Winnipeg, Manitoba, Canada

 
 



 

Your doctor has told you that you need to have a test called a coronary angiogram. (This test is also called a cardiac catheterization, an angio, or a heart cath). We will use the term angiogram.

What is an Angiogram ?
This test is a special x-ray of the heart. A tube called a catheter is put in an artery (blood vessel) in the groin area or sometimes the upper arm or wrist. Once the end of the tube is in the heart, x-ray dye is used to take pictures of the heart.

Why is an Angiogram done ?

The test is done:

  • To see if the artery(s) in the heart are narrowed (the most common reason for this test to be done).
  • To see how the valves in heart open and close.
  • To measure the pressures in the heart.
  • To see how the heart muscle is pumping.

This test does not change or cure heart problems. Your doctor uses the information to decide how best to treat you.
Getting ready for an Angiogram:
  • You will have a blood test and an electrical tracing of the heart beat (EKG).
  • A nurse will ask you questions about yourself, what pills you are taking and about any allergies.
  • A nurse will answer your questions about the test.
  • If you take Warfarin (Coumadin) tell the nurse.
On the day of the Angiogram:
  • Do not eat or drink after midnight, until after the test.
  • Take your heart pills with sips of water.
  • Do NOT take your water pills.
  • Do NOT take your pills for diabetes or any insulin.

If you are coming from home:

  • Bring your bottles of pills with you.
  • Bring your Manitoba Health Card.
  • You will need a ride home, DO NOT drive yourself.
Right before the Angiogram:
  • Your groin will be shaved.
  • You will have a needle put into a blood vessel to give any fluids or drugs (intravenous).
  • You will be taken to the room where the test is done.
  • You will meet the heart doctor (Cardiologist).
  • The doctor will explain the risks and benefits of the test. All tests have some risks involved. The risks are normally low with an angiogram.
  • After your questions have been answered, you will be asked to sign a consent form.
  • You may have to wait if another patient needs to have the test before you
During the Angiogram:
  • You will be awake but a drug can be given to help you relax.
  • A local anesthetic is used to freeze the groin area.
  • You should generally not feel any pain. You may be pressure in the groin where the needle goes in. Tell the doctor or nurse if you have any other discomfort.
  • At one point you may feel a warm feeling. This is normal and will last a few seconds.
Now what ?

The doctor will look at the pictures of your heart. The doctor will discuss the results with you. The results of your angiogram may show several things:

  • Your heart is working normally.
  • Your heart is not working normally. This may include:
    • The artery(s) in your heart are narrowed
    • The valve(s) in your heart are not opening and/or closing properly
    • The heart muscle is not pumping properly

Here are the options to treat these heart problems:

  • Taking heart pills and making lifestyle changes
  • Coronary angioplasty / stent
  • Heart surgery (may include heart by-pass or valve surgery)

This is an artery with no narrowing

If you need a coronary angioplasty / stent, the procedure may de done right away or you may be asked to come back at a later date. The results of your test will be sent to your family doctor and/or heart doctor. Make sure you keep all appointments.
 
Narrowing of
 a heart artery.
Heart artery opened up
after an angioplasty / stent.
    
What is a Coronary Angioplasty / Stent ?
It is a way to open up a blocked or narrowed artery in your heart. This may help to improve your heart symptoms such as chest pain. We will use the term angioplasty / stent.
Getting ready for an Angioplasty / Stent:
Getting ready is the same as for an angiogram.
During the Angioplasty / Stent:
  • The tube or catheter is put in the same place (groin) as the site of your angiogram.
  • There is a deflated balloon on the tip of the tube.
  • The balloon is placed in the narrowed part of the artery(s) in your heart.
  • When the balloon inflates, it opens up the narrowed artery. This will increase the blood flow to your heart.

