A cardiac angiogram is a diagnostic test to evaluate heart problems. This test actually looks at the blood flow through your heart’s vessels.  It can also evaluate heart muscle strength and problems with the valves in your heart.

·         Prior to the procedure you will need to have a chest x-ray and blood tests.

·         Do note eat after midnight the night before your procedure.

·         Take your medications as usual the morning of your procedure with a sip of water unless directed otherwise.  Certain medications need to be adjusted prior to your procedure, such as diabetic medications (especially Glucophage/Metformin), blood thinners like Coumadin (Warfarin, Jantoven), and diuretics (water pills).  You will receive specific instructions regarding these medications.

·         Tell your doctor about any allergies you may have, especially iodine, shellfish, x-ray dye, latex or rubber products.

·         Arrange to have a family member or friend drive you home after the procedure.

In most cases, you will arrive as an outpatient at the cardiac center of the hospital on the morning of the procedure. You will be given a consent form to review and sign. Your blood pressure and heart rate will be checked and an IV catheter be placed in your arm.  Once you are on the catheterization table, electrode stickers will be placed on your chest to monitor your heart beat.   The groin area is shaved and cleaned where the catheter will be inserted.  To minimize discomfort associated with the procedure, a local anesthetic will be used to numb the groin area. Additional medications may also be given through the IV to help you relax.  A small incision at the groin site will be made and a catheter will be inserted into your femoral artery and directed towards your heart.

When the catheter reaches your heart, dye will be injected and a series of x-ray pictures of your heart will be taken.  This procedure usually lasts 30 minutes. If additional intervention is needed it may take longer.

Recovery

Once the procedure is completed, the catheter will be removed from your groin.  To stop the bleeding, applied pressure, suture device or a collagen-like plug may be inserted into the wall of the vessel. It is known by several names (Angioseal, Vasoseal, Perclose). This will slowly be absorbed by your body over time. If only an angiogram was performed you will be able to go home after several hours of bedrest.  If further intervention is necessary you will stay in the hospital overnight.  Your cardiologist will discuss the results of the procedure with the person(s) who accompanied you to the hospital and to you once you are fully awake.  Any specific follow-up instructions will be given to you at that time.  If you have any further questions after the procedure, contact your doctor’s office. 

Percutaneous Transluminal Coronary Angioplasty (PTCA), is a procedure used to correct a narrowing or blockage in one of your coronary arteries. This procedure is sometimes performed immediately following an angiogram, or it can be done separately at a later date.

The procedure is the same as an angiogram in the beginning. The difference is a special catheter with a balloon tip is inserted and is guided to the blocked artery. Then the balloon is inflated and deflated several times to compress the fatty build up against the wall of the artery.

Sometimes people experience some chest discomfort when the balloon is inflated because the artery is temporarily blocked. When the balloon is deflated the discomfort should go away promptly.  If you should experience any discomfort during the procedure, let your doctor know.

Sometimes a stent is placed in the artery after the balloon is inflated.  This is a small mesh tube that will be inserted permanently into the artery to keep it open.

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Angioplasty and stenting are both therapeutic procedures done by an interventional cardiologist to open occluded (or blocked) arteries. During the procedure, a catheter is inserted into a vein or artery in the groin or arm. At the catheter’s tip is a small wire mesh device. Once the catheter has been positioned correctly in the blocked artery, the wire mesh (in the case of the coronary stent) is released and permanently placed inside to help keep it open. In the case of the angioplasty, a balloon which is placed at the end of the catheter is inflated to encourage the patient’s coronary artery to reopen.

The site on your groin where the catheter was inserted should be treated with the following care:

1. Leave band-aid in place for 24 hours.
2. Hold firm pressure to the insertion site if you have to cough or sneeze for the first couple days after the procedure.

3. You may shower and wash the groin site on a daily basis with soap and water. (No tub baths, swimming pools or hot tubs for at least one week after the procedure or until the groin site is completely healed.)

It is not uncommon for your groin to be sore or tender for several days after angiogram.  Bruising may develop after this procedure, which is normal.  Additionally, you may notice a small lump in your groin, about the size of a pea.  This is the closure device that they used. Your body will slowly absorb it.

You may resume all activity the day after your procedure with the exception of heavy lifting (Nothing greater than 10 lbs.)  This should be avoided completely for three days following your angiogram/angioplasty.  You should not plan on driving or making any legal decisions for 24 hours after receiving intravenous sedation.  It is also advised to drink plenty of liquids post-procedure to clear the contrast material from your body.  The doctor will let you know when it is safe to resume driving.

-          Unusual pain at the groin site or down the affected leg

-          Signs of infection: redness, warmth, drainage at groin site, fever, chills

-          Increased swelling at site

-          If you have heavy bleeding at the groin site call 911

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