Undergoing a Coronary Angiogram (Cardiac Catheterization): This booklet has been designed for patients at Ashford and St. Peter's Hospitals NHS Foundation Trust undergoing a coronary angiogram (also known as cardiac catheterisation), and their carers. You may be having the procedure as a day case, or after being admitted to hospital due to angina or a heart attack.
Leaflet Details
| Title | Undergoing a Coronary Angiogram (Cardiac Catheterization) |
| Department | Clinical Measurements |
| Author(s) | C Camargo |
| Review Date | April 2024 |
| Next Review | April 2026 |
| Download | A5 Booklet PDF |
| Accessibility Options | Click on the Recite Me button to show our accessibility resources |
Patient Information
Information for Patients and Carers
This booklet has been designed for patients at Ashford and St. Peter's Hospitals NHS Foundation Trust undergoing a coronary angiogram (also known as cardiac catheterisation), and their carers.
You may be having the procedure as a day case, or after being admitted to hospital due to angina or a heart attack.
It gives important information about the angiogram procedure, about going home and for activity afterwards.
The Cardiac Unit at St. Peter’s Hospital is a privately managed unit.
InHealth Limited works in partnership with the Trust to provide the very highest standards of care and support, ensuring that the patient is always the primary focus of our activity, and by continuous assessment of all aspects of our practice, we ensure our patients are provided with unparalleled levels of care.
Ashford and St. Peter’s Hospitals NHS Foundation Trust employ the doctors and clinical scientific officers that work alongside the staff in the Cardiac Unit.
If after reading this booklet, you have any further questions regarding this procedure please call either:
- Cardiac Nurse Specialist - 01932 872000 and ask for pager number 8334
- The Cardiac Unit - 01932 722262
Why do I need an Angiogram?
An angiogram is performed to find out whether your arteries have become narrowed and whether the flow of blood to the heart is reduced. Narrowing of the arteries may be the cause of symptoms such as pain in the chest called angina.
We also look at the valves and the pumping chamber in the heart.
Assessment and Care
If you are a routine outpatient, you will be given an assessment either by appointment or over the telephone, approximately 2-3 weeks prior to the procedure.
The appointment will be with a cardiac nurse specialist who will describe the procedure, discuss the risks involved and give guidance on preparing for the procedure, including any required changes to your medication, when to stop eating and what to bring with you.
Attendance at this clinic or speaking to the specialist nurse on the telephone is very important for preparing you for the procedure.
Warfarin
If you take Warfarin, you will be given advice for managing your medication before, during and after the procedure.
If you are not sure when to stop your Warfarin, you must contact the Cardiac Unit at least one week prior to your procedure.
You will also need to have a blood test at an anticoagulation clinic, 7-10 days after your angiogram, to ensure your levels have stabilised.
If you have diabetes and use insulin, please contact the Diabetes Nurse one week before your procedure to receive appropriate advice for managing your medication and diet before and during the procedure. The numbers to ring are:
- St Peter's Hospital - 01932 872000 and ask for extension 3315 or the Diabetes Nurse
- Ashford Hospital - 01784 884488 and ask for extension 4997 or the Diabetes Nurse
If you have diabetes and are taking Metformin / Avandamet tablets, you should stop taking the tablets the day before your procedure.
Do not stop taking other diabetic tablets.
Bring your glucose tablets or a snack with you on the day of your procedure.
The evening before your procedure
On the evening before your procedure, please shave your right groin 2-3 inches either side of the crease.
If you are unable to manage the shave please do not worry, a nurse will help you when you arrive on the ward.
On the day of your Angiogram
You must avoid alcohol for 24 hours before and after the angiogram to avoid any complications from bleeding.
If your procedure is in the morning, you must not eat or drink anything after 06.00 hours. If your procedure is in the afternoon, you can have a snack and drink up to 11.00 hours after which you can have sips of water (approximately 10mls).
For both morning and afternoon procedures, you should take your usual medication (including blood pressure or water tablets) at 06.00 hours with a small amount of water.
