Admission for coronary angiogram

Information for Patients and Carers
Introduction
Your doctor has recommended that you have a test called coronary angiogram, (also known as a cardiac catheterisation), as part of your investigation to formulate your future treatment plan. You will have this procedure as a day case. It is essential that you read this leaflet prior to your procedure. Why should I have an angiogram?
A coronary angiogram is a specialised x-ray procedure performed as part of a cardiac catheterisation. This test is done to study the structure of the arteries so as to identify any narrowing in these arteries that bring blood to the heart muscle and to evaluate the function of the main pumping chamber of your heart. Pre-procedure preparation
You must avoid alcohol for at least 24 hours before and after the
angiogram. If your admission is for 8.00 am, you must not eat
anything from 5.30 am but you can have clear fluids up until 7.30 am
on the morning of the admission.
If your admission is for 11.30 am, you can have breakfast before 9.00
am and drink clear fluids up until 11.00 am. On the morning of the
procedure please take a shower or bath as this will help to reduce the
risk of infection. If you are a diabetic who takes Metformin/Avandamet tablets, please do not take them on the day of your admission, but you can take the rest of
your medication as usual. Metformin can be taken 48 hours after
procedure.
If you are taking Warfarin or Sinthrome, please stop this for 5
days prior to your procedure, unless otherwise instructed by
your Consultant.

If you are taking Insulin, then please follow these directions : if you are
attending at 8.00 am – then please DO NOT TAKE YOUR INSULIN; if
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you are attending at 11.30 am – then please TAKE HALF YOUR DOSE
WITH BREAKFAST.
If you have been informed you have an allergy to Iodine, you must inform the unit as soon as possible by ringing the Administration Manager on 0161 419 4634. A change of appointment may be necessary. Please bring your dressing gown and slippers with you. Please do not bring any valuables or cash with you as they may be left unattended while you are undergoing the procedure. Driving is prohibited for 24 hours following the procedure, or 3 days if the procedure is done via the wrist artery, therefore you should arrange
for a relative or friend to bring you and pick you up from the hospital.
You are not allowed to go home on public transport. If you
require an ambulance you must contact your GP at least 48 hours
prior to admission to arrange transport to and from the hospital
(as a day case procedure).
(Car parking is limited and costs up to 2 hours = £2.00, 2-4 hours = £3.00, over 4 hours = £5.00 on a pay and display basis). Where should I report for an angiogram?
The Cardiac Catheterisation Suite is near the Accident and Emergency Unit. You will be admitted to the ward on the day of your procedure. During the admission you will be asked to change into a gown and paper pants. Your details will be checked and an identity name band placed on your wrist. A small area of your body maybe shaved (usually the groin). The same area will be cleaned with an antiseptic solution. Patient Information Leaflets On-line
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What happens during the procedure?
After signing the consent you will be taken to the Cardiac Catheter Lab. You will lie on your back on a special x-ray table with your hands on the side. You will be attached to a cardiac monitor. The test will be performed through the artery in your groin or wrist. The skin around the groin (or wrist) is injected with a small amount of anaesthetic to numb the area. Once the area is numb the doctor will insert a small tube (sheath) into the artery. A catheter is then inserted through the sheath and guided through the body using an x-ray machine until it reaches the heart. The doctor watches the progress of the catheter via x-rays transmitted to a television monitor. You cannot feel the catheter going through the heart because there are not enough nerves in the blood vessels. Once the catheter is in place a small amount of x-ray sensitive dye is injected through it. X-rays are taken as the dye goes through the blood. During one of the injections a large amount of dye (about 40 ml) may be injected. You may feel a warm flush or you may feel you have passed urine as the dye is injected. You will be warned to expect this. This is only a momentary feeling and will pass quickly. You may be asked to hold your breath (for a few seconds) at this stage, while each x-ray is taken. At the end the doctor will remove the catheter. The test will take approximately 30 minutes. What will happen to me after the procedure?
Following your angiogram, the tube will be removed from the artery and a pressure device will be applied. Alternatively a small collagen plug will be applied (angioseal or exoseal) to close the hole in the artery. Mobilisation
You will be advised as to when you can sit up or walk by the nurses on the unit. However, you may be on bed rest for 1 - 2 hours and then you will be allowed to sit out in a chair. Patient Information Leaflets On-line
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If your condition is stable, you will be asked to gradually increase your activity. Recovering from the procedure
• You will be asked to rest in bed for 1 – 2 hours. • Your blood pressure, pulse, (foot pulses), respiratory rate and the • You may eat and drink. It is important to drink plenty of fluids as this will help to flush the contrast dye through your kidneys. • If there are no contraindications you will be allowed to go home Going home after the procedure
• Please arrange for someone to take you from the hospital and stay • You must not drive for 24 hours after discharge, or 3 days if the • After 48 hours you can resume normal activities. • You should not lift heavy things or bend down for 3 – 4 days. • When getting in and out of the car, going up and down stairs, sneezing, coughing or laughing, please apply gentle pressure to the groin area to support it and prevent pain, if the groin is used in • Avoid baths for 3 days, but you can have a shower the next • You may feel slight tenderness; bruising and you may develop a pea-sized lump. This is normal and will settle in 2 weeks. Patient Information Leaflets On-line
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• If you experience pain from the wound, you can take a painkiller • You are prohibited to fly for 7 days following the procedure.
NB: If you feel that the lump appears to grow bigger, or the bruising is
getting larger, darker, or more painful or if you notice a discharge from
The Cardiac Catheter Lab on 0161 419 4649/4650
The Coronary Care Unit (CCU) on 0161 419 5959/5929
In the first week is important to avoid constipation, as straining can increase pressure on the wound site (groin). What are the risks of an angiogram?
Before you give your consent you must understand that there are possible risks and side effects involved in this procedure. They are: • Bleeding and bruising around the site where the catheter is inserted. This is treated by firm pressure for up to an hour. • There can be an allergic reaction to the dye such as skin rash, headache, and visual disturbances. These are treated immediately with medication. • In 1 in 1,000 patients, the test may cause a heart attack, stroke or death. This risk will increase if you are suffering from diabetes or experiencing anginal pain. For some patients, it may therefore by necessary to have an urgent procedure to fix the heart attack (angioplasty and/or surgery). • There is a remote possibility that the catheter may damage the artery in your groin, which would require surgical repair. Patient Information Leaflets On-line
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What are the benefits of an angiogram?
• This procedure will help to make a definitive diagnosis of blocked • It will determine if the blockages are severe enough to cause any • It will help to determine the best way to form a treatment plan i.e. medication alone; open up the arteries (angioplasty with stents) or by-pass surgery (CABG). Our smoke free policy
As per the smoke free law, smoking is not allowed by anyone anywhere on the hospital site. For further information, please read the patient information leaflet 'Policy on Smoke Free NHS Premises'. Patient Information Leaflets On-line
For information about Patient Services, contact Patient and Customer Services (PCS) on (0161) 419 5678
Produced by Stockport NHS Foundation Trust
Review Date: May 2014
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For information about Patient Services, contact Patient and Customer Services (PCS) on (0161) 419 5678

Source: https://www.stockport.nhs.uk/documents/PIL/13344_MED14.pdf