Image: The Yorkshire Heart C entre Jubilee Building, Leeds General Infirmary.

Your Coronary Angiogram Explained Information Booklet for Patients and their Families

The Leeds Teaching Hospitals NHS Trust

NHS

YORKSHIRE HEART CENTRE

Please read about Take Heart at rear of this booklet

Registered Charity No. 1002063

The publication of this booklet has been financed by Take Heart

Raising funds exclusively for the Yorkshire Heart Centre at Leeds General Infirmary, St James’s Hospital and its units within the Leeds Teaching Hospitals NHS Trust

Take Heart F Floor, Jubilee Building, The General Infirmary at Leeds, LEEDS, LS1 3EX Telephone: 0113 392 2888 Fax: 0113 392 5222 Email: [email protected] Web: www.takeheart.net

Please read about Take Heart at rear of this booklet

YOUR CORONARY ANGIOGRAM EXPLAINED

This booklet will provide you with information about Coronary Angiography. It will explain what having a coronary angiogram involves and what will happen during your hospital stay. The ward staff and cardiology team would like your short stay to be as pleasant as possible.

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THE HEART AND CORONARY ARTERIES

Left Coronary Artery

Right Coronary Artery

Circumflex Artery Marginal Branch Left Anterior Descending Artery Diagonal Branch

Posterior Descending Artery

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WHAT IS A CORONARY ANGIOGRAM? A coronary angiogram is an x-ray test which obtains detailed pictures of the arteries that supply the heart with blood.

WHY DO THE TEST? The test is done to look for any narrowing of the coronary arteries. It can also provide vital information about the function of the pumping chambers and the valves within the heart. Results of the test will help the doctor decide on your treatment. Treatment MAY include tablets, coronary angioplasty or an operation (coronary artery bypass grafts).

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BEFORE ADMISSION TO HOSPITAL You should arrange for a friend, relative or taxi to bring you into hospital as you will not be able to drive home. If possible you should make arrangements for someone to stay overnight when you go home. Both your groin areas will need to be shaved. Unless you have been told that the test will be carried out through one of the arteries in the arm. You may do this yourself or your nurse will help you when you are in hospital. Please bring with you into hospital any tablets and medicines that you are taking. Take your morning medication as usual unless otherwise instructed. If you take WARFARIN the hospital admission letter will tell you when you need to stop taking these tablets before your test (usually three days before admission). You will be advised when to restart your Warfarin after your procedure.

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If you are a diabetic and take METFORMIN (GLUCOPHAGE), please stop taking this two days before hospital admission. This is to prevent any risk of the tablet reacting with the x-ray dye used during the test. If you are at all concerned about the control of your diabetes, please contact your G.P. You will need a blood test at your G.P. surgery two days after the procedure, the results of which need to be known prior to restarting Metformin.

DAY OF ADMISSION You will be asked to come to Ward 11 at either 8.00 am or 12.00 midday - please note, this is NOT the time of your procedure. Please DO NOT bring valuables into the hospital wherever possible. You will usually be in hospital for approximately 6 - 8 hours. You will be seen by the doctor and the nurse and you should tell them of any allergies or reactions you have, especially to iodine and x-ray dye. A brief medical history will be taken. The test will be explained to you and you will be asked to sign a consent form. You MAY also need a blood test or an E.C.G. You will be asked to change into a gown. If you are especially nervous you can be given medication prior to your angiogram to help you relax. After your angiogram you may need to lay flat. Please tell the nurse if you will find this difficult. 5

THE CARDIOLOGY DEPARTMENT The angiogram will be done in the Cardiac Catheter Suite. You will be escorted to the Cardiac Catheter Suite by a member of the Catheter Suite Staff. You will notice a lot of equipment which will take x-ray and video pictures of your heart and coronary arteries. There will be several people in the room during your test including the doctor, nursing staff, the radiographer who takes the x-ray pictures, and the technician who monitors and measures your heart beat. The team are all skilled people who want your test to be as comfortable as possible.

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A view of the cardiology ‘lab’ where you will have your angiogram.

THE CARDIOLOGY ‘LABS’

THE CORONARY ANGIOGRAM You will be awake throughout your angiogram. The test is usually done through the right groin (the femoral artery), but arteries in the left groin or arm may be used. The skin will be cleaned and a sterile sheet will be put over the lower half of your body. It is important that you do not touch the top surface of the sterile sheet. The doctor will numb the area with a local anaesthetic. After the initial stinging you should only feel a dull pressure. The catheter, which is a thin hollow tube, is inserted into the artery and manipulated into position. The dye, which will show on the x-ray picture is then injected into the heart and arteries. You will feel a hot flush as the dye is pumped around the body by the heart. The doctor will warn you when this is going to happen. The x-ray machine is moved around you in order to get pictures of the heart from different angles and at times it may get very close to your face and body.

