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CORONARY ANGIOGRAM
PATIENT INFORMATION BOOKLET
Surname:
First name:
Address:
Post code:
Telephone:
Hospital number:
Cardiology Department
Sunderland Royal Hospital
Cardiac Centre
Monday to Friday
8 am to 5 pm.
Tel: 0191 5410132
Coronary Care Unit
Anytime
Tel 0191 5699799
IT IS IMPORTANT THAT YOU COMPLETE THE ‘SELF ASSESSMENT’
SECTION AT THE END OF THIS BOOKLET AND BRING IT WITH YOU TO
YOUR PRE ASSESSMENT APPOINTMENT.
Introduction

This document contains information regarding your planned Coronary Angiogram.

The following information will help you understand what a Coronary Angiogram is and answer
some of the questions you may have. It is difficult to provide written information which will
answer every question. Therefore, please do not hesitate to ask if any aspect of your care is not
clear to you.
The staff will be happy to spend time with you.

You may also hear the term Coronary Angiogram being referred to as “coronary angiography”
or “cardiac catheterisation”. Commonly you will hear hospital staff say ‘angio’ or ‘cath’.

You are advised to read the information and instructions in this document carefully. It can be
useful to let your family/carer read it too. You may find it helpful to write a list of questions to
ask the staff when you attend the hospital.

A Coronary Angiogram is usually carried out as a day case procedure.
On the day of your test we will confirm your details and answer any queries you may have prior
to the test being performed. We generally follow the order of the patient list on any given day
but occasionally the order of the list may be altered. We will inform you of any alterations/
delays.

If your Coronary Angiogram suggests you would benefit from further treatment for your heart
condition, we will discuss the options with you. If the treatment you require cannot be delivered
in Sunderland, you may have a choice of hospitals to be referred to. You will be given
information to help you make an informed decision.

We require you to complete the section on self-assessment prior to admission (at the back of
the booklet). This helps us assess your requirements and provide you with appropriate care
and support during and after the procedure.
Date of test
If you are taking Warfarin:
Warfarin should/ should not stop
Date to stop Warfarin:
If you are diabetic and taking Metformin, date to stop Metformin:
Other special instructions-
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What is a Coronary Angiogram?
This is a test performed to assess the structure and function of your heart. It provides information
about the state of the blood vessels (coronary arteries) which supply blood to the heart muscle.
The commonest reason for this test to be performed is to assess the coronary arteries in patients
with `angina`.
Other information which may be gained from the
test is:



The condition of the heart valves.
How well the pumping chambers of the heart
are working.
Blood flow to the lungs.
Usually the test is performed as a day case which means patients are discharged home the same
day. Angiography can also be performed on patients who are already in hospital. Occasionally
patients are admitted for overnight observation, further tests or treatments depending on the results
of the angiogram. If you do not have someone at home on the night following the angiogram you
may need to stay in hospital overnight. Please discuss this with the Coronary Angiography Nurse
at the pre-assessment clinic.
How is a Coronary Angiogram done?
Access into the body’s circulation is
necessary. A small tube (sheath) is placed in
one of the arteries in the groin or wrist. The
doctor/nurse may explain which area of your
body will be used to gain access at pre
assessment.
You will be given a local anaesthetic to numb
the area and this relieves most of the
discomfort. If you still feel some pain please
let the doctor know straight away as more
local anaesthetic can be administered. The
test is meant to be performed with the
minimum of discomfort.
Once the doctor has placed the small tube
(sheath) into your artery a longer tube called a
catheter is threaded into the circulation and
placed next to the coronary artery. Dye
(contrast) is then injected into the coronary
artery to outline its size, shape and length,
and to identify any narrowing inside it.
The injection of dye can also show any
scarring or damage to the muscle of the main
pumping chamber of the heart (left ventricle).
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Who does the test and how long does it take to do?
The angiogram is usually performed by a Consultant Cardiologist or by an appropriately trained
member of medical staff. The test takes approximately 30-40 minutes to complete but in some
patients it may take longer depending upon the information required. The doctor performing the
angiogram will keep you informed of the progress during the test and you should feel free to ask
questions.
What is pre-assessment clinic?

Pre-assessment is a clinic run by nursing staff which allows us to assess your suitability for a
coronary angiogram. You will also be given information about the test so that you can make an
informed decision regarding the need and usefulness of it. Some blood tests will be taken.
There will be time for you to ask questions.

Please bring your medications (or a list) when you attend the pre-assessment clinic.
You will receive a letter detailing where and when you need to go for this clinic.

