Advice after your nerve block for surgery
On this page…
Why did I need to have a Coronary Angiogram?
Over time ‘plaque’ like deposits can develop on the inside of the artery wall. These deposits cause a narrowing within the artery and reduce the amount of blood that can supply the heart muscle. This can then lead to symptoms which may include chest pain, shortness of breath and general fatigue. This condition is often called Coronary Heart Disease.
While it is not always possible to identify the reason why these deposits occur, what we do know is that certain predisposing factors known as ‘risk factors’ increase your chances of developing heart disease. Some risk factors such as: age, sex, ethnic origin and family history cannot be changed. However other risk factors which include the following can be changed or better controlled. These include:
- Smoking (any amount)
- High cholesterol
- High blood pressure (Hypertension)
- Diabetes
- Inactivity (lack of regular exercise)
- Overweight
- Alcohol in excess
- Stress
Many of these risk factors are influenced by your lifestyle. If you follow a healthier lifestyle these risks may be reduced.
Reducing Risk Factors
Smoking
Smoking is a major cause of heart disease. It is essential that you stop smoking. Cutting down is not enough, you must stop. It may not be easy to give up. You will need the support of family and friends. There is also the support of the Smoking Cessation Service who offers group and one to one counselling, free of charge. Ask the nurses to refer you whilst you are an inpatient or they can be contacted once you are discharged:
- Hampshire: 0845 602 4663
- Surrey: Healthy Surrey website or oneyousurrey.org.uk
- Berkshire East: 0800 622 6360
There is not one particular way to give up smoking. Choose the method that suits you best. Stopping now will greatly reduce the risk of you having further heart problems.
Electronic Cigarettes
These products do not contain tobacco and vaporise the nicotine contained within the device. No carbon monoxide is produced so they are very much safer than smoking (but further testing is needed before they can be considered safe). Many smokers are finding these unlicensed products helpful at reducing nicotine cravings and can be a useful alternative to NRT.
High Blood Pressure
In the presence of Coronary Heart Disease (CHD) and/or you have Diabetes; your blood pressure should be no greater than 130/80 mmHg.
Stress
Stress affects us all in our normal lives. In fact, we need a certain level of stress to motivate us. It can stimulate us to do well. However, being under a constant high level of stress can lead to exhaustion and an inability to cope.
It may be this level of fatigue that has an effect on your physical health. Having angina is a stressful event in itself. The feelings of fear and of not being totally in control of the situation are what you may be feeling now. So now is the time to look at your lifestyle and decide how you can relieve the stress in your life. Methods of coping with stress:
- Take regular exercise
- Learn to relax using relaxation exercises
- Take up leisure pursuits
- Eat a balanced diet
- Learn to say 'no' and not feel guilty about it
- Try to anticipate situations you find stressful
- When you have identified problem areas in your life, try to do something about them
- Discuss your feelings with someone you can trust
Improving Access to Psychological Therapies (IAPT) services provide evidence-based psychological therapies to people with anxiety disorders and depression. If you live in England and are aged 18 or over, you can access NHS psychological therapies (IAPT) services. A GP can refer you, or you can refer yourself directly without a referral
IAPT services offer:
- Talking therapies, such as cognitive behavioural therapy (CBT), counselling, other therapies, and guided self-help
- Help for common mental health problems, like anxiety and depression
The problems that IAPT services can treat include:
- Depression
- Generalized anxiety
- Social anxiety
- Panic and agoraphobia
- Other phobias
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Irritable bowel syndrome (IBS)
- Body dysmorphic disorder
Dietary Advice
It is important to adopt a healthy lifestyle, which includes adopting a healthy diet. This is because certain aspects of diet may play a part in the development and progression of heart disease. Eating healthily should be fun. There is no such thing as a good or bad food, it is important to look at your diet as a whole, and not become obsessed with foods you think are 'good' for you, or to totally avoid foods that you think are 'bad' for you. Aim to eat a Mediterranean style diet, including more fruits, vegetables and fish; less meat and replace butter and cheese with products based on plant oils.
It is not routinely recommended the eating of oily fish for the sole purpose of preventing another heart attack. There is no evidence that eating oily fish causes any harm and fish may form part of a Mediterranean style diet. There is no evidence of harm if you choose to take omega-3 fatty acid capsules or eat omega-3 fatty acid supplemented foods.
