Advice after your nerve block for surgery
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This leaflet has been written for patients undergoing a coronary angiogram (also known as cardiac catheterisation) at Frimley Park Hospital, and their carers.
You may be having the procedure as a day case following an outpatient appointment or after being admitted to hospital due to angina or a heart attack; or you may be having this procedure during your current admission in hospital.
This leaflet gives important information about the angiogram procedure, about going home and for activity afterwards (following a day case).
Why do I need an angiogram?
An angiogram is a procedure performed to find out whether your arteries have become narrowed and whether the flow of blood to the heart is reduced. Narrowing of the arteries may be the cause of symptoms such as pain in the chest called angina. The valves inside the heart and the pumping chamber in the heart may also be looked at during the procedure. This information will help your doctors with your diagnosis and next steps of care (if any are necessary).
Pre-operative assessment and care
We will invite you to attend a pre-assessment appointment either face to face or as a telephone call, with a Cardiac Nurse Specialist before your coronary angiogram. The nurse will describe the procedure, discuss the risks involved and give guidance on preparing for the procedure, including any changes required to medications, when to stop eating and what to bring with you.
If you take Warfarin or Direct Oral Anti-Coagulants such as Apixaban, Rivaroxaban, Dabigatran or Edoxaban you will receive advice for managing your medication in relation to having the procedure.
If you are diabetic and are taking Metformin tablets you should stop taking the tablets the day before the procedure and restart 3 days after.
Do not stop taking other diabetic tablets.
Fasting Blood Test
You will be asked to have a fasting blood test
Appointments for your blood test are booked online via the Frimley Health website
https://
Aldershot Centre for Health
Farnham Hospital
Frimley Park Hospital – Outpatients
Heatherwood Hospital – Outpatients
King Edward V11 Hospital
St Marks Hospital
Wexham Park Hospital – Outpatients
Alternatively book an appointment with your GP
On the day of your angiogram
- We recommend you have a light breakfast before you come in. You will be offered a sandwich and refreshments after your procedure.
- You should take your usual medication including blood pressure or water tablets if you take them.
- Please bring all your medications in the original boxes or dosette box with you on the day of the test as you will be taking these as normal.
- Please bring your dressing gown and slippers (or slip on shoes) with you. Nightclothes are not necessary as we will give you a gown to wear.
- Please remember to bring your reading glasses with you and something to read or occupy you.
- Avoid bringing any valuables or cash with you other than small change for a newspaper as they may be left unattended while you are undergoing your test.
Please be aware that procedures are occasionally delayed or possibly cancelled due to unforeseen emergencies. The ward nurse will keep you informed.
You must be collected from the day ward and be driven home after the test as you must not drive for 2 days after the procedure.
Please arrange for a responsible adult to stay with you overnight.
Visitors
The Cardiac Cath Lab Day Ward team aims to ensure that patients have their dignity and confidentiality always respected.
Due to the lack of space and layout of the day ward, it is not possible for relatives / carers to stay with the patient during their stay.
However, exceptions can be made if the nurse in charge considers it appropriate for the carer to stay with the patient for the duration of their stay.
Relatives / carers may telephone the Cardiac Cath Lab Day Ward on 03006 139572.
The angiogram procedure and care given
During your admission you will stay in the day ward. You will be asked to put on a gown, your details will be checked and a name band placed on your wrist.
The Procedure
The procedure is performed in a special X-ray room which looks like a small operating theatre. You will be asked to walk to the X-ray room. If you are unable to walk a wheelchair will be provided. If you wear glasses and would like to watch the screens, please make sure you wear your glasses.
There will be several members of staff in the room during the procedure including a doctor, nurse, a cardiac technician and a radiographer. You will lie on your back on a special X-ray table.
The test will most often be undertaken through the radial artery (wrist). Other sites that can be used are the groin (femoral artery) or in a few cases the middle of the arm (brachial artery).
The skin around the wrist (groin or the arm) is numbed with a local anesthetic. Once numb, the doctor will insert a small tube, called a sheath, into the artery. Through this sheath the catheters will be inserted to look at your arteries. You will not feel this.
A clear dye is injected into the coronary arteries to outline them on the X-ray. During one of the injections, you may feel a hot flush as the dye is injected, and you may feel like you have wet yourself. This is only a momentary feeling and will pass quickly. The Radiographer will move the table and camera into different positions so that X-ray pictures can be taken. You will be asked to hold your breath while each X-ray is taken. The sheath will be removed at the end of the procedure (if wrist used).
After the procedure – what to expect
The test will take approximately half an hour after which you will be taken back to the Cardiac Cath Lab Day Ward.
If the wrist was used, you will return to the Day ward with a tight band around your wrist. The nurse will reduce the amount of pressure in the band gradually and it will be removed after 2-3 hours.
If the groin area was used, the sheath will be removed and either a nurse will press firmly for 10 minutes, or a doctor will insert a small plug to seal the artery.
If the nurse removed the sheath and applied pressure, you will need to rest on a bed for 1 hour. It is important that you do not bend your leg during this time to avoid bleeding from the groin site.
