CORONARY ANGIOGRAM

CardioVascular Unit Exceptional People. Exceptional Care.

This brochure provides information about coronary angiogram procedures performed at Mater Private Hospital’s CardioVascular Unit. If you require further information, please ask your Cardiologist or one of the nursing staff attending to you. If you are having a coronary angiogram please report to the Mater Private Hospital Admissions area on Level 6. If you are unable to attend hospital on the day of your scheduled admission, please notify the Mater Private Hospital Brisbane Admissions Office on telephone (07) 3840 1255 or the Mater Private Hospital CardioVascular Unit on telephone (07) 3840 6700 at least 48 hours prior to your scheduled admission.

CORONARY ANGIOGRAM A coronary angiogram is performed to show the amount of disease in the blood vessels that supply the heart. It will be performed in hospital in the CardioVascular Unit under a local anaesthetic. You may be given a mild sedative prior to the test.

Plaque

THE PROCEDURE Access to the blood circulation may be from the right leg, right elbow or right wrist artery depending on your Cardiologist. A small amount of a local anaesthetic agent (usually 1% Lignocaine) is injected into the skin. You may briefly experience a freezing or a mild stinging sensation. Generally speaking this is the only discomfort associated with this procedure.

A hollow needle is inserted into the artery and a small tube (6cm to 9cm in length) called a “sheath” is inserted to gain access to the circulatory system. You may feel a bit of pressure while the sheath is being inserted but should not feel any discomfort. The catheters (long tubes approximately 2mm in diameter) are inserted into the artery by means of a flexible guide-wire and to a series of taps that allow ongoing blood pressure monitoring. A separate catheter is used for the right and left coronary arteries. An x-ray dye is injected into the coronary arteries, this solution reveals any blockages or narrowing of those arteries. Images of the arteries are then recorded on a digital x-ray which will be reviewed by your Cardiologist. A third catheter called a “pigtail” may be placed into the main pumping chamber of the heart (the left ventricle). When the contrast is injected into this catheter you may experience a sudden warm sensation which will only last for a few seconds. During the test you will be asked to take deep breaths which you will have to hold for a few seconds with the x-ray pictures are being taken. The x-ray contrast is cleared away by the kidneys. The procedure usually takes about 30 minutes. After the test the attending Nurse will remove the sheath and apply pressure to the puncture site for approximately 10 to 15 minutes. After the risk of bleeding has passed and a seal has formed over the puncture site, a dressing will be applied. This may be done either in

Balloon/stent positioned

the CardioVascular Unit or on the hospital ward. You will be observed for the remainder of your stay. For leg punctures you will need to rest in bed for 2 to 4 hours to reduce the likelihood of groin bleeding. After the procedure your Cardiologist will advise you of the findings. They will also talk to you about any implications on your overall cardiac care before you are discharged from hospital or at a follow-up appointment.

Please Note: The contrast solution used in this procedure contains Iodine. If you have an allergy to Iodine, shellfish, Valium or local anaesthetic you must inform you Cardiologist prior to this procedure. POSSIBLE RISKS AND COMPLICATIONS OF A CORONARY ANGIOGRAM The risks of coronary angiography depends on: • your level of coronary artery disease. • how well your heart is pumping. • how old you are. • how healthy your other organs are. • if you have had a previous bypass operation. Please see listed to the right for some of the more serious risks of coronary angiography. Please note these are not the only risks.

Less than 1 in 10 000 people • Skin injury from radiation, can cause reddening of the skin 1 in 1 000 people • A dangerous reaction to the x-ray dye, which may cause a severe reaction such as asthma, shock and convulsions. Death in extremely rare cases - about 1 in 250 000 to 400 000 injections. • A higher lifetime risk of cancer from x-ray exposure • Blood clot • Death • Heart Attack • Infection • Stroke, which can cause paralysis and long term disability • Need for emergency open heart surgery or balloon angioplasty • Need for major surgery to the leg at the puncture site • Perforation of large blood vessels or heart Less than 1 in 500 people • An abnormal heart rhythm that may require electrical shock treatment or temporary/permanent pacemaker • Deterioration of kidney function 1 in 100 people • Minor reaction to contrast medium such as hives Less than 1 in 100 people • Major bleeding • Pseudo-aneurysm formation – blood clot with connection to the artery lumen • Need for surgery because of blood vessel complications • Surgical repair of the groin puncture site, which may require a longer stay in hospital 1 in 20 people • Allergic skin reaction • Major bruising or swelling at the groin puncture site Most people • Minor bruising

