3017 YLH Having an Angiogram
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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.