We will also start the consent procedure at this visit. A member of staff will ask you to sign the
first stage of the consent form allowing us to organise the timing of your angiogram. The
second and final stage of the consent process will be completed on the day of the test, just prior
to it being performed. Usually there is a 2 to 3 week time interval between pre-assessment and
test date.
Pre-assessments normally take place in the Cardiac Centre. For inpatients this process is
carried out on the ward and the time between the pre-assessment and procedure date is
much shorter.
What do I have to do to prepare for the test?

You should not eat after 12 midnight the night before your test although you are allowed to drink
a glass of water with your tablets.

Please shave both right and left groin areas before you attend. If you cannot manage this, don’t
worry but please inform the nurse on your arrival.
Do I take my normal tablets before the test?

You will be given individual instructions about your tablets at pre assessment clinic.

Generally speaking you will be advised to continue to take all your medications as usual before
the test.

If you are diabetic on INSULIN or METFORMIN it is important you read the section below
relating to this

If you are taking WARFARIN it is important you read the section below relating to this.
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I am Diabetic, what should I do?

Do NOT take your diabetic tablet or insulin on the morning of your test (however, remember to
take all other medication as usual).

Bring your diabetic tablets or Insulin with you. You will be given it along with some food after
your test is complete.

If you take METFORMIN (GLUCOPHAGE) do not take it on the day of your test and for 2 days
after.
I am on Warfarin, what should I do?

You may be asked to stop your warfarin. This will vary from patient to patient. Please follow
the individual instructions given to you at pre assessment.

Your blood will be checked on the day of your test and if appropriate you will be advised when
to restart your warfarin.

You will need to inform the staff at the warfarin clinic that your warfarin has been interrupted.
Where do I go for the test?

You will come to the Cardiac Centre to the left of the main hospital entrance, off Kayll Road.
You will be informed of the time to attend when you are seen in the pre-assessment clinic.

In-patients who need to have angiography will be brought to the angiogram suite by ward/
portering staff.
What do I bring with me to the hospital?
When you come to hospital for your coronary angiography you will need to bring:

Your tablets (particularly diabetic medication or Insulin).

Dressing gown and slippers.

You may wish to bring something to read.
Please do not bring valuables (jewellery or large amounts of cash) with you.
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Are there any risks?
All tests carry a risk of complications and side effects. We do everything we can to reduce the risks
but a small amount of risk cannot be completely avoided. Both minor and serious risks are listed
below:
Minor risks

Bleeding/bruising around the access site
5% - (5 people out of 100)
Bruising may extend down the inner thigh to the level of the knee (if your groin area was used
as access) but usually resolves over a 2-3 week period. Bruising may also occur at the wrist (if
the arm has been used for the angiogram). Please let us know immediately if you have any
concerns regarding the extent of the bruising or if the site becomes swollen / painful. Contact
numbers are provided on the day of the angiogram.

Tenderness/discomfort at the access site
Less than 6% (less than 6 people out of 100)
This can last for a few hours or a few days but usually responds to simple pain relief such as
Paracetamol. Please let us know if you experience pain that does not respond to simple
painkillers. We can assess your need for stronger medication.

Swelling at the access site
5% - (5 people out of 100)
Most patients will feel a small `pea` sized lump at the access site which may be slightly tender
for a few days but should not restrict your movement / mobility too much.
AFTER DISCHARGE: If you notice a large swelling or if the swelling is gradually increasing
in size please contact us immediately via the contact numbers provided. You might need to
attend the hospital for examination and treatment.
If for any reason you are unable to contact us and are concerned regarding a possible
complication, go immediately to the Accident and Emergency Department and ask for
advice. If necessary they can contact the Cardiologist on call for advice.

Dye reaction
1 person in every 2000 (0.05%)
Occasionally patients may experience an allergic reaction to the contrast dye which is used.
Quite commonly people will experience temporary visual disturbances and headaches.
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Serious risks

Change in Heart rhythm
Less than 0.5% (1 person in 200)
Introducing tubes into the arteries / pumping chamber of the heart may upset the usual rhythm
of the heart. This is usually a short-lived problem and resolves with the removal / withdrawal of
the tube. If the abnormal rhythm persists, you may require further treatment or need to be
admitted for observation.

Risk of Heart attack
Less than 0.12% (1 person in 800)
There is a very small risk of heart attack during the angiogram test.

Risk of Stroke
Less than 0.1% (1 person in 1250)
There is a very small risk of a stroke occurring during the angiogram which may cause short or
long term weakness/disabilities.