IF YOU NEED CARDIAC SURGERY Mater Private Hospital Brisbane does not provide a cardiac surgical service. If at any time during your stay there is a need for cardiac surgical intervention, you will be stabilised and transferred to another hospital for your procedure. Transfer of patients is uncommon and would be managed with the greatest care on a case by case basis. BEFORE YOUR PROCEDURE Before your procedure you may have several tests including an ECG, blood tests and chest x-ray. You will be asked not to eat or drink for 4 hours before the procedure and we request that you have a thorough shower on the morning of your procedure, paying particular attention to the groin area. MEDICINES Please continue to take any prescribed medicines, including Aspirin and Plavix during your fasting period or as instructed by your doctor. If you are on diabetic medicine or on Warfarin and have not been given any special instructions by your doctor, please contact the CardioVascular Unit on (07) 3840 6700. If you take Frusemide (Lasix/water tablets) do not take them on the morning of your procedure unless directed by your doctor. Please bring all your current medicines, doctors letters and any recent x-rays and blood test results with you to hospital.

If you develop a cold, flu or illness prior to your procedure, please contact the CardioVascular Unit on telephone (07) 3840 6700. If there is any possibility that you may be pregnant, please contact the CardioVascular Unit on telephone (07) 3840 6700. WHAT TO WEAR We recommend that you wear casual, comfortable and loose fitting clothes. Please leave all jewellery (other than your wedding ring), any other valuables and large sums of money at home. AFTER YOUR PROCEDURE You will be encouraged to drink plenty of water after the procedure to flush the contrast dye out of your system. You will be required to remain in bed until your access site, either right leg, right elbow or right wrist artery has been assessed by one of the clinical staff. Once your access site is stable you will be allowed to change and get ready to go home. If you are an inpatient on the ward you will be able to go to the toilet at this point and resume light activity. Most patients admitted as a day procedure will be allowed home accompanied by and adult on the same day, after discussion of the results and treatment recommendations by your Cardiologist. It is helpful to have a family member present during this discussion.

GOING HOME You should arrange for somebody to be available to drive you home from hospital and stay with you overnight on the day of your discharge. If it is not possible for someone to drive you home please phone the Mater CardioVascular Unit on telephone (07) 3840 6700 as soon as possible or discuss with your Cardiologist. You and your carer will receive information on care of your wound prior to discharge. You should avoid strenuous activity for 48 hours and return to your normal healthy cardiac diet. Your Cardiologist will let you know which activities can be resumed and when. It is important for you to follow all of your Cardiologist’s instructions to ensure a safe and speedy recovery. GENERAL INFORMATION If you do not understand or speak English, please advise Mater Private Hospital Brisbane Admissions on telephone (07) 3840 1255 and we will arrange an interpreter to be present for your procedure. Please inform us on the day of your procedure if you require a medical certificate and also bring with you the name of your General Practitioner. On arrival you will be greeted by a Mater staff member and admitted to the hospital. You will be asked a series of questions and requested to sign a consent form. Please ensure that you have understood and are happy

with the information in the consent form before you sign it. A consent form must be signed by yourself and your Cardiologist before the procedure can commence. If you have any questions, you will be able to see your Cardiologist prior to your procedure. Regrettably, there may be some delay before your procedure. This is unavoidable due to the number of patients having similar procedures on a daily basis but we aim to ensure you are seen within a reasonable time of your appointment. FURTHER QUESTIONS If you have any questions or concerns about your coronary angiogram procedure or further treatment, please do not hesitate to contact the staff at the CardioVascular Unit on telephone (07) 3840 6700. To learn more about coronary angiogram and other services at Mater Private Hospital’s CardioVascular Unit, please visit our website – www.mater.org.au

LOCATION AND CONTACT DETAILS

Mater Private CardioVascular Unit Mater Private Hospital Brisbane Level 6, 301 Vulture Street, South Brisbane, Queensland 4101 Telephone: (07) 3840 6700 Bookings: (07) 3840 1146 or (07) 3840 1147 Facsimilie: (07) 3840 6720 www.mater.org.au

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