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CORONARY ARTERIES Examples of the x-ray pictures taken during the test.

Normal Coronary Artery shown on x-ray picture. (Right hand artery has catheter in place).

Narrowing of a Coronary Artery.

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HOW LONG DOES IT TAKE? About 30-40 minutes.

WILL IT HURT? There are no nerve endings within the arteries or heart, so you should not feel any pain from the catheter. Sometimes a missed heart beat, or palpitation is felt when the catheter is inserted into the heart. This is to be expected. If you do have any discomfort or chest pain during the procedure, please tell the doctor.

AFTER THE ANGIOGRAM Femoral Arterial Puncture (Groin) If the coronary angiogram was performed through the artery in your groin, the catheter will be removed on your return to the ward. A nurse will press on the area for about 10 minutes to make sure there is no bleeding. Alternatively, a pressure device called a Femostop may be used. You must lay flat for 1 hour then at 45 degrees for a further hour. This is to reduce the risk of bleeding. It is very important that you take the nurse’s advice at this time.

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Radial Arterial Puncture (Wrist) If the coronary angiogram was performed through the artery in your wrist, the catheter will be removed whilst you are in the catheter suite. A pressure device called a TR Band will be used to to make sure there is no bleeding. You may sit up straight away. Your nurse will give you advice about resting your arm. You will be taken back to the ward on your bed. Regular checks will be made on your blood pressure, pulse and the puncture site. Your nurse will make you comfortable in bed and give you a drink and something to eat. You should have several drinks after your test to help flush the x-ray dye from your body. The dye is removed from the body through your kidneys within a couple of hours.

ANY WORRIES OR QUESTIONS Please feel free to ask the doctors or nurses any questions at any time.

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YOUR RESULTS It is not always possible to tell you the results straight after the angiogram. The pictures need to be processed and examined by a doctor and this can take several hours. You will be told your results either on the ward or when you return to the Out-Patient Department.

BACK AT HOME You should take things easy for 24 - 48 hours after the procedure. It is quite common to develop bruising around the puncture site. This may take a couple of weeks to go. If there is any bleeding, you should press firmly on to the puncture site for 5-10 minutes. If the bleeding is severe call for an ambulance. If you develop a lump in your groin (anything bigger than a pea) at the puncture site you should contact Ward 11/19 in the first instance.

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For three days following your angiogram you should not lift anything heavy, such as shopping bags or the vacuum cleaner. This may mean taking a couple of days off work, particularly if you have a heavy job. You may resume sexual relations after two or three days if it is comfortable to do so.

DRIVING For your own comfort you should not drive for two or three days after your angiogram.

We hope that this booklet has been helpful. If you do have any further enquiries, please contact: Ward 11 on 0113 392 7111 or Ward 19 on 0113 392 7119 The staff will be pleased to answer any other questions you may have.

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Fund Raising for the Yorkshire Heart Centre at The General Infirmary at Leeds, St. James’s Hospital and its Units within the Leeds Teaching Hospitals NHS Trust Registered Charity No. 1002063

TAKE HEART work to provide the best possible comfort, care and pleasant surroundings for patients who have suffered with a heart related illness, supporting them and their relatives at what can be a very stressful time. It works also to support investigation, provide publications relevant to the centre, donate, where possible, equipment to the latest and highest standard to give total support to aftercare and rehabilitation of patients. It aims to make the working environment of staff as pleasant as possible. The Charity is run entirely by volunteers which ensures that the vast majority of funds raised go directly to the projects for which they were intended. Many of the charity’s trustees have experienced heart related problems and understand the many worries and issues of patients and their families.

We support fully the work of The Yorkshire Heart Centre, one of the finest in the United Kingdom, which draws its patients from the whole of West Yorkshire, Airedale and parts of North Yorkshire. Take Heart invite anyone to become a member. You do not have to be a heart patient. You will receive a regular newsletter and any fund raising or effort is entirely your choice. Donations welcome and acknowledged. To help us make a difference contact: Take Heart, ‘F’ Floor, Jubilee Building, Leeds General Infirmary, Leeds LS1 3EX Tel: 0113 392 2888 Fax: 0113 392 522 E-mail: [email protected] Web site: www.takeheart.org.uk

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Membership Application Membership of Take Heart is open to anyone for a once only fee of £1.50. In return you will receive a regular newsletter and the opportunity to participate in the club’s activities. Title: ...................Surnames(s): .................................................................................................................. First Names:

Member 1: ...................................................................................................................... Member 2: ......................................................................................................................

