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1 FORM # W /15 Coronary Angiogram and Angioplasties/Stents A Guide to Guide relatif à la procédure d angioplastie/ endoprothèse coronaire et à la coronarographie FORMULAIRE No W /15

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3 Table of Contents What is an Angiogram?... 2 Why is an Angiogram done?... 2 Getting ready for an Angiogram... 3 On the day of the Angiogram... 3 Right before the Angiogram... 4 During the Angiogram... 5 Now what?... 5 What is an angioplasty/stent?... 6 Getting ready for an angioplasty/stent... 7 During the angioplasty/stent... 7 After an Angiogram or angioplasty/stent... 8 When you return to your room... 8 What is cardiac rehabilitation?... 9 Directions to Y2 Cardiac Sciences Reception... 9 Patient responsibility checklist Suggested accommodations in the area

4 A Guide to Coronary Angiogram and Angioplasties/ Stents 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 and its arteries. A tube called a catheter is put in an artery (blood vessel) in the groin area or 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? This 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 the heart open and close To measure the pressures in the heart To see how the heart muscle is pumping 2004 Guidant Corporation This test does not change or cure heart problems. Your doctor uses the information to decide how best to treat you. 2

5 Getting Ready for an Angiogram You will have a blood test and an electrical tracing of the heart (EKG) Bring your bottles of pills with you Bring your Manitoba Health Card A nurse will ask you questions about yourself including what pills you are taking, any allergies as well as explain what pills to take prior to the test A nurse will answer your questions about the test If you have diabetes, a nurse will give you direction regarding your medications/insulin Please see the back of this booklet for a: list of items to consider bringing with you to the hospital list of places to stay guide to help you to where you will have the test and where your family will be able to wait for you **You will need to arrange a ride home and have someone stay with you the night of your test - DO NOT drive yourself On the Day of the Angiogram Do not eat or drink anything after midnight unless the nurse has told you it is OK. When you are told to stop eating and drinking you will not be able to eat or drink again until after the test. Take your heart pills with sips of water Do NOT take your water pills 3

6 4 Juste avant la coronarographie Il se peut qu on procède à l examen en passant par l aine ou le poignet. Le personnel rase ou coupe les poils du côté droit de l aine. On insère une aiguille dans un vaisseau sanguin pour vous administrer des liquides ou des médicaments (intraveineux). On vous amène au local où se déroule l examen. Vous y rencontrez le médecin spécialisé dans les maladies du cœur (cardiologue). Le médecin vous explique les risques et avantages de l examen. Tous les examens comportent des risques. Après avoir répondu à vos questions, on vous demande de signer un formulaire de consentement. Heart Cath Lab Vous devrez peut-être attendre si un autre patient doit subir l examen avant vous. You may have to wait if another patient needs to have the test before you Laboratoire de cathétérisme cardiaque After your questions have been answered, you will be asked to sign a consent form The doctor will explain the risks and benefits of the test - all tests have some risks You will meet the heart doctor (Cardiologist) You will be taken to the room where the test is done You will have a needle put into a blood vessel to give any fluids or drugs (intravenous) Your right groin will be shaved or clipped by the staff Your groin/wrist may be used for the test Right before the Angiogram 4

7 During the Angiogram You will be awake but a drug will be given to help you relax A freezing (local anaesthetic) will be used in your groin/wrist area to numb the area. You may feel pressure in your wrist or groin where the needle is inserted - tell the doctor or nurse if you have any 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 and 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 and making life style changes, taking heart pills Heart surgery (may include heart by-pass or valve surgery) and making life style changes and taking heart pills 5

8 What is an 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. If you need a coronary angioplasty/stent, the procedure may be done right away or you may be asked to come back at a later date, the option depends of factors such as your medical status. The results of your test will be sent to your family doctor and/or heart doctor. Make sure you keep all appointments and follow up with your family doctor preferably within days after your test. This is a heart artery with no narrowing Left: Narrowing of a heart artery Right: Heart artery opened up after an angioplasty/stent 6

