Cardiac catherization(angiogram)/stent

What is a Cardiac Catheterization (angiogram)?

Cardiac Catheterization, also known as cardiac angiogram or heart catheterization, is a common, relatively painless, nonsurgical procedure performed by an interventional cardiologist.

The information provided by this procedure provides details about the heart’s function and circulation. This information helps your doctor make a diagnosis and choose a proper treatment plan. It can be used to:

  1. Assess the presence and severity of coronary artery disease
  2. Assess the pumping function of the heart
  3. Study the structure and function of heart valves
  4. Measure pressures and oxygen content in the chambers of the heart

If a significant blockage is detected in one of the coronary arteries, your cardiologist performs an additional procedure in which a stent is placed in the blockage.

Click on these links for more information about these procedures:

https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/cardiac-catheterization
https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/stent

NOTE: Be sure to tell your doctor or nurse if you are allergic to x-ray dye (contrast) or shellfish, or if you are allergic to Aspirin, Plavix (clopidogrel), Effient (prasugrel), or Brilinta.

Before Your Cardiac Catheterization/Angiogram

Pre-Admission Testing

Prior to your procedure, you will be required to have routine pre-admission testing performed. The hospital will call you to schedule your pre-admission testing, if required.

  • During this appointment, you will be interviewed by a nurse, who will review your medical history and medications.
  • Bring all medication bottles in a zip-lock bag or a detailed list of what your medications including dosage and frequency.
  • Fasting bloodwork, EKG, and CXR may be performed at this appointment.
  • Warfarin (Coumadin)/Xarelto/dabigatran etexilate/Eliquis/Savaysa patients: You should have been given a stop date. If not, please call the office.
  • Diabetic patients: Do not take your diabetes medications or insulin the morning of pretesting. You will be permitted to take your medicine/insulin after the blood work has been drawn.
  • All patients must have blood work within 30 days prior to the test to check your kidney function
  • Depending on the results of your blood work, you may require hydration (intravenous fluids) prior to your test or a possible consult with a nephrologist
  • HCA will contact your insurance for pre-authorization. If a referral is required, we will fax a referral request to your primary care physician with all the necessary information.

LCxThe Night Before

  • Coumadin/Xarelto/dabigatran etexilate/Eliquis/Savaysa patients: You should have been given a stop date. If not, please call the office.
  • Diabetic patients: Do not take your diabetes medications/insulin the morning of your procedure.
  • Drink plenty of water during the day before your test as you need to be well hydrated. If you are on a fluid restriction (ordered by a physician) due to a medical condition, please inform us immediately.
  • No solid food or drink after midnight including gum or candy. You may take your usual medications with a sip of water the morning of the procedure. (Except diabetes medications or insulin, see below).
  • If your arrival time is 12:00 pm or later: You may have clear liquids up to 6 hours prior to your arrival time. Clear liquids include apple juice, chicken broth, popsicles (no red), jello (no red), ginger ale.
  • You CAN NOT drive yourself the day of your procedure.
  • If you develop symptoms of a cold, flu or fever or if you have been exposed to any communicable diseases (chicken pox, shingles, mumps, measles or tuberculosis, COVID) since your preadmission visit, immediately notify us.
  • Be prepared to stay overnight as there is always a possibility you will be admitted following your procedure. If you are discharged the same day, you MUST have someone to stay with you that night.

FOR PATIENTS WITH AN ALLERGY TO IVP DYE, IODINE, OR SHELLFISH ALLERGY (i.e., lobster, crab, mussels, oysters, clams, and shrimp) having their procedure done at:

  • Take Prednisone 50mg 13 hrs prior to your test
  • Prednisone 50mg 7 hrs prior to the test
  • Prednisone 50mg 1 hrr prior to the test
  • In addition, take two Benadryl 25 mg tabs (available over the counter at your pharmacy) the evening before your procedure

After The Procedure

Your treatment depends on the type of heart problems that you have. If you have coronary artery disease here are some of the options:

  1. Medicine to help reduce symptoms of chest pain (angina)
  2. Bypass surgery to detour around the blockages
  3. Angioplasty, atherectomy, and stents: this may be performed immediately following the angiogram, or may be scheduled to be performed at a later date
  • In angioplasty, a special catheter with a small balloon at the tip is passed into a narrow portion of the artery and inflated. This compresses the plaque against the walls of the artery.
  • The angioplasty is often followed by the placement of a “wire coil” or stent. The stent, an implant, will remain in the artery. Within weeks, new tissue will grow and cover the stent.

