Coronary Angiogram, Angioplasty and Percutaneous Coronary Intervention (PCI) A Guide for Patients

A cardiac catheterisation (angiogram) may be performed during a stay in hospital or carried out as a day procedure. For both the preparation is the same. Before your coronary angiogram, the doctor will explain the procedure to you and your family. They will discuss all possible complications and you will be asked to sign a consent form. If you need any further information or clarification, please ask the doctor before signing the form or at any time during your stay.

The Angiogram is preformed in the cardiac catherization lab. A nurse will be with you at all times and explain everything to you along the way.

How to prepare for your procedure and what to bring to hospital

If you are a planned day procedure please ensure you have organised someone to drive you home. You will not be permitted to drive yourself home. You will also be required to have an adult stay with you overnight.

However, even as a planned day procedure your situation may change requiring you to stay in hospital overnight. Please prepare for an overnight stay and bring overnight clothes, slippers and toiletries with you.

Bring all your current medications. Bring a book or something to occupy any waiting time. If your doctor has pre-ordered blood tests please ensure these are completed within a week prior to admission.

Please do not bring any valuables with you to hospital.

Day of the procedure

Food

You will be asked not to eat or drink for 4 hours prior to your procedure. You may be permitted to eat and drink soon after the procedure is completed.

Diabetics

On arrival please inform your doctor or nurse if you are diabetic. Your doctor or Specialist should give you instructions regarding your diabetic medicines and insulin prior to your procedure. You must withhold your Metformin for 24 hours pre and 48 hours post your procedure.

Please bring your insulin with you.

Medications

Unless advised otherwise, you should take all your medications as prescribed the morning of your procedure. Please bring all your tablets and a list of your medications with you to hospital. Anti-coagulation tablets (blood thinning tablets) should be discussed with your doctor prior to your procedure. Warfarin must be stopped before your procedure. Some blood thinners, such as Aspirin, are safe to take. If you are unsure of any of your medications, please withhold them the morning of your procedure and discuss them with your nurse upon arrival to the hospital.
 
Please inform the doctor or nurse of any allergies you may have.

Before the procedure

On admission, you will have an Electrocardiograph (ECG), blood tests, blood pressure (BP), temperature and heart rate recorded.

Clothes

Prior to the procedure you will be given a hospital gown to wear. You will be asked to remove all your clothes including your underwear. You may wear your glasses, false teeth and hearing aids.

Skin

To perform the Coronary angiogram we need to access either the wrist (radial artery) or groin (femoral artery). For that reason, the hair around your wrist and groin area will be shaved.

The Procedure

You will be connected to a heart monitor and BP machine.

The test is performed using a local anaesthetic and intravenous sedation and usually takes between 20 and 30 minutes. The doctor places a small plastic tube into an artery in your wrist or groin. A small amount of contrast dye is injected through this tube into the coronary arteries which can be seen on the x-ray screen.

If blockages are found your Doctor may decide that an angioplasty or stent are required. Stenting is a treatment used to open narrowed or blocked arteries and increase blood flow to heart muscle.

This may be performed in the cardiac catheterisation lab immediately following your coronary angiogram or later or as a separate procedure

Procedure via Wrist Access (Radial Artery)

The tube in your wrist is removed immediately and a small band will be wrapped around your wrist and inflated with a balloon to stop bleeding. This will slowly be deflated over 1-3 hours and the wrist band is then removed.

  • You must not do any heavy lifting (greater than 5kg) with this arm for at least five days.

Procedure via Groin Access (Femoral Artery)

The tube will be removed and either firm pressure applied to the site for 10-15 minutes to stop bleeding, or alternatively, a collagen plug, or closure device may be used to close the puncture site.

  • You will require bedrest and to lay flat for at least 2 hours post your angiogram. If you need to cough or sneeze, place hand over puncture site and press down firmly.
  • You must NOT bath or go swimming for 5 days.
  • You must not do any heavy lifting or intense activity for 2 days.
  • You may resume normal activities after 2 days (or as indicated by your cardiologist).

Please remove the dressing from your puncture site the next day following your procedure. Bruising, tenderness or numbness at and around the puncture site is normal for up to a period of 3 weeks.

Recovery

Frequent observations of your pulse, blood pressure and groin/wrist site will be taken in the cardiac cath lab or ward area.

You will be encouraged to drink plenty of fluids to help flush the contrast dye out of your system. Please inform your nurse if you are on a fluid restriction. If you have received sedation during your procedure you are advised not to consume any alcohol, sign legal documents or make important decisions for the next 24 hours.

If you are a day patient you will usually be allowed home 3-6 hours post the procedure. Please ensure that you have arranged someone to collect you and stay with you overnight.

You will not be permitted to drive yourself home or stay home alone overnight.

If you have had a PCI or require further investigations, you will stay overnight on the 9th floor Cardiac Ward.

It is expected in most cases that you will be allowed home the next morning at 09.30. Please ensure you have organised someone to take you home as you will not be permitted to drive.

Leaving Hospital

The result of the Coronary angiogram will be discussed with you. Your medications will be discussed with you, including information on when you may restart all blood thinning and diabetic medications.
Please ask the doctor for a medical certificate if you or your carer need to take time off work.

Driving Post coronary angiogram

The RTA and Heart Foundation recommend not driving for 2 days. Post stent and/or if you have had a heart attack you will be advised on when it is safe for you to resume driving – this is usually within 5 days.

The puncture site may be a little bruised and tender, Paracetamol should be enough to relieve the discomfort. At home most people have no complications after their procedure, however for a small number of people complications may occur. If bleeding, swelling or intense pain occurs at the puncture site lay down and apply firm pressure with your hand immediately. Call 000 for an ambulance to assist you.

If your cardiac symptoms reoccur please inform your cardiologist or GP immediately.

Important

If you experience any angina pain/ chest discomfort not relieved by rest, Anginine or GTN spray immediately call 000 for ambulance assistance.

Download our Patient Guide

Click here to download a copy of our full Coronary Angiogram, Angioplasty and Percutaneous Coronary Intervention (PCI) A Guide for Patients PDF

Additional Contact Numbers

St Vincent’s Private Hospital Melbourne 9th floor: (03) 9411 7890

St Vincent’s Private Hospital Melbourne Cath Lab: (03) 9411 7256

Recommended Websites

Heart Foundation Australia

Diabetes Australia