The advice is not to take supplements containing beta-carotene. It is also recommended not to take antioxidant supplements (vitamin E and/or C) or folic acid to reduce cardiovascular risk. The main points to follow are:
- Maintain an ideal weight for your height
- Cut down on the amount of fat you eat; replace saturated (animal) fat with unsaturated, polyunsaturated and monounsaturated fat/oils
- Eat plenty of foods that are less processed and rich in fibre
- Eat 5 – 7 portions of fruit or vegetable per day
- Moderate your alcohol intake
- Moderate your salt intake
- Eat a variety of foods
- Eat less meat and more fish
Lowering Cholesterol
Try to keep your total cholesterol level (TCL) as low as possible. If you have coronary heart disease aim for a TCL of less than 4mmol/L with a Low density lipoprotein (LDL) under 1.4mmol/L and a High density lipoprotein (HDL) above 1mmol/L. Your GP should monitor this and advise on how often they wish to check your levels. If you have just started to take a statin or a cholesterol-lowering drug or if a dose of this drug has been changed, your GP should check your cholesterol levels within two months of this medication change.
Familial Hypercholesterolaemia (FH)
This is an inherited genetic condition that causes the LDL to be very high. If we suspect that your cholesterol results might indicate this, we will discuss a referral to the FH cascade team at Southampton Hospital for further investigation with you.
Controlling weight
Women should aim for a waist measurement of 32 inches and men a waist measurement of 37 inches.
Drinking within sensible limits
The NHS recommends that alcohol consumption is:
- 14 or less units a week
- Men should not regularly drink more than 3-4 units of alcohol a day
- Women should not regularly drink more than 2 – 3 units of alcohol a day.
‘Regularly’ means drinking every day or most days of the week. Two alcohol free days is recommended per week. This may vary with your condition and with medications, so check ideal intake levels with your GP. To keep track of your units visit www.
Diabetes Control
If you are diabetic, aim for a blood sugar level between 4-7mmol/l before meals. Your blood sugar level should also not be more than 10mmol/l after meals. This may vary depending on your condition so check with your GP or diabetic nurse.
Inactivity (lack of regular exercise)
We should all aim to do at least 30 minutes of moderate intensity activity five or more days a week. The Cardiac Disease Risk Management Programme exercise classes are designed to help you recognise and improve your exercise capacity and enable you to achieve this target.
Resuming your sex life
There are no strict rules on this – you and your partner can start to have sex again when you both feel ready. Sex is no different from any other form of exercise – if climbing stairs and walking briskly do not cause chest tightness (angina) or breathlessness, it is possible to resume sexual activity. Sexual health is an important part of an individual’s overall physical and emotional well-being. Erectile dysfunction (ED), also known as impotence, is a very common medical condition affecting sexual health. ED can have a range of causes that can be both physical and mental (psychological). Physical causes include narrowing of the blood vessels going to the penis – commonly associated with high blood pressure and high cholesterol or diabetes. Psychological causes of ED include anxiety and depression. You can find more information about any of the conditions listed in bold type at www.
There are several treatment options that have proved very successful for ED. If you have problems resuming your sex life, it is important to discuss this with your GP or Cardiac Nurse. Ignoring the problem may only worsen it, and it may cause stress in your relationship with your partner. Further information and advice can be found on www.
Driving
DVLA guidelines state after a coronary angiogram, you should not drive for at least 3 days. You do not need to inform the DVLA about this procedure. If you experience angina at rest, with emotion, or behind the wheel, you should not drive until symptoms are controlled.
Travelling abroad
If you have travel arrangements already booked, please discuss these with the Cardiologist or Nurse Specialist. We recommend that you ensure you have adequate travel insurance if travelling abroad. It is important to update your travel insurance company with any new medical conditions +/or pending treatment.
Advice can be found on the British Heart Foundation website www.
Following your discharge home
You will be contacted by phone by the Cardiac Nurse specialist within 3 working days of your discharge. This will give you the opportunity to discuss your recovery and an appointment will be arranged with you to join the Cardiac Disease Risk Management Programme as recommended by your Cardiology Consultant. This has been shown to accelerate physical and psychological recovery and can significantly reduce the risk of problems in the future.