Please do not take Aspirin, Clopidogrel or Persantin in the morning.
Please bring all your medications with you on the day of the procedure. If you have diabetes, please follow the instructions given to you.
Please bring your dressing gown and slippers with you. Nightclothes are not necessary as you will be given a gown to wear.
Avoid bringing any valuables or cash with you, as these may be left unattended while you are undergoing your procedure.
Please note the Day Surgery Ward is a mixed gender ward.
Benefits of Coronary Angiogram
Having a coronary angiogram performed will provide your consultant with detailed information about your coronary arteries, and whether there is any reduction in blood flow to your heart caused by narrowing.
This will enable the consultant to decide what, if any, further treatment is required.
Where to go
Please arrive at The Cardiac Unit, St Peters Hospital at the time requested on your appointment letter. The Cardiac Unit can be accessed from the Outpatient Departmental block or via the Duchess of Kent wing. It is not in the Department of Cardiology.
Telephone: 01932 722262
The Cardiac Unit Day Ward is a same-sex gender ward, and it is not suitable for visiting children. Due to limited space in the Cardiac Unit, we ask that no relatives or friends remain with you for the day. They may drop you off and collect you.
You must be escorted or be driven home after the procedure, as you must not drive for at least one week. A responsible adult should stay with you overnight.
The Angiogram Procedure
During your admission, you will be asked to put on a gown and paper pants. Your details will be checked, and a name band placed on your wrist.
The procedure is performed in a special X-ray room which looks like a small operating theatre. You will be asked to walk to the Cardiac Unit or, if you are unable to walk, a wheelchair will be provided.
If you wear glasses, please bring these with you to ensure you can read and confirm details on the consent form.
There will be several members of staff in the room during the procedure including a doctor, nurses, a cardiac technician, and a radiographer.
You will lie on your back on a special X-ray table and be asked to put your hands above your head. The radiographer will move the table and camera into position so that the X-ray pictures can be taken.
The procedure will most often be undertaken through the groin artery. In a few cases, due to problems with circulation of blood in the legs, the catheter will be introduced through the artery in the elbow.
The skin around the groin (or in the wrist or elbow) is numbed with a local anaesthetic. Once numb the doctor will insert a small tube, called a sheath, into the artery. A catheter is then inserted through the sheath and guided through the artery until it reaches the heart.
Contrast dye is injected into the coronary arteries in order to outline them on the X-ray. During one of the injections, you may feel a hot flush as the dye is injected and you may feel like you have passed urine. This feeling is only momentary and will pass quickly.
You will be asked to hold your breath while each X-ray is taken. At the end, the catheter will be removed by the doctor.
The procedure will take approximately half an hour. You will then be taken to the recovery room where a nurse will apply pressure to the wound for approximately 10 minutes after the sheath is removed.
If the incision is in the middle of the arm, you will receive 3-4 stitches. If the wrist artery has been used, a pressure dressing will be applied for approximately 2 hours.
A doctor will discuss the results of the angiogram with you and give you the opportunity to ask any questions. The doctor will discuss any changes to your medication or further treatment that may be required. A letter will be sent to your GP confirming this information.
You will then rest for 2-3 hours. For the groin artery for the first hour, you will be nursed flat with one pillow. To avoid bleeding from the groin site, it is important that you do not bend your leg during this time. To detect any restriction in blood flow to the lower limbs caused as a result of the procedure, your foot pulses will be checked.
If the wrist artery is used, you will need to rest for 2 hours. To detect any restriction in blood flow caused as a result of the procedure, the pulse in your wrist will be checked.
You may eat and drink. It is important to drink plenty of fluid as this will help to flush the contrast dye through your kidneys.
Providing there are no complications, you will be allowed to go home approximately 2.5 hours after the procedure.
The groin site will be covered with a plaster that may be removed after 24 hours.
If the test was performed via the elbow artery, the dressing can be removed after 24 hours. You do not need to replace it if the wound looks dry.
