| |
Your specialist has recommended
that you have a medical test called cardiac catheterisation or
angiogram. This leaflet provides some standard information and
advice about the procedure. However, you should always follow
the instructions of your own specialist.
If you have any unanswered questions or concerns, please do not
hesitate to ask your specialist or nurse for more information.
It is natural to feel anxious, but often knowing what to expect
can help. |
| |
| What is cardiac catheterisation?
|
| |
This is an examination of
the heart muscle and the blood vessels (arteries) that supply
blood to the heart using a thin, flexible tube called a catheter
combined with a special dye that shows up on X-ray pictures.
The procedure is usually performed as a day case using a local
anaesthetic, so you will stay awake but should not feel serious
pain.
The procedure helps to find out:
- If your arteries are narrowed or blocked - and
if so, how badly and where
- How well your heart is working
- If valves that control the direction of blood
flow in the heart are faulty
The results will help you and your doctor to decide if you need
further treatment with drugs or surgery.
You will not be able to drive for 24 hours after the test, so
you need to arrange for someone to collect you. |
| |
| Preparing for the procedure
|
| |
Your specialist or hospital
will give you some information about when and how to check into
hospital.
On the day of your admission you should have a bath or shower
at home. It's best not to wear jewellery, make-up or nail varnish.
Avoid eating for around six hours before the procedure. More advice
about fasting will be given by your doctor or hospital.
When you arrive at the hospital, a nurse will explain the care
you will receive. Your specialist may also visit you to explain
the test in detail. This is a good time to ask any outstanding
questions, which you may wish to write down in advance.
Before the procedure, you may need to have a physical examination,
blood and urine tests, and an electrocardiogram (ECG) - which
measures electrical activity in the heart. Your nurse may ask
you to shave your groin area to help reduce the risk of infection.
|
| |
| Consent |
| |
You will be given a consent
form to sign. By doing this, you confirm that you understand what
the procedure involves, including the benefits and risks, and
give your permission for it to go ahead.
Please see the back of this leaflet for further information about
possible side-effects and complications of this procedure. You
need to know about these in order to give your informed consent.
|
| |
| What to expect |
| |
You may be given a mild
sedative to relax you. This will be in the form of a tablet or
an injection through a narrow tube (cannula) placed in a vein
in the back of your hand.
The procedure lasts 20 to 40 minutes and is usually carried out
in a 'catheterisation lab', which looks like an operating theatre.
A nurse will stay with you throughout to provide reassurance and
to ensure you are as comfortable as possible.
In a private room or cubicle, you will be asked to change out
of your clothes and put on a surgical gown. At the lab, you will
lie on a bed and an X-ray machine will be positioned above your
chest. You will be given an injection of local anaesthetic in
your groin or arm. This may sting but will quickly numb the area.
Your specialist will make a small cut (incision) in your groin
or arm and thread the catheter through an artery and towards your
heart. Once it's in the correct position, dye will be injected
into the tube. You may feel a warm flushing sensation or your
heart thumping. This is normal and will quickly pass.
The X-ray machine takes pictures of the dye flowing through your
blood vessels and heart and sends these to a video monitor. Your
doctor will watch this to see if there is any narrowing in the
arteries or pumping problems in the heart. You might be asked
to cough or breathe deeply to help get better pictures.
The catheter is then removed. A nurse will press firmly on your
groin (or arm) for a few minutes to seal the artery. This can
feel uncomfortable. You will have a dressing on the wound but
you are unlikely to need stitches. |
| |
| After the procedure |
| |
You will be taken back to
your room or the day care ward in a wheelchair. You will need
to lie flat on a bed, or reclining on a chair, for a couple of
hours to allow the cut in your groin (or arm) to seal properly.
The catheter used in the procedure is very thin so you are unlikely
to feel any lasting discomfort, although the incision site may
feel sore once the anaesthetic has worn off (about two hours after).
The nursing staff will regularly check your blood pressure, pulse
and the incision. If you feel ready, you can sit up after a couple
of hours, and walk around after about six hours (or more quickly
if the catheter was inserted through your arm). Try to drink plenty
of water as this helps to flush the dye out of your system. |
| |
| Results |
| |
| You will get preliminary
test results at the end of the procedure or shortly after you
have returned to your room. Your doctor will explain what these
results mean and, if necessary, discuss further treatment options.
If you have had a sedative, it may be a good idea to have someone
with you when you are told the results, as you may not remember
later. |
| |
| Going home |
| |
| Before you go home, a nurse
will advise you how to care for your wound. You will also be given
a follow up appointment with your specialist. |
| |
| After you return home |
| |
Once home, it's sensible
to take it easy for the rest of the day. If you've had a groin
incision, it's best not to drive for 24 hours after the procedure
and to avoid vigorous walking or heavy lifting for a few days.
You can expect to have a bruise where the catheter was inserted.
If you suffer any swelling in your groin (or arm), continuous
bleeding, change in the sensation or colour of your legs, or if
you have chest pain, contact your doctor straight away. These
can be signs of damaged blood vessels or clots. |
| |
| What are the risks? |
| |
| This is a commonly performed
and generally safe procedure. For most people, the benefits of
having a clear diagnosis are much greater than any disadvantages.
However, like all invasive medical procedures, there are some
risks. These can be divided into the risk of side effects and
the risk of complications. |
| |
| Side-effects |
| |
| These are the unwanted,
but usually mild and temporary, effects of a successful procedure.
Some people experience some angina pain or a fluttery heartbeat
during and straight after the test because the catheter and dye
irritate the heart. This is not usually serious and will quickly
pass. After the test, your groin (or arm) may feel sore where
the catheter was inserted and the cut may bleed slightly. |
| |
| Complications |
| |
This is when there are problems
during or after the procedure. Most people are not affected.
However, it is possible for blood vessels in the groin to be damaged
causing heavy bleeding. This blood can accumulate internally and
create a painful, solid swelling called a haematoma. This can
resolve itself or may require surgery. It is also possible, but
uncommon, for blood vessels leading to the heart to be punctured
during the procedure. If this happens, you will need urgent surgery
to repair the damage.
Some people have an allergic reaction to the dye, which can cause
an itchy rash that usually disappears quite quickly. Rarely the
reaction can cause shortness of breath and shock - medication
is on hand to treat this.
Occasionally, complications develop after the test is finished.
In rare cases, the tip of the catheter can dislodge a clot of
blood or fatty plaque from the wall of a blood vessel. It is possible
for these to block an artery leading to the heart or brain causing
a heart attack or stroke. Clots can also form near the wound,
blocking blood flow to your arm or leg. If this happens, you may
need surgery to restore circulation.
The chance of complications depends on the exact type of procedure
you are having and factors such as your general health. Ask your
specialist to explain how these risks apply to you. |
| |
| Further information |
| |
The British Heart Foundation
http://www.bhf.org.uk/hearthealth/index.asp
WebMD
http://my.webmd.com/encyclopedia/article/1675.60428
|
| |
Healthwise (Health Information Resource
Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : info@healthwise.org.hk
Homepage : http://www.healthwise.org.hk/
This leaflet is for information only. For a detailed
opinion or personal advice, please consult with your own
doctor |
|
| |
| |
|
|