercises and make smaller increases. I will pair them in 2 or 3 exercises for a monster set and continue to do a circuit. I will Linearly progress them. I will be back to about 135# for the Sq / DL / RDL by my 6 week appointment. I then plan to begin a more traditional strength training LP. I was signed up for a powerlifting meet on July 20th. I would still like to compete in that but I know my wife is concerned. I would have about 12 weeks of the traditional strength training LP and whatever that progression morphs into. I would love to compete but just do whatever weight I am at in my training program not really max out. I am not concerned about the Valsalva at all but want to be prepared for my doctors appointment. I know you cannot give medical advice like this but, you have more strength training knowledge than my doctors and cardiac rehab techs. Is my training progression reasonable? is there a concern with the stent moving? Thoughts on a powerlifting meet 4 months after a stent? Thank you so much for all you do. I greatly appreciate you for bridging the gap and promoting strength training.

Hi,

There is not concern for stent migration in these situations. Rather, it sounds like they are applying a “standard” cardiac rehab protocol, the same type they would provide to a patient with no exercise history who just had an MI. This may be too conservative / under-dosed for your situation given your training history and the presentation of angina without infarction, but I’m not really able to provide an individualized assessment of this for you via the forum. Your progression sounds reasonable assuming you are tolerating it well without any recurrent symptoms; I would ensure you are taking the prescribed medications since your procedure and keep up with conditioning alongside your strength training.

Sure. The main complication we worry about with stents in the short-term after they are placed is thrombosis (clotting, resulting in a severe acute MI), and in the long term is re-stenosis (gradual re-narrowing, although this is less of a risk with modern stents). Taking the prescribed medicines can minimize the risk of these things happening.