If a plug was used in the groin, you will be able to sit up directly after the procedure and be on bed rest for 1/2 hour. You will be provided with a hot drink, sandwich and water. We encourage you to drink plenty of fluids to flush the contrast dye through your kidneys.
Providing there are no complications, you will be allowed to go home later in the day.
Results
A doctor will discuss the results of the angiogram with you and give you the opportunity to ask questions. The doctor will discuss any changes to your medication or further treatment that may be required. The results of the test will be sent to you in a written report with a copy going to your GP.
Going home from hospital
Wound care
The site will be covered with a small dressing which must be removed after 24 hours. You may have a shower after 24 hours and it may be easiest to soak the dressing off in the shower. You do not need to replace the dressing. Do not have a bath or use talcum powder for 48 hours.
Your wound site may feel tender or be bruised. You can take a painkiller such as Paracetamol but do not take Aspirin as a painkiller.
Radial (wrist): If the wound bleeds, elevate arm and apply pressure over wound site for 5-10 minutes and seek help (GP or 999).
Groin: You may develop a small pea sized lump which should flatten within the next 2-4 weeks. Bruising can extend towards the knee, this may take 2-3 weeks to clear.
If the lump feels larger than this, appears to be increasing in size, with the bruising getting harder and painful or spreads to buttocks and/or abdomen, or you notice a discharge you must see your local GP urgently. If out of hours you should contact your Emergency Department.
If the wound begins to bleed, lie down; then you or the responsible adult should press firmly over the wound area for 10 minutes. It is important to contact your GP or the Cardiac Cath Lab Day Ward for further advice or dial 999.
General information
• Aim to drink 2-3 litres of water daily for the 48 hours after the procedure.
• Avoid lifting or strenuous activity for 3 days to ensure artery recovery.
• Avoid alcohol for 24 hours to avoid bleeding complications.
• During the first 48 hours after your angiogram your activities should be restricted.
If the groin was used, avoid bending for 3 days and for the first 48 hours when moving in and out of the car, going up and down stairs or sneezing, coughing or laughing. Apply gentle pressure to the groin area to help support it and prevent pain.
It is important to avoid constipation, particularly in the first week, as straining can increase pressure around the groin area.
We advise you to take the next day off work. The nurse will discuss this with you at your pre-assessment appointment.
Driving
You must not drive for 2 days. Please arrange for a responsible adult to collect you from the day ward, drive you home and stay with you for 24 hours.
Flying
Patients who have undergone uncomplicated coronary angiography may fly 3 days after the procedure unless advised otherwise by the doctor on the day of the procedure.
Benefits of a coronary angiogram
Having a coronary angiogram performed will give your consultant detailed information about your coronary arteries and if there is any reduction in blood flow to your heart caused by narrowing.
Risks of a coronary angiogram
To consent to the angiogram procedure, you should understand that possible adverse effects and risks are involved such as:
- Bleeding or bruising around the area where the catheter was inserted.
- In 1 in 100 cases a patient will have an allergic reaction to the dye. This is usually very mild and temporary, such as a skin rash, headache, nausea. It is quite common to experience visual disturbance after the procedure which tends to last for about 30 minutes and then goes.
- In 1 in 500 cases the catheter may cause damage to the wrist/groin artery which will require surgical repair.
- In 1 in 1000 cases the test will lead to heart attack, stroke or death. The risk may be increased if you are experiencing angina or heart attack at the time of the procedure or if you have diabetes.
- In less than 1 in 1000 cases the test will require emergency Coronary Angioplasty (balloon treatment) or Coronary Artery Bypass Grafting Surgery.
Following an angiogram you may need an angioplasty/stent insertion.
Angioplasty uses a balloon to open a narrow coronary artery. A stent is a small mesh tube introduced into the artery and positioned at the site of a narrowing to improve the blood supply to the heart muscle.
Coronary Artery Bypass Grafting is a surgical procedure where a blood vessel (artery or vein) is removed from one part of the body and repositioned on the heart to bypass a blocked coronary artery.
Alternatives to this surgery / treatment / procedure
Other tests such as ECG, echocardiogram, blood tests or treadmill ECG are available, but these will not show narrowing of the coronary arteries.
Useful websites
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Any questions?
If, after reading this leaflet, you have any further questions regarding this test please call or ask to speak with either:
- Cardiac Pre-assessment Team - 03006 139575
- Cardiac Cath Lab Day Ward - 03006 139572
- Cardiac Admissions - 03006 133344
- Coronary Care Unit (CCU) on 03006 134524
- GP emergency number or go to your nearest Emergency Department
The team/staff involved in your case have written this information sheet to make your admission and care as smooth as possible. However, it does not cover every aspect of your care, and the staff will always be happy to answer any other questions or points of concern.
Contact us
If you have any queries relating to this information, please contact the Cardiology service.
About this information
Service:
Cardiology
Reference:
C/029
Approval date:
9 January 2025
Review date:
9 January 2028
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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.