Risk of death
Less than 0.1% (1 person in 2000)
This is an extremely rare occurrence. All equipment and staff needed for managing a cardiac
arrest situation are present in the room where the angiogram is performed.
What happens after the angiogram has been done?
When your angiogram is complete, you will be transferred into the recovery area. If the procedure
has been performed from the wrist, the tube (sheath) is removed in the lab and you will have a tight
strap over the wrist which a member of staff will gradually loosen. If you have had the test
performed from the groin, a member of the team will remove the sheath from your groin and press
firmly over the site to seal the puncture hole in the artery. This usually takes 10-15 minutes to
achieve. Occasionally a small plug will be used to seal the artery at the groin, and if this is the case
the plug will be inserted before you leave the lab.
If the tube has been removed from the groin, you will be asked to rest flat on your back for 30
minutes after which you will be allowed to sit up. Two hours later you will be allowed to get dressed
and walk around. If the tube has been in your wrist, you will normally sit up straight away.
While you are recovering the nursing team will need to check your blood pressure, pulse rate and
foot pulses regularly. You will also be offered some food and refreshments.
.
When will I get the results of my angiogram?
The results of the angiogram and the possible treatments will be discussed with you before you
leave the recovery area.
It is important that you understand what your results mean to you so please let us know if you
do not understand anything you are told.
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What happens if I need further treatment?
If you require treatment such as angioplasty (opening a narrowing in the artery with a balloon and
stent), heart bypass surgery or valve replacement surgery, you may be given a choice of hospitals
where the treatment can be carried out.
Your consultant and the nursing team will provide any additional information you may need to
make an informed decision. If you are able to make this decision on the day, a letter of referral
from your Cardiologist will be sent to the chosen hospital. You may wish to return home to think
about this and inform the hospital when you have decided.
Once you have been referred for either angioplasty or bypass graft surgery you will be seen in the
community by the Cardiology Specialist Nurses who will support you while you are waiting.
When can I go home and what care do I need to take afterwards?
Most patients will be allowed home mid to late afternoon after their angiogram has been completed
and they have been seen by the doctor. There is a discharge advice leaflet on the following page.
How do I get in touch with you if I need to?
The discharge advice leaflet on the following page lists the contact numbers for the team.
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Discharge advice following Coronary Angiogram
Once your angiogram is complete and you are ready for discharge, you will be allowed to return
home, accompanied by a family member or companion.
It is important that you:

Drink plenty of fluids (water, juices etc).

Do NOT drive for 48 HOURS to ensure that all medications are totally out of your system and
that your arterial puncture site has healed.

Have a responsible adult to stay with you for the first 24 hours following your procedure.

Do not perform any strenuous activity for the next 48 hours such as strenuous lifting or
gardening.

Do not take a bath or shower for 24 hours following discharge.

You may eat as normal.
Please observe for:

Bleeding at the insertion site.

Any change in colour or temperature of the leg/arm (a small bruise is not uncommon).

A swelling of the leg / arm.

Signs of infection i.e. discharge from the insertion site, redness or fever.
If you develop any of the above signs please contact the hospital on the numbers provided below.
Cardiac Centre
Monday to Friday
8 am to 5 pm.
Tel: 0191 5410132
or if unable to contact anyone at this number, use:
Coronary Care Unit
Anytime
Tel 0191 5699799
Restart warfarin
Date:
Restart Metformin
Date:
Dose:
Other
If you have chest pain which lasts for more than 15 minutes and is not relieved
with rest or GTN spray, get immediate help - dial 999.
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EMERGENCY CARE DIRECTORATE
DEPARTMENT OF CARDIOLOGY
PATIENT SELF ASSESSMENT FORM
(Please complete this form and bring it to the pre-assessment clinic with you)
Your name:
Address:
Date of
birth:
Tel. No:
/
/
On the day of your procedure you will be asked to arrive at the hospital between 07:30 - 09:30. You
will usually be allowed to leave between 16:00 - 18:00.
Please note:
* You cannot drive or use the bus for 24 hours following you procedure.
* You will need a responsible adult to stay overnight with you on the day of discharge.
How do you intend to travel home after your test?
Name and relationship of person who will care for you overnight after your test.
(N.B. this must be a responsible adult)
Name:
Relationship:
Telephone number you may be contacted at the following day if different from above.
Tel. No:
Please list name, dose and times taken of all current medication.
Name:
Dose:
Frequency:
Allergies:
PTO
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Please write below any questions or concerns you have with regard to your test.
Please state any special needs or request you may have for the day of your test.
Signature:
Date:
/
/
/
/
To be used by Nursing Staff only
Comments:
Above details checked by:
Name:
Signature:
Date:
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