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Coronary Angioplasty

AMBULATORY CARE:

What you need to know about coronary angioplasty:

Coronary angioplasty is a procedure that opens arteries in your heart that have a buildup of plaque. Plaque is a mixture of fat and cholesterol. This procedure helps to increase blood flow to your heart.

How to prepare for a coronary angioplasty:

  • Your healthcare provider will talk to you about how to prepare for surgery. He or she may tell you not to eat or drink anything after midnight on the day of your surgery. He or she will tell you which medicines to take or not take on the day of your surgery.
  • You may need blood tests and a stress test before your procedure. Talk to your healthcare provider about these or other tests you may need. Contrast liquid will be used during your procedure to help healthcare providers see your heart better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.

What will happen during a coronary angioplasty:

  • You will be given medicine in your IV to help you relax or make you drowsy. You will also get local anesthesia that will numb the area where the catheter (long, thin tube) will be placed. You will be awake during the procedure so that your healthcare providers can give you instructions. You may be asked to cough or hold your breath during the procedure.
  • A catheter is put into an artery in your groin or wrist. The catheter will be guided through this artery to your heart and into the narrowed or blocked artery. Healthcare providers will use x-rays and contrast liquid to find this artery. You may feel warm as the liquid is put into the catheter. A guidewire is then placed into this catheter. Healthcare providers may do any of the following to open your arteries:
    • A balloon catheter is placed into the artery using the guidewire. Healthcare providers inflate the balloon several times for short periods. The inflated balloon pushes the plaque against the artery walls. This opens them and allows more blood flow to your heart.
      Coronary Artery Angioplasty (Balloon)
    • A stent may be placed into your artery. A stent is a tiny mesh tube or coil. Healthcare providers may use another balloon catheter to place a stent in your artery. The stent will be left in your artery to help keep it open.
      Coronary Artery Angioplasty (Stent)
    • A catheter with a laser at the end may be placed into your artery. Healthcare providers may use energy from a laser to break up the plaque in your artery instead of using a balloon catheter.

What will happen after a coronary angioplasty:

Your healthcare provider will apply pressure for about 15 minutes to stop the bleeding. You may need to lie still for several hours if your leg was used for the procedure. Do not get out of bed until your healthcare provider says it is okay. You will need to stay in the hospital for at least the night after the procedure. Your healthcare provider may have you take aspirin or another medicine to prevent a blood clot from forming inside or around your stent.

Risks of a coronary angioplasty:

  • You may develop a hematoma (swelling caused by collection of blood) or bleed more than expected from your catheter site. The contrast liquid used during angioplasty may cause an allergic reaction or kidney problems. You may develop an infection. An artery in your heart may become completely closed or have a spasm. If this happens, your heart will not get enough blood. This may 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. The clot may cause life-threatening problems, such as a heart attack or stroke. Your arteries may become blocked again, and you may need another angioplasty or heart surgery.

Call your local emergency number (911 in the US) for any of the following:

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • You may also have any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat
  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss

Call your doctor if:

  • Your incision is swollen, red, or has pus or foul-smelling fluid coming from it.
  • You cannot stop the bleeding from your catheter site after you hold pressure for 10 minutes.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You have a fever or chills.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Antiplatelets prevent blood clots from forming. You will need to take aspirin and another type of platelet medicine. Take this medicine daily as directed. Tell your cardiologist if you miss a dose.
  • Nitrates , such as nitroglycerin, relax the arteries of your heart so it gets more oxygen. This medicine helps to relieve chest pain.
  • Cholesterol medicine helps decrease the amount of cholesterol in your blood. Cholesterol can cause plaque buildup that blocks your arteries.
  • Blood pressure medicine lowers your blood pressure.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your cardiologist as directed:

Write down your questions so you remember to ask them during your visits.

Activity:

You may feel like resting more after your procedure. Slowly start to do more each day. Take walks around your house. Make a plan for rest during the day. Ask when you can return to your normal daily activities. Do not take a bath or get in a hot tub. Do not swim in a pool or lake.

  • For wrist procedure:
    • Do not lift more than 2 pounds for 1 day after your procedure.
    • Do not jog, golf, play tennis, or do any strenuous activity for 2 days.
    • Do not push or pull for 2 days.
  • For groin procedure:
    • Do not lift more than 10 pounds for 5 to 7 days after your procedure.
    • Do not strain to have a bowel movement.
    • Only walk up and down stairs if needed. Walk up and down stairs slowly.

Wound care:

Do not get your wound wet until your healthcare provider says it is okay. Carefully wash the wound with soap and water. Dry the area and put on a new, clean bandage as directed. Change your bandage when it gets wet or dirty.

Do not smoke:

Nicotine and other chemicals in cigarettes and cigars can cause heart, lung, and blood vessel damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Cardiac rehab:

Your cardiologist may recommend that you attend cardiac rehabilitation (rehab). This is a program run by specialists who will help you safely strengthen your heart and reduce the risk of more heart disease. The plan includes exercise, relaxation, stress management, and heart-healthy nutrition. Healthcare providers will also check to make sure any medicines you are taking are working.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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