Click on this link to learn more about stents: https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/stent

Follow-Up Care :

Dressing If the band-aid was not removed in the hospital, you may remove it once you get home, unless otherwise instructed. It is less painful if you remove it while in the shower.
Bathing You may shower the day after the procedure. Gently cleanse the site with soap and water 24 hrs after the procedure. You may not take a bath, swim, or soak in a hot tub or Jacuzzi until after your office follow-up appointment.
Exercise You may resume walking at home. After 24 hours, you may walk the distance at which you are accustomed. If you have not been walking, you may start at a low level. If your procedure was performed via your radial artery (wrist): Do not hyperextend your wrist (radial artery approach) for 7 days
Sexual Activity You may resume after 48 hours, unless advised otherwise.
Household Chores You may resume household chores (dishes/laundry). Wait 5 days before vacuuming. You may not shovel for 5 days.
Lifting Femoral artery approach (leg/groin): Do not lift over 10 pounds for the first 5 days at home. Radial or Brachial Artery approach (wrist/arm): do not lift over 5 pounds with the affected arm for 5 days. You may resume 24hrs after the procedure, unless advised otherwise, regardless of arterial access approach.
Driving You may resume 48 hours after discharge, unless advised otherwise.
Stairs As tolerated
Work Depends on your type of work. Check with your Doctor
Medications Take as directed. Do not stop any medications unless you are instructed by your Cardiologist. Contact the office for specific instructions
Diet Follow a low fat, low cholesterol diet. If you have any other dietary restrictions (i.e. diabetes), follow your doctor’s recommendations
Smoking Smoking is a major risk factor for most diseases. If you smoke, you are strongly encouraged to quit. Talk to your Doctor for assistance.
Notify your Doctor if: Chest pain (angina) returns. Take Nitroglycerin as directed (cardiac angiogram patients). Temperature greater than 101.5. Bleeding at the puncture site. Femoral artery approach (leg/groin): leg is white, numb, cold, very painful, or if a lump appears at the incision site. Radial or Brachial Artery approach (wrist/arm): arm is white, numb, cold, very painful, or if a lump appears at the incision site.
Follow-Up Appointments Schedule and keep your appointment for 7-10 days post procedure. Your Cardiologist will check your puncture site at this appointment.

 

Post catheter Based Intervention (amgioplasty/stent)

 

Dressing If the band-aid was not removed in the hospital, you may remove it once you get home, unless otherwise instructed. It is less painful if you remove it while in the shower.
Bathing You may shower the day after the procedure. Gently cleanse the site with soap and water 24 hrs after the procedure. You may not take a bath, swim, or soak in a hot tub or Jacuzzi until after your office follow-up appointment.
Exercise You may resume walking at home. After 24 hours, you may walk the distance at which you are accustomed. If you have not been walking, you may start at a low level. If your procedure was performed via your radial artery (wrist): Do not hyperextend your wrist (radial artery approach) for 7 days.
Sexual Activity You may resume after 5 days, unless advised otherwise.
Household Chores You may resume household chores (dishes/laundry). Wait 5 days before vacuuming. You may not shovel for 5 days.
Lifting Femoral artery approach (leg/groin): Do not lift over 10 pounds for the first 5 days at home. Radial or Brachial Artery approach (wrist/arm): do not lift over 5 lbs with the affected arm for 5 days.
Driving Femoral artery approach (leg/groin): You may resume 4 days after discharge, unless advised otherwise. Radial or Brachial Artery approach (wrist/arm): You may resume after 72 hrs, unless advised otherwise.
Stairs Femoral artery approach (leg/groin): You may resume after 24 hours, as tolerated. Radial or Brachial Artery approach (wrist/arm): As tolerated.
Work Depends on your type of work. Check with your Doctor
Medications Take as directed. Do not stop any medications unless you are instructed by your Cardiologist. Do not stop your anti-platelet medication (aspirin, Plavix, Effient, Brilinta), unless directed to do so by your cardiologist. Contact the office for specific instructions
Diet Follow a low fat, low cholesterol diet. If you have any other dietary restrictions (i.e. diabetes), follow your doctor’s recommendations
Smoking Smoking is a major risk factor for most diseases. If you smoke, you are strongly encouraged to quit. Talk to your Doctor for assistance.
Notify your Doctor if: Chest pain (angina) returns. Take Nitroglycerin as directed (cardiac angiogram patients). Temperature greater than 101.5. Bleeding at the puncture site. Femoral artery approach (leg/groin): leg is white, numb, cold, very painful, or if a lump appears at the incision site. Radial or Brachial Artery approach (wrist/arm): arm is white, numb, cold, very painful, or if a lump appears at the incision site.
Follow-Up Appointments Schedule and keep your appointment for 7-10 days post procedure. Your Cardiologist will check your puncture site at this appointment.

 

Thank you for allowing Hamilton Cardiology to participate in your care.

Your cardiovascular health is our priority.

If you have any questions, please contact the office