Cardiac Disease Risk Management Programme
The Cardiac Disease Risk Management Programme includes the following:
- Lifestyle risk factor management:
- Physical activity and exercise
- Diet
- Smoking cessation
- Psychosocial health
- Cardioprotective therapies
- Medical risk factor management
- Long term management
Giving Blood
Unfortunately if you have had a heart attack or been given a diagnosis of coronary artery disease you are no longer able to donate blood.
GTN use
It is recommended you receive a GTN spray prior to leaving hospital, although for a few patients this may not be suitable. Please check with the team of doctors looking after you regarding this. If you are suitable to carry one, please ensure you keep it on your person at all times. Should you experience any of the following when you are at home and you are undertaking an activity follow the CHEST PAIN INSTRUCTIONS BELOW:
• Central chest pain or you may experience a heaviness / dull ache / tightness in your chest area. This may radiate to the following areas – arms, neck / throat, across shoulders, jaw.
• Remember the pain in your chest may be similar to indigestion discomfort. It is therefore recommended you follow the advice below.
|
CHEST PAIN INSTRUCTIONS |
| At the onset of pain rest for 1-2 minutes. If the pain persists take 1-2 puffs of GTN spray |
|
|
| If unrelieved after 5 minutes take further GTN spray/tablet |
|
|
| If unrelieved after 5 minutes take further GTN spray/tablet |
|
|
| If you have chest pain despite taking 3 doses of GTN spray |
|
|
| CALL 999 IMMEDIATELY |
It is recommended that you do not phone your GP first as this delays any emergency treatment you might require.
If in doubt don't wait - phone 999 for an ambulance
Further support
Heart Smart
A local support group run by cardiac patients for cardiac patients.
Contact Ian Marshell on 07760 485875.
THROB
Cardiac rehabilitation in the Berkshire area is covered by Heatherwood Hospital in Ascot and Wexham Park Hospital in Slough http://
HEARTBEATS
West Berkshire Heart support group. A cardiac support group formed from cardiac patients and partners http://www.heartbeats-berkshire.co.uk
Heartbeat Support Woking
Holds a monthly social evening with guest speakers and runs rehabilitation sessions with its sister group 'Bravehearts' at Woking Leisure Centre http://
Patients from the Royal Surrey Hospital
Patients from the Royal Surrey will be referred back to the Royal Surrey Hospital after discharge, and can expect to be contacted 4 – 6 weeks after discharge. If you would like more information please contact: The Cardiac Nurse Specialists 01483 571122, Ext 6370 or Bleep 0774.
Flu Vaccination
The Department of Health recommends that individuals with heart disease receive the flu vaccine. It is free if you have heart disease and you should be vaccinated against flu every winter to make sure you are protected against the latest strains of flu. Contact your GP to organize your vaccination.
Prescription Prepayment Certificate (PPC)
If you will have to pay for four or more prescription items in three months or more than 14 items in 12 months, you may find it cheaper to buy a PPC via the PPC page on www.gov.uk. Alternatively you can call them on 0300 330 1341
Do I need to see my GP after I am discharged from hospital?
We recommend that soon after your discharge you contact your GP practice to ascertain if your GP wishes to see you. In some cases your GP may wish to instigate follow on care, for example blood testing if your medicines have been changed. In other cases your GP may not need to see you unless you have concerns or a medical need.
For further information
Please contact the Cardiac Disease Risk Management team at the following sites depending on where you live and where you were treated:
Frimley Park Hospital 0300 613 6384
Wexham Park Hospital 0300 615 4684
There is an answer phone facility available on this number. Please leave a message if we are unable to answer and we will return your call. Please note this may not be on the same day.
Contact us
If you have any queries relating to this information, please contact the Cardiology service.
Contact us
If you have any queries relating to this information, please contact the Cardiology service.
About this information
Service:
Cardiology
Reference:
C/031
Approval date:
8 August 2025
Review date:
1 August 2028
Click ‘show accessibility tools’ at the bottom of the page
Then click ‘select language’
Alternative formats
You can use the accessibility toolbar at the bottom of your screen to:
-
Change the text size
-
Adjust the font
-
Modify the colour contrast
-
Use the translate function
If you would like this information in another format, such as Braille, audio, or easy read, please speak to a member of staff.
You can also print as well as download as PDF using the “Print this page” button at the end of the page.
Staff will print a copy for you on request
Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.