Address: ...................................................................................................................................................... ....................................................................................................... Postcode: .......................................... Telephone:.................................................................................................................................................. An attractive club badge is available at £1.00. Please indicate the quantity required in the box shown and add the cost to the Membership fee. No of Badges required: I enclose a cheque/postal order for £ .......................... payable to TAKE HEART

Donation Form Donations should be sent to: The Secretary, Take Heart, The Yorkshire Heart Centre, ‘F’ Floor, Jubilee Wing, The General Infirmary at Leeds, Leeds LS1 3EX. I would like to make a donation of £........................... to TAKE HEART Name:.......................................................................................................................................................... Address: ...................................................................................................................................................... ........................................................................................................ Postcode: .......................................... If you are a UK taxpayer, the Charity can benefit further from your donation. If you would like further details, please tick this box:

PLEASE MAKE ALL CHEQUES PAYABLE TO TAKE HEART

Donations are always welcome and will be acknowledged, and published in our newsletter Please send completed Membership/Donation Forms to: The Secretary, Take Heart, The Yorkshire Heart Centre, ‘F’ Floor, Jubilee Wing, The General Infirmary at Leeds, LS1 3EX. Tel: 0113 392 2888. Fax: 0113 392 5222. 1000/07/11

This booklet updated June 2011 by Helen Reed, Sister, Ward 11, The General Infirmary at Leeds

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Registered Charity No. 1002063

We Are Take Heart Take Heart is a small, but professional charity, run on a completely voluntary basis, raising funds exclusively for the Yorkshire Heart Centre at Leeds General Infirmary, St James’s hospital and its units within The Leeds Teaching Hospitals NHS Trust. We were founded in 1989 by a small number of heart patients wishing to return something for the excellent care received. From a small beginning, we have raised over three million pounds and this has been used to provide comfort and enhance the surroundings for the many thousands who visit the centre every year. We have also made significant progress in supporting staff in their work and improve their working environment. Some of the major achievements of the charity are the provision of a suite of relatives rooms available free of charge when required, a roof garden providing a peaceful area for patients and relatives, and an internal garden. We provide free bedside television, free telephone calls and free internet for all patients on the heart wards and we have recently provided changing rooms for an additional MRI scanner. Take Heart have refurbished most waiting areas and made sure that patients enjoy comfort of the highest standard. We also fund information booklets (such as the one you are now reading) which are available in all the Heart Centre wards. Look around and you will see that all the bedside furniture in the heart wards was provided by Take Heart. We also provide equipment to help bring the latest technology into the centre which, in some cases, helps to reduce waiting times. Our latest major projects include two new portable echo machines and an Intracoronary Optical Coherence Tomography Scanner, (catheter-based invasive imaging systems using light rather than ultrasound for detailed examination of stents), costing in excess of £165,000 and complete refurbishment of the Roof Garden and spent some £60,000 on a major refurbishment of Ward L16. Take Heart funds are raised in many ways - through donations - events - sponsorship, and bequests, mainly through its thousands of members and supporters. We would love you to become a member of Take Heart. As a member, you will receive our newsletter about five times a year and if you wish to take part in anything, this is absolutely at your choice. Please note that you will never be bombarded with follow-up mail. You can join by going to our web site www.takeheart.net or picking up a form from any ward reception area. Use your SmartPhone to visit our website > > > > Colin Pullan, MBE Chairman, Take Heart.

For more information contact: Take Heart, ‘F’ Floor, Jubilee Building, Leeds General Infirmary, Leeds LS1 3EX. Tel: 0113 392 2888. Fax: 0113 392 5222 Email: [email protected] Web: www.takeheart.net

Registered Charity No. 1002063

Raising funds exclusively for the Yorkshire Heart Centre at Leeds General Infirmary, St James’s Hospital and its units within the Leeds Teaching Hospitals NHS Trust

© This booklet is copyright. Further information regarding this booklet and its reproduction can be obtained from: Cardiac Rehabilitation Services, ‘F’ Floor, Jubilee Wing, Leeds General Infirmary, Leeds LS1 3EX. Tel: 0113 392 8110 or 0113 392 5639