After the Procedure
You will leave the Catheterization Lab on a stretcher, and one of the following will happen:
- After an angiogram: The catheter will be removed and a special clamp or manual pressure will be applied. A sand bag will then be placed over your groin to continue pressure on the puncture site.
- After an angioplasty: You will be transferred to a unit which specializes in catheter (sheath) removal if a groin insertion was used, or back to the sending unit if the wrist was used.
The nurse will frequently check your pulse, blood pressure, pulses in your feet or wrist, and the puncture site.
1. Following a groin insertion:
- If the doctor used your groin (femoral artery), you must remain on bed rest for up to 6 hours after the procedure.
- It is important to keep your head on the pillow and your affected leg straight. You will be reminded frequently to do these two things to avoid bleeding from the puncture site.
- If you experience back discomfort, you can be repositioned with the help of a nurse, keeping your affected leg straight. The head of your bed may be elevated slightly.
- During this time you may sleep, read or rest. You will be given a snack.
2. Following a wrist insertion:
- If the doctor used your arm (radial artery) you will have a clamp applied to your arm in the lab to prevent bleeding.
- You will be on bed rest for approximately 1 hour after the procedure.
- It is important to keep your arm on the pillow and refrain from twisting your wrist. You may move your fingers. Your nurse will be available to assist you while the clamp is in place.
- During this time you may sleep, read or rest. You will be given a snack.
You will be encouraged to drink fluids so the dye will flush out through your kidneys. Ask your nurse for assistance as soon as you need to empty your bladder. It is important not to sit up. The nurse will assist you in getting up once your bed rest is complete. You will be encouraged to walk around during the hour before discharge.
You must have someone pick you up at the hospital and drive you home. Someone should stay with you overnight the day you go home. If this is a problem, tell your cardiologist or inform the Wait List Management Office at 613-696-7061.
Results of Your Procedure
Sometime following the procedure, prior to your discharge, the doctor will review the results and treatment options. In general, there are three treatment options for coronary artery disease: medical therapy, angioplasty, or coronary artery bypass surgery. The most appropriate treatment will be discussed with you by your physician. A copy of the results of the angiogram will be made available to your referring cardiologist and/or your family doctor.
Your doctor will use this picture of a heart to show you what was done during your procedure.
Day of Procedure
Please note any bruising or discoloration at the insertion site. A certain amount of bruising, stiffness or soreness is expected. A small bruise or lump at the procedure site is normal and will likely go away on its own. Some numbness or tingling in the affected limb immediately after the test is normal. Such numbness and tingling should disappear by the time you are ready for discharge.
Prior to discharge please report to the nursing station. You may need:
- A saline lock removed
- A return appointment
- A prescription
Returning to Another Hospital
If you have been transferred from another hospital, the clerks will make return arrangements for you. Transfer times depend upon your recovery period as well as the availability of ambulances. It is not unusual to encounter delays.
YOU MUST NOT DRIVE HOME YOURSELF. You should make arrangements to be driven home by a relative or friend. If such an arrangement is not possible, a taxi may be acceptable if approved by your physician.
Advanced arrangements should be made to have someone with you at home throughout the evening and night after you are discharged from the hospital. If this is not possible, you need to discuss this with your doctor in advance of your procedure.
Daily Activity Guidelines
Discuss individual questions about specific activities with your doctor.
Generally, if you are discharged the same day as your test, once home, you should take it easy and rest. The day following the test, you can gradually begin to resume normal activities.
1. Groin (femoral) insertion:
- Limit the amount of stair climbing as much as possible. Try to climb the stairs only once on the day of your procedure.
- Do not lift anything heavy—greater than 10 lbs (4.5 kg) —for 48 hours.
- Apply pressure to your groin if you have to sneeze or cough hard for 48 hours. The easiest way to apply pressure is to make a fist and place it firmly on the groin area over the band-aid.
2. Wrist (radial) insertion:
- Do not lift anything greater than 10 lbs (4.5 kg) with the affected arm for 48 hours after the procedure. Avoid vigorous wrist movements of the affected arm.
- You may elevate your arm on a pillow to help prevent swelling.
Returning to Work
You must discuss your return to work with your doctor. If you have a job which involves mostly sitting, you may be able to return to work within a few days following discharge. If your work is active, involving much movement, you may be advised to stay off work for a longer period of time.
