CARDIAC CATHETERIZATION

What is an angiogram?

An angiogram or cardiac catheterization is a procedure to detect narrowing or blockages in your coronary arteries.
Contrast dye is injected into the heart arteries while X-ray images are taken. The pictures provide a road map of your vessels visualizing blockages, narrowing, or other abnormalities of the arteries. The blockages found severe are opened by placing a stent during same procedure.
The angiogram is performed in the hospital, in cardiac catheterization lab. Most patients are able to go home the same day of procedure; if other conditions are present (kidney failure, severe heart failure ) you may stay overnight for observation .

Before your procedure

• Do not eat or drink 6 hours before your angiogram.
• You may take medications with a sip of water. Continue to take all your regular medications with the following exceptions: Coumadin must be stopped at least 2 days before your procedure.
• If you take Eliquis / Xarelto / Pradaxa stop them 48 hours prior to procedure
• If you are on insulin, take half of the normal dose. If you are taking Metformin (Glucophage or Glucovance), stop it for 24 hours before the procedure and restart 48 hours after procedure
• In addition, if you have an allergy to X-ray dye, please notify your physician as soon as possible.
• Take aspirin on the day of procedure
• The hospital will call you the night before with last minute instructions

During your procedure

• An area of your groin will be shaved and cleaned. If you are a candidate for radial approach, we will perform the angiogram through the wrist artery. This alternative approach has the advantage of eliminating the bed rest necessary with the groin method
• You will be given a mild sedative and pain medication to keep you comfortable throughout the procedure. (twilight sedation )
• The groin will be numbed with Lidocaine and a very small tube called a catheter will be inserted into the vessel.

• A rapid sequence of X-rays is taken while the dye is injected into the vessel. Each time the contrast is injected you may experience a sensation of warmth.

• Most routine procedures take about 30 minutes If the angiogram reveals a narrowed vessel, a stent placement may be performed at the same time.
• When the procedure is completed, the catheter will be removed, and pressure will be held on the entry site in order to stop any bleeding. Closure device may be used for early ambulationAfter your procedure
• Once the angiogram is completed, you will be on bed rest for 4 hours or less if radial approach is used
• You will be allowed to eat and encouraged to drink plenty of fluids to flush the dye from your system.
• During this time, the catheter insertion site will be watched closely and your blood pressure and pulse will be monitored.

Home after Angiogram
• Groin area at the catheter entry site may be sensitive and bruised for a few days.
• A small nodule may be felt in the groin, which is expected and will dissipate within few weeks. Call us if you feel a bulging that is getting bigger or is becoming red and more painful.
Avoid heavy lifting or strenuous exercise for 3 days after procedure, to allow healing of the groin entry site.
Your medications may be changed after angiogram.
If a stent was placed, is mandatory to be compliant with the blood thinners prescribed: Plavix, Brilinta, Effient (in addition to baby aspirin) . Noncompliance with blood thinners may trigger in-stent stenosis with catastrophic consequences such as heart attack or sudden death.
Sexual life after angiogram – If the procedure was done through your groin, wait 5 days, allowing the puncture site to fully heal. Read more about sexual life after a cardiac event