Coronary Angiography

What is Heart Catheterization and Coronary Angiography?
Heart Catheterization and Coronary Angiography is a special test done to assess the function of the heart muscles, the valves within the heart and the small coronary arteries feeding the heart. During this test, a thin tube called a catheter is inserted into an artery and sometimes a vein, in the groin or arm, and then advanced to the heart. These tests give important information to your cardiologist, so that he/she is able to diagnose and treat your heart disease.

What preparations will I have to do?
You will be booked for your test through the Consulting Clinic Unit Receptionist or Ward Unit Receptionist. At that time, a deposit will be requested to confirm your appointment for your procedure. This deposit is non-refundable. If you are unable to come for your heart catheterization for any reason on the day of your admission, please call the Cardiac Catheterization Laboratory at Telephone: 92-21-4861401 or the Consulting Clinic at Telephone: 92-21-4861011. Before your heart catheterization, several tests must be done including a chest x-ray, electrocardiogram or ECG and fasting blood test. For the blood test, you should not have anything to eat or drink for twelve hours before the blood test is taken, except taking needed pills with sips of water.

SPECIAL INSTRUCTIONS

• Pack a bag for possible over night stay.
• Medication tablets should be taken in the morning as usual with a sip of water.
• Bring all your medications with you to the Hospital.
• Do not bring any valuables or jewellery.
• Special parking facilities are available at Aga Khan University Hospital.
• Arrange a ride home from the Hospital. You should not drive yourself home.

What can I expect?
You will be admitted the day before or the same day as your procedure, provided your tests have been completed ahead of time. Once you have registered at the Admissions Office or the Cardiac Short Stay Unit, you will proceed to your room, where the nurses will complete a short history and checklist to ensure that you are ready for your test.

The procedure will be fully explained to you, (if it was not explained earlier), so if you have any questions, please ask at that time. Before the procedure, you will be given a pill to help you relax and you will be taken in a wheel-chair to the Cardiac Catheterization Laboratory.

In the Catheterization Laboratory, you will be asked to lie on a x-ray table and there will be lots of equipment around you. Your groin will be washed and shaved by the nurse, if this has not already been done in the ward. Towels and sheets will be placed carefully covering your chest and legs. It is very important that you should neither move nor touch the towels once they are laid out. If you have to move, please ask the nurse and she will assist you. The doctor and nurse will be wearing masks and gowns as this is a sterile (as clean as possible) procedure. ECG skin patch electrodes will be attached to your shoulders and thighs so that your heart rate and rhythm can be checked during the procedure.

Is it a painful procedure?
You will feel little or no discomfort during the procedure. The doctor will explain what he is doing as he goes on. The groin area will be numbed with a local anesthetic. The doctor will make a small nick in the skin of the groin, then place a catheter into the artery and advance it to the heart using an x-ray television. When the catheter is in place, dye is injected through the catheter. This will outline the arteries in the heart and will show any blockage or narrowing. Video and movie films are taken of the x-ray picture to record the procedure. Dye will be injected using a special pump. During this injection, you may feel a hot flush across your chest and down your arms.

You may also feel sick in your stomach or you may feel as though you have urinated. This feeling is normal and only lasts for 15 to 20 seconds. The total procedure lasts between 30 to 50 minutes. Once the procedure is complete, you will return to your room on a stretcher. The catheter is then taken out and pressure will be applied at the punctured spot by your doctor or nurse to prevent bleeding. Pressure may be applied by a special clamp or by hand, and is usually kept on for at least 20 minutes or until the bleeding has stopped.

Can I move after the procedure?
You must remain flat on your back for four hours keeping the affected leg straight after pressure or the clamp is removed. If you feel any type of discomfort or a warm wet sensation at the punctured spot, call the nurse immediately. After four hours, you may turn from side to side with the help of the nurse, keeping the affected leg straight. During this time, you may read, rest or sleep. The head of the bed may be raised slightly if you wish. You must stay in bed for six to eight hours after the procedure. A bed-pan or urinal will be provided if needed. The nurse will regularly check your blood pressure and heart rate. Your punctured spot and pulses in your feet will be checked frequently. After the procedure, on returning to your room, you may have tea, juice or water. Your first meal after the procedure will be a light meal (snacks), as it will be difficult to digest food while lying on your back. After six to eight hours, you will be allowed to eat a regular meal.

When will I find the results of the test?
Usually the result of the catheter test will be given to you before you go home. Plans for a follow-up visit at the clinic will be discussed with you if required. A copy of the results can be obtained from the Medical Records Department or the Cardiac Angiography Laboratory at AKUH.

When can I go home?
Six to eight hours after the test, you will be allowed to get up. It is important that you walk. Sometimes bleeding occurs and usually starts shortly after walking. You may be discharged from the Hospital that evening or early on the following morning.

How should I care for the punctured spot?
You may notice a bruise or small lump at the punctured spot. This is normal and may take three to six weeks to completely disappear. No special care is required for the punctured spot. Be sure to arrange a ride home from the Hospital. You should not drive yourself. Do not do any strenuous activity that day or the next. If you should have any extra swelling, bruising or bleeding at the punctured spot, please come to the Emergency Department at Aga Khan University Hospital.

For more information, please contact:
Aga Khan University Hospital , Karachi
P.O Box 3500, Stadium Road, Karachi-74800, Pakistan.
Telephone: 92-21-4861011 and 4864701
Fax: 92-21-4934294, 4932095
Email: cardiology@aku.edu