What is a Coronary Angiogram?
This is a test that uses dye and special x-rays to show the inside of your coronary arteries. These arteries supply blood and oxygen to your heart.
Why do I need a Coronary Angiogram?
To find out if you have narrowing of the coronary arteries, which may be a cause of your symptoms. Sometimes, as a result of other tests you may have had, the doctor will recommend this test even if you do not have any symptoms.
The benefits of a Coronary Angiogram
Once we have the result of your test we can discuss our findings with you, and discuss options for treatment in order to reduce your symptoms and improve your quality of life. The doctor who has recommended this test for you has taken these benefits in to consideration and would not recommend it if the benefits did not outweigh the risks for you.
On the day of the examination
- This procedure is normally performed as a day case, unless arranged otherwise at pre-assessment. Occasionally following an Angiogram, the doctor may feel you need to stay in hospital.
- You will be given a hospital gown to change into, and the nurse will complete a checklist. This is to ensure that, among other things, you have stopped any medication you have been asked to.
- The nurse will take you to the cardiac catheter lab where you will have the procedure.
What does it involve?
- A specialist doctor will perform the test assisted by a nurse. A radiographer will take x-rays.
- You will be lying flat on a table, which can be moved around.
- The x-ray camera is mounted above. Although the camera does come quite close to you it will not touch you.
- A fine tube is passed into an artery usually in the right wrist, (left Wrist or either groin can also be used). This is not usually painful, as an injection of local anaesthetic is given first to numb the area.
- The doctor then guides the tube into coronary arteries and sometimes the left ventricle (the main pumping chamber of the heart), using x-rays.
- X-ray dye is injected through the tube and a series of pictures is taken.
At the end of the test, the doctor or nurse will remove the tube and apply strong pressure to the needle site to stop the bleeding.
This test is not painful, but you must inform the nurse if you have any pain or discomfort, do not worry this does not necessarily mean anything is wrong.
After the examination
- If you have the procedure via the wrist, you will have a plastic bracelet or bandage placed on the wrist to stop any bleeding. If a plastic bracelet is used, this will be slowly loosened over the course of 2-3 hours. You should be careful with your wrist during this time and not move it excessively. However, you will be able to get up, move around and eat and drink if you wish.
- If you have the procedure via the groin, you will need to lie flat in bed for 1 hour. Following this, if there are no problems, you can sit up in bed for 1 hour. At this point you can have something to eat and drink.
- The nursing staff will check your blood pressure, pulse and wound site at regular intervals.
- There may be some bruising around the injection site, and it may be a little sore as the local anaesthetic wears off.
- The doctor will discuss your results with you before you go home, and what treatment he/she recommends.
- You should be ready to go home approximately four hours after your return to the ward providing; you have someone to stay with you overnight. Sometimes the doctor may advise you to stay in hospital; this will be discussed with you at the time.
Are there any risks?
This is a very safe test.
On very rare occasions there can be serious complications such as
- A heart attack or stroke.
On rare occasions there can be
- Damage to the artery from the catheter.
- An allergic reaction to the dye, this is usually very mild and temporary such as a skin rash.
- Bruising, especially around the catheter site, is common and can take some time to go.
You will have time to discuss these risks with your doctor before you sign your consent form.
What happens when I go home?
- You must have a responsible adult with you overnight after your discharge if the procedure is performed via the groin.
- Remove the elastoplast dressing from your wound 24 hours after discharge.
- You may have a bath or shower, but ensure that your wound site is kept dry. Do not use talcum powders at or near the wound site.
- Simple pain relief, e.g., Paracetamol, may be used for the pain from the wound site. (Do not exceed the stated dose.)
- No lifting for 24 hours and no moderate or strenuous exercise.
- You should not drive for 24 hours if you have the procedure via the groin. There is no restriction on driving if you have the procedure via the wrist.
- You should be able to resume normal activities after 48 hours.
Recovery after Angiography is speedy and problem free for the majority of patients. However, occasionally problems may occur. It is important you can identify certain problems and know what to do about them should they happen to you.
What problems can occur?
Bruising at the puncture site.
This is the most common problem, and we expect you to have a bruise. As long as you are well and have no other symptoms there is usually no need to worry.
Your wound may bleed
If your wound bleeds or a swelling develops, the following steps should be taken:
- Your carer should dial 999 and ask for an emergency ambulance.
- Lie down and cover wound with a folded clean cloth. Apply direct and firm pressure until medical help arrives.
- Elevate your legs.
Wound infection
This can cause pain and discomfort and lead to general ill health. Infection can be identified when the following occurs:
- There is redness or swelling near the wound site.
- The wound site begins to irritate.
- The skin temperature at the wound site appears higher than that of the surrounding skin.
- You have a fever.
- You feel generally unwell.
- Your wound begins to ooze.
Circulation Impairment
This requires medical attention. Impairment of circulation can be identified when:
- Your hand/arm/leg feels unusually cold.
- Your hand/ arm /leg becomes discoloured (mottled blue or very cold)
- Your hand/arm/ leg is unduly painful.
If any of the above symptoms occur, contact A&E immediately who will review your care.
Can I contact the ward when I get home?
Yes. This is encouraged. We do not want you to have any questions unanswered or worries. You can ring us on our direct line 0191 445 8340 if you, your carer or family have any worries about your care at home, please discuss them with any member of the nursing team. You may also contact Ward 8 if there is no answer, it is after 8pm or at the weekend on 0191 445 2005.