9 Getting Ready for an Angioplasty/Stent Getting ready is the same as an angiogram. During the Angioplasty/Stent Your groin or wrist will be used for the angioplasty. A tube with a balloon on the tip 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 Guidant Corporation During the procedure, when the balloon is inflated you may feel some pressure or chest pain, this is NORMAL and may last a few minutes. If the pressure or chest pain 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 in the heart artery. The balloon is removed and the stent will stay in the artery permanently Guidant Corporation 7

10 Recovery area After an Angiogram or Angioplasty/Stent Right after: You will be taken to a recovery area The tube in your groin or wrist is removed. Firm pressure is applied over the groin/wrist till the bleeding is stopped A band-aid is placed where the tube was removed When you return to your room You will be on bed rest for a period of time, your nurse will let you know when you can get up Do not bend your hip, leg or wrist on the side of your test A nurse will be in to check you often. Please let the nurse know if you have any pain, swelling, bleeding or discomfort at your groin/wrist site A snack will be given to you Someone will help you the first time you get out of bed 8

11 If you have had an angiogram: - You may go home after you have been up walking If you have had an angioplasty/stent: - You may spend the night in the hospital or you may go home - 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 Remember, you will need a ride home. Do NOT drive yourself On your first night home have someone stay with you What is cardiac rehabilitation? Cardiac rehabilitation programs offer education and support to patients who have heart disease. Depending on the results of your angiogram you may be contacted by staff members from a cardiac rehabilitation program. The staff will tell you about the program and the services that you can use to help improve your heart health. Directions to Y2 Cardiac Sciences Reception at St. Boniface Hospital Enter through the Emergency Entrance or the South Side Doors of the Hospital closest to the Emergency parking lot. Take the first single elevator up to the 2nd floor. When leaving the elevator, follow the signs to the Cardiac Sciences area. It is located down a short hallway and will take you right to the reception desk where you will sign in. If you become lost, please ask someone to direct you to the Y2 area. 9

12 Patient Checklist The following list will help you prepare for your test: Arrange for a ride home from the hospital. You cannot drive yourself home. If you live more than 1½ hours away from Winnipeg, you will need to stay in the city overnight Arrange for someone to stay with you overnight. If no one can stay with you, notify the Heart Cath Lab Slating office at or Toll Free at ] Take your pills as directed by the Nurse in the Cardiac Clinic Bring all your pills in the original bottles given by pharmacy Bring a pair of slippers, housecoat, toiletries and something to read Do not bring any valuables (including money and jewellery). The hospital is not responsible for loss or damage of such items. Remove nail polish and do not apply makeup You may shower and brush your teeth the morning of your test Do not use any scented skin products (talcum, lotion, perfume, cologne, aftershave, etc.) for yourself and your visitors Tell family members and visitors that visiting is limited to one person at the bedside at a time for 10 minutes Cell phones may be turned on, however, for the comfort of our patients, the phone must be on the vibrate setting and be answered out of the unit Bring a phone number(s) of an emergency contact person If you are unable to keep your appointment for any reason, please notify the heart cath lab slating office at (204) or Toll Free at

13 Suggested Places to Stay in the Area: PLEASE CALL FOR ROOMS AND RATES For St. Boniface Hospital Hotels: Radisson Hotel 288 Portage Avenue Sheraton Hotel 161 Donald Street Inn at the Forks 75 Forks Market Road Norwood Hotel 78 Marion Street Canad Inn 1034 Elizabeth Road Travelodge 20 Alpine Avenue Bed and Breakfast: Gite de la Cathederal 581 Langevin Street Gospel Guest House 271 Archibald Street For Health Sciences Centre: Lennox Bell Lodge 60 Pearl Street Comfort Inn 770 Sargent Ave or Canad Inn 720 William Ave or Airport Motor Hotel 1800 Ellice Ave or Holiday Inn 360 Colony St or

14 Questions or Concerns 12