Angiogram
	Length of Procedure	Hospital Entry	Hospital Stay	Location
	45 Mins	Same day as procedure	Discharge same day	Cardiac Cather Lab Ward 35

What is an Angiogram? An angiogram is a technique where x-rays are used to examine blood vessels. This technique is useful for mapping the layout of blood vessels in any part of the body and is very useful for diagnosing heart problems. Since most fluid tissues such as blood do not show up on x-ray images, a dye is added making the blood visible. Dye is inserted via a small tube (catheter) into the blood vessel. The procedure is performed in the Cardiac Catheter Lab Before the Angiogram Patients on Warfarin are advised to stop it for 5 [five] days prior to the procedure. Patients on metformin are advised not to take it on the day of the procedure. A doctor or nurse will advise the patient on when to restart taking any medication, after the angiogram. Patients are then welcomed onto Ward 16 by a member of staff and shown to a bed. A nurse will then see the patient.. She checks the patient details are correct and if needed, takes some blood . She also records blood pressure and pulse. Patients then are asked to change into a gown for the procedure - this fastens up at the front and there are paper pants to wear underneath.

Image from angiogram. Click to see larger picture.

. Blood vessels of the heart

The Angiogram

The procedure is performed in the Cardiac Catheter Suite. Patients should go to the toilet before they leave the ward. On arrival to the Catheter suite, the patient will be met by a nurse who will stay with them during the procedure. The patient will be asked to lie down on a special table in one of the laboratories - there will be lots of equipment in the rooms, which may cause the patient some concern but they are really nothing to worry about.

During the procedure, the patient remains awake but if required some sedation can be given which will causes drowsiness. Patches are stuck on the patient's chest. These will record heartbeats during the test. The patient will then lie flat and will be asked to keep as still as possible. A blood pressure cuff is also put on the arm and this will inflate every 10 minutes. An oxygen mask will be provided to wear if a sedative had been administered. The skin on the right groin will be cleaned with some iodine - this will feel cold, then covered with towels to keep the area as clean as possible. The doctor will freeze the skin with some local anaesthetic - this can sting. After a few minutes the groin will be numb and the test can be started. The doctor will place a thin tube into the main artery in the groin - this usually is not painful, but some pushing may be experienced. Through this tube a fine catheter is passed, through which a dye is injected. This dye will show up the blood vessels around the heart and its blood supply. Once the procedure is completed the tube will be removed from the groin. It is necessary for one of the nurses to press firmly on this area for about ten minutes to stop any bleeding. The patient will then be taken back to the ward on a trolley and helped into bed.

After the Angiogram

The patient is taken back to the ward on a trolley and transferred into bed. The patient has to lie flat for 2 hours, during this time the nurses will check blood pressure regularly and also look at the catheter site to ensure there is no swelling or bleeding. After 2 hours, if everything is all right, the patient will be able to sit up in bed for a further 1 hour.
After the third hour, the patient will be able to get up and get dressed and start to walk slowly around the ward. The doctor who has carried out your angiogram will see the patient on the ward and discuss the results with them. NB. - The doctors are very busy and we ask that patients please be patient whilst waiting to be seen.
Once the patient has been seen by the doctor, and is up and dressed, they will be allowed to go home with relatives, or whoever is taking them home. Patients need to organise transport to and from the hospital before they come. They will not be allowed to go home on public transport - buses or trains. If transport cannot be arranged for the return trip Ward 16 needs to be informed. Should transport be a problem - then the patient's GP should be able to arrange a hospital car. NB. - This must be done by the G.P. before attendance of Ward 16.
Before the patient is discharged they are given an information sheet, which contains instructions, and useful phone numbers, which patients should use should they have any problems.

At Home

Patients must have someone at home with them on the first night of the angiogram - this can be family or a friend. This is in case any help, in the night, is needed. Patients should rest for 48 hours following the procedure. Anything strenuous i.e. lifting or hovering should not be attempted. Bathing or showering on the evening of you angiogram is not advised - leave it until the following day. Patients may eat as normal. Warfarin takers may re-start them that evening unless the doctor tells says otherwise. Metformin users should not take them for 2 days following the procedure unless told otherwise by the doctor. Driving should not be attempted for 36 hours after your angiogram. Slight bruising around the puncture site may occur, this is acceptable as long as it is not swollen or painful. The puncture site may start to bleed. If this is excessive, pressure needs to be applied to the area and an ambulance should be summoned immediately. This will take the patient to the nearest casualty department where it can be dealt with. The same applies if there is a large swelling or a lot of pain in the puncture site. After 48 hours normal activities can slowly be build back up to your normal level.

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