After a Coronary Angiogram or Angioplasty Procedure – Discharge Information for Patients

  • Reference Number: HEY-366/2016
  • Departments: Cardiology

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

Introduction

This leaflet is intended to provide information for you after you have left hospital following an angiogram or angioplasty procedure.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

Care of the wound site

Your procedure will most likely have been performed from either the blood vessel in your wrist or at the top of your leg and it is common to be a bit bruised afterwards. If this is uncomfortable then take painkillers such as paracetamol.

Do not take painkillers that contain aspirin.

The dressing should be kept on for 48 hours after the procedure after which it may be removed and you can take a shower as usual. It is best not to use a bath for a further two days and avoid putting talc or cream directly onto the puncture site.

Avoid heavy lifting for 7 days after the procedure.

A lump may develop around your wound site. If it is the size of a pea then do not worry – this is just the scar. If, however, a large lump develops, which is bigger than a 10 pence coin, or the site starts to bleed you must seek immediate medical advice. If the bleeding is from the groin you should then lie down and apply pressure. If it is from the wrist you should apply pressure and elevate the arm. You should also seek advice if you experience numbness, coldness or pain in the affected leg or arm.

What to do if I get chest pain

It is important to remember that chest pain is not always the heart. However, any symptoms of chest discomfort should be taken seriously and the following steps taken:

  1. Stop what you are doing, sit down, rest, and try to relax.
  2. If you have a Glyceryl Trinitrate (GTN) spray, take 2 puffs under the tongue and wait for 5 minutes. Repeat up to three times if necessary (a total of 6 puffs in 15 minutes).
  3. If, despite this, the pain has not gone, or if you also have palpitations or feel sick, breathless or dizzy, then dial 999 for an ambulance.

Driving

The DVLA make the following recommendations regarding driving:

  • After an angiogram: do not drive for 3 days.
  • After a planned angioplasty: do not drive for 1 week.
  • If you have had a heart attack, a return to driving depends on how well the heart muscle is pumping. If the muscle pump has been weakened from the heart attack, driving should be delayed for 4 weeks. If no major damage has been done to the pump then you may be eligible to drive after 1 week. Your doctor will advise you.

If you hold a group 2 licence (LGV/PCV) then you will need to inform the DVLA of your condition and are not able to drive this type of vehicle for at least 6 weeks. (You may drive a car as per the guidelines listed above). You may need additional tests to fulfil the DVLA requirements for a group 2 licence.

You should discuss your individual circumstances with your doctor/nurse.

Travelling by aircraft

Although it is generally not recommended to take a long haul flight shortly after an angiogram/angioplasty procedure, most people who are otherwise well, should be fine to fly. The UK Civil Aviation Authority advises all passengers to discuss their individual circumstance with their doctor. The general guidance regarding fitness to fly is as follows:

  • After an angiogram or routine angioplasty, you may be able to fly after 2 days.
  • After an uncomplicated heart attack, you may be able to fly after 3 – 10 days.
  • After a more significant or complicated heart attack, delay flying for 4 – 6 weeks.

Please note that it is not recommended to travel outside the UK without medical insurance. You should inform your insurance company of your heart condition and should be aware that many medical insurance companies will not provide insurance within 1 month of an angioplasty procedure.

Working

Return to work will depend on your occupation. In general, you may return to work 3 days after an angiogram, and after 1 week following a straightforward angioplasty. If you have had a heart attack then you will likely need 4-6 weeks off work.

Additional information if you have had an angioplasty

You have had an angioplasty procedure because of an important narrowing within one or more of the arteries of your heart. The procedure was done to improve the blood supply to the heart. It involved stretching the narrowed area with a small balloon and, usually, a small metal scaffold device (stent) is left inside to keep the blood vessel open. After you go home following an angioplasty procedure there is a small risk of problems developing within the treated area so it is important that you read the following information.

Blood clots

In approximately 1 in every 100 patients, the stent may suddenly block off due to a blood clot developing inside it (called a stent thrombosis). To reduce the chance of this happening, it is very important that you take 2 types of tablet to reduce the stickiness of the blood. One of these is Aspirin, which most people remain on for life. The other is called Clopidogrel, Ticagrelor or Prasugrel and is usually needed for between 1 month and 1 year depending on the type of stent you have had – your doctor/nurse will tell you how long.

Sudden blockage of the stent due to a blood clot can cause sudden severe chest pain and can lead to heart attack or death. Most, but not all, of these clots occur within the first 7 days after the angioplasty so it is very important to call for emergency help (dial 999) if you get chest pain after the angioplasty.

Repeat narrowing

After the angioplasty has been performed, the same area may become narrowed again because of scar tissue. This is a process called restenosis, and usually occurs during the first 6 months after the procedure. If a lot of scar tissue develops then symptoms such as angina may come back and further treatment will be needed in around 1 in every 10 patients. For most people this will be with another angioplasty procedure, though a few patients are advised that they should consider undergoing bypass surgery. If you are concerned that you are having symptoms then please see your GP.

It is important that we monitor your recovery after you have had an angioplasty, especially if you have any problems. In the next few months or years, we may contact you by telephone to see how you are getting on. Please keep us informed of any changes to your contact details. If you do not want us to contact you please let the nurse or doctor know before you go home.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the day ward on tel (01482) 461517 or 461518.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.