A must known guide for heart patients
It is important for a patient to know about the entire process of angiography, information obtained through it and the small risk involved in it. In most of the cases, echocardiography to know the structure and function of the heart precautions are required.Over and above kidneys and presence of any blood transmitted diseases (HBSAg, HIV, etc.) can be known by patient’s blood tests.
The patient is instructed to get admitted after taking tea and breakfast in the morning. It is necessary for the patient to take all regular medicines related to heart and blood pressure. Medicines for diabetes were discontinued from the previous day.
After admission, shaving of body parts like wrist / thigh is done to facilitate the sterilization which is a must to avoid infection. Saline / glucose is given as a continuous intravenous infusion through an intracath. Investigations like ECG, blood tests, etc. are done if not carried out previously.
All routine activities like using washroom, reading, watching TV, communicating with relatives / friends, working on computer, etc. can be done by patient during the waiting time. Doctors wish that the patient keeps busy in such activities so that he / she may not get worried by continuous thoughts of angiography.
The patient is taken to the cardiac catheterization laboratory where angiography is done. ECG and Spo2 (apparatus showing % oxygen in blood) monitoring cables are attached. Antiseptic medicine is applied at the wrist (if angiography is to be done through radial route) or at the upper part of the thigh (if angiography is to be done through femoral route) and the patient is covered with a linen drape.
After injecting 2 ml of lignocaine (local anaesthesia), a 4-6 inch long plastic sheath in the radial artery through a small hole. A catheter of 1.5 – 1.75 mm diameter is passed through this sheath under fluoroscopic guidance (by looking at the monitor like a TV screen) and is taken up to the heart. Then day (a colourless, thick fluid like castor oil) is injected through the catheter in the right and left coronary arteries of the patient and a picture (movie) is obtained.
The entire process is almost painless and gets completed within 2 -5 minutes with least risk.
The patient is kept under monitoring for some time. If he does not have any problem (which is the case in > 99% of patients), the sheath inserted in his hand or leg is removed. After giving heavy pressure, a very tight bandage / dressing is fastened at that place.
The patient is instructed to take plenty of liquid water so that the dye is washed out through urine. The patient is allowed to take a normal diet and do other activities. All routine medicines are given as per the schedule.
If the Angiography is done through the lower limb/leg, the patient has to lie straight for 6 hours.He has to use bedpan and movement is also restricted. There is a small possibility of bleeding from the operating site of angiography. No such limitations are observed when angiography is done by hand.That is why trans radial angiography (on hand) has been gaining more and more popularity across the globe.
The patient is discharged after 2-6 hours, along with a CD record of angiography and an understanding about further treatment.