What preparations should I make before the procedure?
Discuss your current medications with your physician. She may
ask you to discontinue certain medicines, such as anticoagulants,
prior to the coronary angioplasty. If you are taking insulin,
your doctor will most likely recommend that you take a half dose
prior to the procedure.
Shower the night before. Do not eat or drink after midnight.
If you have diabetes, consult your physician about eating. You
may take approved medications with small sips of water.
Leave all valuables and money at home or with a relative. Do
not wear any jewelry to the hospital. You may be allowed to wear
eyeglasses, hearing aids, dentures or dental bridges. This varies
from place to place.
If it is allowed, bring reading material with you. There may
be periods of waiting before the actual procedure commences.
How long does the procedure take?
The procedure takes from one to three hours
Does the procedure hurt?
You may feel a twinge in your chest when the balloon is inflated.
The pain should discontinue when the balloon is deflated. Some
people feel nauseated or have a headache during the procedure.
What happens on the day of the procedure?
Before the coronary angioplasty, a heart doctor (cardiologist),
will examine you and review your medical history and diagnostic
tests. He will explain the procedure and its risks and benefits.
You will have to sign a consent form. Do not hesitate to ask questions
and voice your concerns. Tell the doctor if you are pregnant or
think you may be.
The doctor will ask if you have any allergies, particularly to
certain food, dyes and materials. If you have allergic reactions
to shellfish, and/or iodine-containing x-ray contrast, you may
be given medication to prevent an allergic reaction during the
procedure. He will also want to know if you are allergic to latex
or rubber products such as gloves or balloons.
The doctor will question you about your current medications.
Make sure to tell him if you are taking nitroglycerin medicine.
If you bring your medications with you, the doctor can ascertain
the exact dosages you are taking.
Usually, you will have blood tests, an electrocardiogram, urinalysis,
and a chest x-ray taken prior to the procedure. Sometimes these
tests are performed within a week to ten days before the procedure.
What happens before the procedure?
You may be given a mild sedative to help you relax. You will stay
awake throughout the procedure, and will be asked to perform some
simple tasks such as: taking a deep breath, coughing, turning
your head to one side, or refraining from speaking for a few minutes.
What happens during the procedure?
The procedure will take place in a cardiac catheterization laboratory,
which is usually cold and dimly lit. You will lie on a bed under
an x-ray camera.
Electrodes will be applied to your chest and back to monitor
your heart rhythm at all times. A blood pressure cuff will be
placed on your arm to monitor your blood pressure. You will be
shaved and cleansed with antiseptic solution in your groin where
the catheter will be inserted. These steps are taken to prevent
An intravenous line will be started in your arm to allow for
the administration of medication during the procedure.
A local anesthetic will be injected into the skin to numb the
insertion site. This stings a little bit. Then a small incision
will be made in the skin. The doctors will use a special needle
to puncture the artery into which the catheter will be introduced.
Usually, this procedure is performed from the groin, but it can
also be is done by inserting catheters in the arm or wrist. You
will feel some pressure. If you feel pain, let the doctor know,
so that more numbing medication can be given to you.
An introducing sheath is placed in the artery. A cardiologist
will insert a guiding catheter (a thin tube) into the introducing
sheath, and then he will thread it carefully into the narrowed
coronary artery. Contrast fluid (dye) will be injected through
the catheter into the artery. This creates angiograms (x-ray movies)
which enable the doctor to see inside your artery to confirm the
areas of blockage. The doctor may ask you to hold your breath
briefly during this process. You may feel a warm sensation as
the contrast fluid flows through your blood vessel.
Then a guide wire is inserted through the guiding catheter and
moved through the narrowed area in your artery. The doctor can
watch the movement of the wire on the television screen.
A balloon-tipped catheter will be inserted into the first catheter
and then threaded over the guide wire.. The balloon will be inflated
and deflated a number of times until the plaque is compressed
against the arterial walls. The lumen are thus widened. Then the
balloon is removed. This procedure may be repeated with additional
What happens after the procedure?
The sheath of the guiding catheter may be removed shortly after
the procedure or may be left in place for a few hours or overnight.
Pressure will be applied to the site for 10 to 20 minutes when
it is removed. A small dressing is applied and sometimes a five
pound sandbag will be placed on top of the bandages for 4 to 6
hours. This additional pressure helps prevent bleeding.
You will leave the catheterization laboratory and go to another
room where you will have bed rest. You must lie straight, but
you may raise your head slightly. You should not bend your knee.
You may wiggle your foot and toes to prevent stiffness.
You will remain connected to a heart monitor and an intravenous
line while you rest.
A nurse will check your insertion site and vital signs. If you
are in pain, ask her for medicine to relieve it. You may feel
drowsy. Notify the nurse if you experience a sudden pain at the
insertion site or if you have a warm, sticky or wet feeling around
It's a good idea to drink a lot of fluids. This will hasten the
removal of the contrast fluid from your body.
How long will I stay in the hospital?
Usually there is an overnight stay following this procedure. Arrange
in advance for someone to drive you home from the hospital.
What happens before I'm discharged from the hospital?
Your doctor will discuss the results of the procedure with you
and advise you as to exercise, diet, and care of your insertion
Your doctor may prescribe medications to prevent the formation
of blood clots. He may want you to continue taking medicine for
What should I do when I get home?
Continue to drink fluids. Do not drive, shower, bathe, or smoke
for 24 hours. .Call your doctor if you experience angina, or if
the insertion site is red, bleeding, swollen or draining. Also
notify your physician if you have a fever or if the site is cold.
Are there follow-up visits/procedures?
You will have regular check-ups which may include diagnostic testing.
such as an exercise stress test.
Sometimes the coronary arteries narrow again. This is known as
"restenosis". Sometimes blockages recur. If they do, it usually
happens within the first few months following angioplasty. Your
physician may recommend a repeat coronary angioplasty.