Coronary Angioplasty

WHAT YOU SHOULD KNOW:

Coronary angioplasty is a procedure to open arteries in your heart that are clogged with plaque. Plaque is a mixture of fat and cholesterol. When your arteries are clogged, your heart may not get enough blood. This could lead to angina (chest pain), heart disease, or a heart attack.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• The dye used during angioplasty may cause an allergic reaction or kidney problems. Fluid could build up in your lungs and cause trouble breathing. An artery in your heart could become completely closed or have a spasm. If this happens, your heart will not get enough blood. This could cause chest pain or a heart attack. You might need heart surgery right away to bypass (go around) the artery.
  
  
• You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Your arteries could become blocked again, and you may need another angioplasty or heart surgery. If you do not have this procedure, plaque may continue to build up in your arteries, and you may have a heart attack.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Urine sample: For this test you need to urinate into a small container. You will be given instructions on how to clean your genital area before you urinate. Do not touch the inside of the cup. Follow instructions on where to place the cup of urine when you are done.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Pulse check: A caregiver may take a blood pressure reading in both arms and both legs. The pulse in your feet and ankles will be measured. A caregiver may put an X over the spots on your legs and feet where the pulse is the strongest.
  
  
• Medicines: You may be given a sedative right before the procedure. This medicine may make you feel sleepy and more relaxed. You may also receive the following types of medicine before or during the procedure:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Blood thinner medicine: This medicine may be given to prevent clots from forming during and after the procedure.
    
    
  • Antihistamines: This medicine may be given to help decrease itching. This medicine may protect you from an allergic reaction to the dye.
    
    
  • Steroids: If you had an allergic reaction to dyes or medicines in the past, you may get steroids. Steroids may help to protect you from a reaction to the dye.
    
    
  • Nitroglycerin: This medicine may be given if you have chest pain or discomfort during the procedure. Nitroglycerin opens the arteries to your heart so the heart gets more oxygen.

During your procedure:

• The hair will be removed from your groin area. Local anesthesia will be put into your groin to keep you from feeling pain when the catheter is put in. You will be awake during the procedure so that your caregivers can give you instructions. Caregivers may ask you to cough, hold your breath, or tell them how you feel during the procedure.
  
  
• A catheter (long, thin tube with an empty balloon on the end) is put into an artery, usually in your groin. The catheter is gently threaded up to your heart and into the blocked artery. Caregivers will use x-rays and dye to find the place where the artery is blocked. You may feel warm as the dye is put into the catheter. Caregivers may do more than one of the following to open your arteries:
  
  
  • Inflate a balloon-tipped catheter: Caregivers inflate a tiny balloon on the tip of the catheter. The inflated balloon pushes the plaque against the artery walls. This opens them up and helps more blood flow to your heart.
    
    
  • Vaporize plaque with a laser light: Caregivers may vaporize (melt away) some of the plaque with a laser light.
    
    
  • Put in a stent: A stent is a tiny mesh tube or coil. Caregivers may put a stent in your artery to keep plaque from building up again.
    
    
  • Shave away plaque: Caregivers may use a catheter with a shaver or tiny drill tip to remove plaque from the arteries. Plaque may be suctioned away after it is shaved or drilled off the sides of the artery.
  
  
• The catheter will be taken out of the artery and a tight pressure bandage will be put on the area. Caregivers will put pressure on the bandage with a sandbag to stop the bleeding. You may have a collagen plug or stitches to stop the bleeding. You will need to lie still and flat for 4 to 6 hours or longer after the procedure to prevent bleeding. Do not get out of bed until your caregiver says it is okay.

After your procedure:

• Monitoring: You will be taken back to your room or to a recovery area. Caregivers will take your vital signs every 15 to 30 minutes for 1 to 2 hours. The pulses in your feet will also be checked often. Caregivers will watch you closely for problems that can happen after this procedure. Tell your caregiver if you have any of the following:
  
  
  • Chest pain or discomfort
    
    
  • Change in color or temperature of your arm or leg
    
    
  • Pain, numbness, or tingling in your arm or leg
    
    
  • Swelling or bleeding from the area where the catheter was
    
    
  • Pain in your back, thigh, or groin
    
    
  • Nausea
    
    
  • Sweating
  
  
• Activity:
  
  
  • Do not raise the head or foot of your bed without asking a caregiver first. Do not remove your pressure bag or bandage.
    
    
  • Tell your caregiver if you get tired of lying on your back. Caregivers may have ways to make you more comfortable.
    
    
  • Call your caregiver before you get up for the first time. If you ever feel weak or dizzy, sit or lie down right away. Then call your caregiver.
    
    
  • You will use a bedpan or urinal during the time that you must lie flat. After your caregiver says it is okay to get out of bed, you may walk to the bathroom.
  
  
• Eating and drinking: You may be on a liquid diet after the procedure. Drink as much water as you can. This will help to flush the dye from your body.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.