3017 YLH Having an Angiogram

Hello. You have been invited for an angiogram. An angiogram is an X-ray study of the blood vessels, called coronary arteries, which supply blood to your heart muscle, so that we can see any blockages or narrowings which reduce the flow of blood. Coronary artery narrowing can cause angina or lead to a heart attack, so an angiogram helps your doctor to decide if further treatment is needed. A small tube called a catheter is inserted into an artery at your wrist or groin. The catheter is fed along blood vessels until it reaches your heart. A special type of dye that shows up clearly on X-ray is injected through the catheter and into the coronary arteries. Rapid X-ray images are taken to show the flow of blood through the arteries. You will be invited for a pre-operative assessment. This may be several weeks before you are scheduled to have the angiogram. Please bring a list of all of your medicines including any homeopathic or herbal remedies, and medicines you have bought over the counter. You should wear loose fitting clothes and women should wear a top and trousers or a skirt, rather than a dress. You can bring a friend or family member with you, but they may not be allowed into the examination room. At your pre-operative assessment we will: Take a blood test and measure your blood pressure. Perform an ECG to record the electrical activity of your heart. Review the medications you are taking, and advise you which tablets you can and can't take in the lead up to your procedure. Some drugs, like warfarin, may have to be stopped for a few days. We will also answer any questions you have about the procedure and check whether you have any mobility problems so that we can arrange appropriate support for your admission. You will be safe to drive after your assessment and can return to work. You will receive a letter with the date of your angiogram. Please ring us to confirm whether you are able to attend. Once you have a date, you should arrange for someone to bring you into hospital and to take you home as you will not be able to drive for 48 hours after the procedure. In preparation for your admission, take your tablets as advised at the pre-operative appointment. Before coming into hospital, please remove all nail varnish, and do not wear jewellery or make-up. On the day of your angiogram we recommend that you drink normally and eat a light breakfast before coming in to hospital. If your appointment time is at 12:30, you may also have a light lunch. Please arrive at the angiography department at the time detailed in your appointment letter, and take a seat outside recovery. A nurse will welcome you into your bed space when it is available. You will be asked to change into a gown, and one of the nurses will take your blood pressure, oxygen levels and temperature, as well as a cannula into a vein, preferably in your left arm. After admission a specialist heart doctor called a cardiologist, will visit you. They will check that you understand the purpose of an angiogram, what the procedure involves and the possible complications. Complications include bruising, bleeding and infection at the site of catheter insertion, a short episode of angina-type pain, and vary rarely, a heart attack. You will be asked to sign a consent form to give the doctors permission to perform your angiogram. You will then have to wait your turn for the procedure. Any emergency cases will be done first. We recommend that you bring a book or magazine as you may have to wait several hours. Phones, tablets and ebooks are permitted in the hospital, but please be aware that they are brought into hospital at your own risk. When it is your turn, you will be taken into the angiography suite where you will meet the cardiologist, radiographer, nurses, physiologist and occasionally, clinical students. You will be asked to lie on the bed. The radiographer will check your position to ensure we get good images of your heart. The physiologist will attach sticky pads to your chest to monitor your heart rhythm. Sometimes we have to shave a small amount of hair from your chest to make sure the pads stick firmly. The cardiologist will feel the pulses at your wrist and groin and decide which artery to use. The area over the artery will be exposed and thoroughly cleaned. Once clean, a local anaesthetic will be injected into the skin to numb the area. A needle, and then a sheath, is inserted into your artery. You will not experience any pain, although you may feel some pressure. The needle is removed and a catheter is fed through the sheath along your blood vessels until it reaches the coronary arteries that supply your heart muscle. When the tip of the catheter is in one of the coronary arteries, the dye is injected and multiple X-rays are taken to see the flow of blood in the coronary arteries. This sequence may be repeated several times in different coronary arteries. Once complete, the catheter is removed, but sometimes the sheath may be left in place and removed in recovery. When it is removed, we will place a sealing device on the insertion site to stop any bleeding. This will be stuck on very tightly to put pressure on the wound. The whole procedure should take about 30 minutes. After the procedure you will have to lie in bed for two to four hours to ensure there is no bleeding. Most people will be able to go home on the same day, although if your procedure is late in the day, or you have a complication, you may have to stay in overnight. If you go home on the same day, you should make arrangements for someone to stay with you for 24 hours. The angiogram images will be reviewed by the cardiologist who will discuss the results of the angiogram and any further treatments whilst you are in recovery. If you have any questions, please speak to your GP or your cardiologist.