  • When the balloon is inflated, you may feel some pressure or chest pain. This is NORMAL and may last a few minutes. If it lasts longer, make sure you let the nurse or doctor know.
  • A stent is a small, spring-like device that helps keep the artery open. The stent is placed over the balloon that is used for your angioplasty. When the balloon is inflated, the stent expands and is placed i nthe heart artery. The balloon is removed and the stent will stay in the artery.
After an Angiogram or Angioplasty / Stent:

Right after:

  • You will be taken to a recovery area.
  • The tube is removed from your groin. Firm pressure is applied for about 20 to 25 minutes.
  • A band-aid is placed where the tube was removed.


Recovery Area

When you return to your room:

  • You are to stay in bed with your leg straight for 3 hours after an angiogram and for 5 hours after an angioplasty / stent.
  • If there is no bleeding after one hour, you can roll onto your side. Do not bend your leg at the hip or knee. Your head can be up on a pillow.
  • A nurse will be in to check you often.
  • A snack will be given to you. You should drink lots of fluids.
  • After being on bed rest, someone will help you walk.
  • Outpatients may go home after an angiogram if they have been up for at least one hour.
  • If you have had an angioplasty / stent:
    • You will spend the night in the hospital
    • You will be given a prescription for pills. The pills help prevent the artery from closing.
    • You will be given a stent card. Carry the card in your wallet. Make sure you show the card if you go to a hospital
When you go home:
  • Remember, you will need a ride home. Do NOT drive yourself.
  • Do not stay alone the night after the test.
  • You may bathe or shower the next day. Do not rub the spot where the tube was removed. Take the band-aid off after 24 hours.
  • You can do normal activities in 5 days. Your doctor will tell you if you should not.
  • Do not strain or lift heavy objects (greater than 5 pounds) for at least 5 days.
  • They may be a small lump in your groin.
  • Bruising near the groin site may happen right away or within 1 - 2 days of the test.
 
 
Bleeding:

The site should not bleed. If it does, you should:

  • Lie down and have someone press on the site, using a clean gauze, with his or her fingers for five minutes.
  • If it does not stop bleeding, have someone drive you to the nearest Emergency Department. Keep pressure on the site.
  • When the bleeding stops, take the old band-aid off and put a clean one on.
  • See a doctor within 24 hours for any bleeding.
Do not ignore:

If you have your heart symptoms:

  • Stop what you are doing.
  • Take your Nitro. If the heart symptoms do not go away within 5 minutes, take another Nitro. Take your Nitro every five minutes until you have had a total of 3 pills / sprays.
  • If you still have heart symptoms after 3 Nitros, you need to get medical help right away. Call 911 or your local emergency number for an ambulance. DO NOT DRIVE YOURSELF.

Call a doctor or go to the nearest Emergency Department if you have:

  • Any increase in the amount of bruising or new bruising with pain, or if the lump in the groin gets bigger.
  • Any signs of infection such as pain, swelling, drainage, redness, chills or fever.
  • A cold, numb or blue foot on the same side as the test.

Medication, angioplasty / stent and heart surgery are not cures for your heart disease. What can you do to reduce your risk of any further heart problems?

  • Quit smoking
  • Control diabetes
  • Reduce your cholesterol
  • Reduce your blood pressure
  • Exercise regularly
  • Lose weight
  • Reduce your stress
 
Cardiac Rehabilitation programs are the BEST way to help you deal with your risk factors and reduce further heart disease. There are a number of options:  
  The Wellness Institute at Seven Oaks General Hospital Phone: 1-204-632-3907  
Kinsmen Reh-Fit Centre Phone: 1-204-488-8023
Heart to Heart™ Programs (Heart and Stroke Foundation of Manitoba) Phone: 1-888-473-4636
or 1-204-949-2000
Brandon Heart Rehab Program Phone 1-204-578-4204
 
If you have any questions or concerns, ask your doctor or nurse to answer them.
 
We wish to thank all WRHA staff who contributed to the development of this information, as well as representatives from Brandon Regional Health Authority, Heart and Stroke Foundation of Manitoba, the Wellness Institute at Seven Oaks General Hospital and the Kinsmen Reh-Fit Centre.
Some images have been used with permission from Guidant Canada.
 

 


© 2012 WRHA Cardiac Sciences Program, Winnipeg, Manitoba, Canada

  

 

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