You will need to make an appointment at your GP's surgery to have the stitches removed on the 5th day after your procedure. If the test was performed via the wrist artery, the dressing can be removed in 24 hours. Do not replace if the puncture site looks dry.
Going home from hospital
You must not drive for 24 hours after discharge. Please arrange for a responsible adult to drive you home and stay with you for 24 hours.
This will enable the consultant to decide what, if any, further treatment is required.
Risks of Coronary Angiogram
In order to consent for the angiogram procedure, you must understand the possible adverse effects and risks involved. These are:
- Bleeding or bruising around the area where the catheter was inserted.
- In 1 in 100 cases, a patient will have a mild allergic reaction to the dye.
- This is usually very mild and temporary, such as a skin rash, headache, nausea or visual disturbance.
- In 1 in 500 cases, the catheter may cause damage to the groin artery requiring surgical repair.
- In 1 in 1000 cases, the procedure may lead to a heart attack, stroke or death. If you are experiencing angina or heart attack at the time of the procedure, or if you have diabetes, the risk may be increased.
- In 1 in 1000 cases (0.1%), the procedure will require Emergency Coronary Angioplasty (balloon treatment) or Coronary Artery Bypass Graft surgery.
Angioplasty is a procedure undertaken to improve blood supply to the heart muscle using a balloon and, in some cases, a stent which is a small mesh tube introduced into the artery and positioned at the site of the narrowing.
A Coronary Artery Bypass Graft is a surgical procedure where a blood vessel (artery or vein) is removed from one part of the body and placed on the heart to "bypass" a blocked coronary artery. This procedure is not performed at St. Peter's Hospital.
Alternatives to this procedure
Other tests such as ECG, echocardiogram, blood tests, or treadmill ECG are available, but these will not show narrowing of the coronary arteries, which is the main benefit of the Coronary Angiogram Procedure.
Further Information
If, after reading this booklet, you have any further questions regarding the necessity for and / or concerns about going through this procedure, please contact the cardiologist responsible for your care via the appropriate consultant's secretary listed below:
- Dr M Williams / Prof M Mahmoudi / Dr P Dhillon
01932 722069
- Dr I Beeton
01932 722308
- Dr A Jacques / Dr M Gallagher (visiting consultant)
01932 722230
- Dr R Kaba / Dr P Wilkinson
01932 723988
- Dr Y Daryani / Dr O Odemuyiwa (visiting consultants)
01372 735128
Additional information may be obtained by logging on to any of the following websites:
- https://www.britishcardiovascularsociety.org/
- https://www.bhf.org.uk/
- https://www.gov.uk/government/organisations/driver-and-vehicle-licensing-agency
- https://www.nhs.uk/ and https://patient.info/
Patient Feedback
At the end of their procedure all patients will be offered the opportunity to complete a patient satisfaction survey. This information is audited and made available to other patients.
If you think it could be improved in some way, we would also appreciate your comments regarding this information.
Complaints
We do apologise if you are unhappy with any aspect of the service provided within the Cardiac Unit or ward. Should you wish to make a complaint please address your letter to Unit Manager at the following address:
The Cardiac Unit,
St. Peter’s Hospital,
Chertsey, Surrey,
KT16 0PZ
Alternatively, you can request a copy of the InHealth or Ashford and St. Peter’s NHS Foundation Trust, Complaints Policy by contacting any of the staff at the suite.
If you remain unhappy or have concerns about your treatment, please contact Patient Advice and Liaison Service (PALS) on 01932 723553.
Healthcare Commission
If you are unhappy with the handling of your complaint, you can contact the Healthcare Commission, Finsbury Tower, 103-105 Bunhill Row, London EC1Y 8TG.
Telephone 0207 448 9200
Should you be unhappy with the handling of your complaint by the Healthcare Commission, you can contact the Public Service Ombudsman, Millbank Tower, Millbank, London SW10 4QP.
Helpline: 0345 015 4033
