What coronary angiogram is for?

Coronary angiogram is performed to diagnosis and treat diseases of the vessels of the heart. Your doctor may recommend a coronary angiogram if you have:

1. Angina
2. Heart Attack
3. New or increasing chest pain (unstable angina)
4. A heart defect you were born with (congenital heart disease)
5. A heart valve problem that requires surgery

What to expect before the procedure?

1. Before your procedure, your doctor will review your medical history, including allergies and medications you take. The team may perform a physical exam and check your vital signs including blood pressure and pulse.
2. The doctor will obtain verbal and written consent ( after explaining procedure and potential complications)
3. You will be asked not to drink or eat anything for at least 4-6 hours before the procedure.
4. An IV line is inserted into a vein in your arm for IV fluids and other medications

Possible complications

As with any invasive procedures, there are some risks associated with the procedures. Although risks are there but the benefits of finding the underlying conditions of the vessels are important. The Potential complications include:

1. Heart attack
2. Stroke
3. Injury to the catheterized artery
4. Irregular heart rhythms (arrhythmias)
5. Allergic reactions to the dye or medications used during the procedure
6. Kidney damage
7. Excessive bleeding
8. Infection

What to expect during the procedure?

1. For the procedure, you will be transferred inside a catheter lab.
2. You will then lie on x-ray table. The table height and position can be adjusted by the team. The X-ray cameras may move over and around your head and chest to take pictures from many angles.
3. The doctor may give you medications including pain killers and sedatives ( to help you relax). You may feel sleepy but you'll still be able to be easily awakened to follow any instructions.
4. You will attached to heart monitor, blood pressure cuff and Oxygen monitor.
5. A small amount of hair may be shaved from your groin or arm where a flexible tube (catheter) will be inserted. The area is washed and disinfected and then numbed with an injection of local anesthetic.
6. You will be completely covered with sterile drape sheets during the procedure.

Procedure

A small incision is made at the entry site (either arm or groin), and a short plastic tube (sheath) is inserted into your artery. The catheter is inserted through the sheath into your blood vessel and carefully threaded to your heart vessels.

You shouldn’t feel any movement of catheters inside your body. Tell your health care team if you have any discomfort.

Dye (contrast material) is injected through the catheter. When this happens, you may have a brief sensation of flushing or warmth.

The dye is easy to see on X-ray images. As it moves through your blood vessels, your doctor can observe its flow and identify any blockages or constricted areas.

Depending on what your doctor discovers during your angiogram, you may have additional catheter procedures at the same time, such as a balloon angioplasty or a stent placement to open up a narrowed artery.

Having an angiogram takes about one hour, although it may be longer, especially if combined with other cardiac catheterization procedures. Preparation and post-procedure care can add more time.

What to expect after the procedure?

1. After the procedure, the doctor will close the puncture site into your body.
1. For arm: The team will apply small band for few hours to stop any bleeding.
2. For Groin: They may use an closure device or after moving to the ward the nurse will remove tube and apply pressure for 10-15 minutes.
2. If you feel any swelling or bleeding from the entry site , Immediately inform the medical team.

After discharge from hospital

1. You may see some bruise at the puncture site (wrist or groin) which will improve itself. If you feel some discomfort, you can use paracetamol or other simple painkillers.
2. Avoid heavy lifting for 7 days after the procedure.
3. A lump may develop around your wound site. If it is the size of a pea then do not worry – this is just the scar. If, however, a large lump develops, which is bigger than a 10 pence coin, or the site starts to bleed you must seek immediate medical advice.
4. If the bleeding is from the groin you should then lie down and apply pressure. If it is from the wrist you should apply pressure and elevate the arm.
5. You must seek immediate medical advice. if you experience numbness, coldness or pain in the affected leg or arm

Driving after procedure

1. After an angiogram: do not drive for 3 days.
2. After a planned angioplasty: do not drive for 1 week.
3. (FOR UK )If you hold a group 2 licence (LGV/PCV) then you will need to inform the DVLA of your condition and are not able to drive this type of vehicle for at least 6 weeks. (You may drive a car as per the guidelines listed above). You may need additional tests to fulfil the DVLA requirements for a group 2 licence.

** For any special circumstances, discuss with your doctor/nurse.

Traveling by Aircraft

1. Although it is generally not recommended to take a long haul flight shortly after an angiogram/angioplasty procedure.
2. After an angiogram or routine angioplasty, you may be able to fly after 2-3 days.
3. After an uncomplicated heart attack, you may be able to fly after 3 – 10 days
4. After a more significant or complicated heart attack, delay flying for 4 – 6 weeks.

** For any special circumstances, discuss with your doctor/nurse or contact
The UK Civil Aviation Authority

Working

Return to work will depend on your occupation. In general, you may return to work:

1. 3 days after an angiogram
2. 1 week following a routine angioplasty.
3. If you have had a heart attack then you will likely need 4-6 weeks off work.

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