Before discharge, be sure to talk to your doctor about when you may start driving again. Do not drive or operate any motorized vehicles for two days following your procedure. Additional driving restrictions (from two days to one week) may apply following such procedures. The restrictions may be extended if you have had a heart attack.
Care of Insertion Site
- You may remove the clear dressing or band-aid the day after the procedure, and replace it with a new band-aid.
- A small amount of dried blood on the old dressing and puncture site is normal.
- You may take a shower the day after your test, but do not allow the dressing to stay wet.
- Do not take a tub bath or cleanse the arterial puncture site for 48 hours after your test.
- You may re-apply a dry band-aid for a few more days in order to keep the skin clean and reduce the risk of trauma or infection. The band-aid may be removed 72 hours after the procedure.
- Try to avoid wearing tight or restrictive clothing over the puncture site.
Examine the insertion site each day and notify your physician if any of the following develops:
- An expanding lump or persistent area of redness and warmth
- Yellow drainage from the insertion site
- Increasing numbness in the leg, hand, wrist or arm
- Severe discomfort at the insertion site
Mild discomfort at the insertion site or in the forearm is normal and may be treated with Tylenol or the application of a warm, dry towel.
- You should try to drink more fluid than usual for 48 hours after your procedure. This will help your kidneys flush the dye from your system.
- You may resume your usual diet after discharge.
If there is a small amount of bleeding at the puncture site:
- For a wrist site, sit down immediately and apply firm pressure to your wrist with your fingers for ten minutes.
- For a groin site, lie down and apply pressure to your groin using a fist placed firmly on the groin area over the band-aid.
If the bleeding stops, stay still and keep the affected leg or wrist immobile for two hours.
If recurrent bleeding occurs, notify your physician as soon as possible.
- If you are unsure as to what action you should take phone 613-761-4708, press 0 and ask to speak with the Cardiology Nursing Co-coordinator.
If the bleeding does not stop or if there is a large amount of bleeding:
- CALL 911 IMMEDIATELY. DO NOT DRIVE YOURSELF TO THE HOSPITAL.
- Lie down and hold firm pressure on the site until help arrives.
Medications after Your Angioplasty
If your cardiologist places a stent in your artery, you will need to stay on your medication Plavix®. These stents are very effective in reducing the risk of artery renarrowing. It is very important that you take the two blood thinners, aspirin and Plavix®, as prescribed by your doctor to reduce the risk of blood clots forming on these stents. You must not stop these medications without consulting your cardiologist.
Discuss any medication issues with your doctor prior to discharge.
If you normally take antacids, discuss this with your doctor. Antacids may interfere with some medications.
See the following chart for general information about some common heart medications. For more detailed information about your specific medications, ask your pharmacist.
|Type||Names||Action||Potential Side Effects|
ASA = aspirin
Plavix® = Clopidogrel
enzyme (ACE) inhibitors
Altace® = Ramipril
Vasotec® = Enalapril
Coversyl® = Perindopril
Lopressor® = Metoprolol
Tenormin® = Atenolol
Monocor® = Bisoprolol
Lipitor® = Atorvastatin
Zocor® = Simvastatin
Crestor® = Rosuvastatin
Pravachol® = Pravastatin
Angiotensin II Receptor Blockers
Cozar® = Losartan
Diovan® = Valsartan
Avapro® = Irbesartan
Atacand® = Candesartan
What to do if you experience any chest discomfort (similar to your previous symptoms) which:
- Travels to your shoulder, arm, neck or jaw
- Feels vice-like, constricting, like a crushing weight/pressure or indigestion
- Is accompanied by sweating, shortness of breath, nausea, fear, denial
At the first sign of discomfort » Stop immediately and rest
If no relief with rest » Take first nitroglycerine tablet/spray
If no relief within five minutes » Take second nitroglycerin tablet/spray
If no relief within five minutes » Take third nitroglycerin tablet/spray
If no relief after the 3rd nitroglycerin, call 911 or have someone else drive you to the nearest emergency department.
Before you go, did you discuss the following with your doctor?
- Activity guidelines
- Return to work (if applicable)
Remember you may, at any time (24 hours/day), call the Nursing Coordinator should you have any questions or concerns:
613-696-7000, press 0 and ask for the nursing coordinator