Angioplasty Information

8/19/2019 Angioplasty Information

1/16

Percutaneous Coronary intervention(Coronary angioplasty/ stenting)

Cardiac Procedures Unit

What every patient needs to know


2/16

This guide has been prepared by William Osler Health System to help you

understand heart disease, angioplasty and how you can improve your heart

health.

Acknowledgements

Hamilton Health Sciences

Trillium Health Centre

Disclaimer

This guide does not replace professional health care advice, medical diagnoses

or treatment. It will help you understand your cardiac procedure. If you have

any questions or concerns, ask a health care professional. William Osler

Health System does not guarantee the quality accuracy, completeness,

timeliness, appropriateness, usefulness or suitability of the information in thisguide.

William Osler Health System

1


3/16

TABLE OF CONTENTS

Part I – Angina and Heart Attacks 3

What is coronary artery disease? 3

Progress of coronary artery disease 3

What is angina? 4

How do you know if you have angina? 4

How do you test for angina? 5

How do you treat angina? 5 What is a heart attack? 6

What are the signs of a heart attack? 6

Part II - Coronary Angioplasty 7

What is an angiogram? 7

What is angioplasty? 7 What is a stent? 7

Preparing for your angioplasty 8

What happens during your angioplasty? 8

How is an angioplasty done? 9

What happens after the angioplasty? 10

Going home after your angioplasty 10

What to watch for after your angioplasty 11

PART III – Cardiac Rehabilitation Program 12

William Osler Heart Smart Cardiac Rehabilitation Program 12

Quit smoking 12

Learn more about Healthy Heart Habits 13

PART IV – Frequently Asked Questions about Angioplasty 13

www.williamoslerhs.ca

2


4/16

PART I – ANGINA AND HEART ATTACKS

What is coronary artery disease?

Coronary artery disease is a build up of fat and other materials including

cholesterol and calcium inside

the arteries called atherosclerosis.

The artery walls become thick,

narrowing the blood flow. Blood

carrying oxygen to the heartcannot flow through these

arteries well.

Normal artery - The blood flows througheasily

Damaged artery - Plaque starts to build

up and narrow the artery.

Narrowed artery - Blood flow becomes

partially blocked because of the build up

of plaque. This decreases the amount of

oxygen your heart gets during activity.


3

Aorta

Right coronaryartery

Left maincoronary artery

Circumflexartery

Left anteriordescending artery

Your Heart

Artery

Smooth blood flow

Plaque build up

Progress of coronary artery disease


5/16

Blocked Artery

Over time, the flow of blood becomes

sluggish and causes blood clots which

block the artery. A heart attack happens

when oxygen cannot reach your heart

due to a blocked artery.

What is angina?

Angina is chest pain. It occurs when your heart does not get enough blood oroxygen. Your arteries may be plugged with plaque, cholesterol or fatty build

up. When this happens less blood flows to your heart. Angina is a warning

sign that your heart is under stress and needs help.

How do you know if you have angina?

You may have any of these signs Pain in your chest which moves to your neck, jaw, back, shoulders and

arms

Chest pressure tightness or heaviness

Squeezing or burning in your chest

Sharp pain or cramping in your chest/back

Numbness in your arms Nausea or vomiting

Trouble breathing or shortness of breath

Women may have less typical symptoms

*Please note that these signs and symptoms may vary from person to

person


4

ClotNo blood flow


6/16

How do you test for angina?

Your doctor may send you for these tests

ECG: helps to find problems with heart rhythm

Stress Test: exercise or medication will stress your heart. Your ECG, heart

rate and blood pressure will be monitored for changes

Chest X-ray: shows your lungs, heart and larger blood vessels

Nuclear Scanning: shows areas of heart that are unhealthy

Echocardiogram: creates sound waves to create a picture of your heart. It

tells us how well your heart pumps and can also check your heart valves

Cardiac Catheterization: checks for blockage in the arteries and also

measures how the heart and valves work

Blood Work: checks for elevated cholesterol levels and diabetes

How do you treat angina?

Based on test results your doctor may1. Treat you with medication

Nitroglycerin: relaxes and widens your blood vessels allowing more blood

to flow to your heart.

Beta Blockers: reduce blood pressure, slow your heart rate and reduce the

workload of the heart.

Calcium Channel Blockers: lower blood pressure and relax the blood

vessels. Also may slow your heart rate.

Ace Inhibitors: help relax blood vessels, lower blood pressure and

strengthen heart muscle.

Antiplatelets: medication to stop platelets from clumping together. They

reduce the risk of heart attack and stroke by preventing clots from

forming.

Diuretics: remove excess fluid from your body and decrease blood

pressure.

Statins: lower blood cholesterol which may over time decrease the

blockage in your arteries. It may also stabilize existing cholesterol plaques.


5


7/16

2. Recommend lifestyle changes: These will reduce your risk factors for heart

disease and control chest pain. Your heart health depends on the lifestyle

changes you make.

Risk factors you cannot change

Your age and gender

Your family history

Your race

Past disease problems

Risk factors you can change

Stop smoking

Lower your blood pressure

Watch your cholesterol levels

Control your weight

Manage your diabetes

Begin exercising

Limit your stress

3. Treat you with angioplasty or heart bypass surgery.

What is a heart attack?

A heart attack occurs where your blood doesn’t get to an area of your heart.

When this happens, you will have chest plain. If the blood flow is not re-

started in time, the heart can be damaged forever.

What are the signs of a heart attack?

Chest pain:

That does not go away with rest

Reaches your neck, jaw, back and arms

Feels like pressure, burning, squeezing, heaviness or tightness

Trouble breathing

Nausea or vomiting

Sweating, or feeling cool and clammy

Feeling anxious


6


8/16

PART II - CORONARY ANGIOPLASTY

What is an angiogram?

An angiogram is a test that takes X-Ray pictures of the coronary arteries and

the vessels that supply blood to the heart. The test gives doctors valuable

information about the condition of the coronary arteries and helps them to

decide your treatment options. During an angiogram, a special dye is released

into the coronary arteries from a catheter inserted in a blood vessel. This dye

makes the blood vessels visible when an X-ray is taken of them. What is angioplasty?

An angioplasty is a procedure to open up blocked arteries found during your

angiogram.

During an angioplasty, a catheter with a

special balloon goes into the blocked artery.The balloon is inflated (blown up). This

pushes the material known as “plaque”

against the walls of the artery and expands

the artery. Another balloon, covered with a

wire mesh (called a stent), is then put into

the artery. The stent expands and locks into

place. This holds the artery open.


7

What is a stent?

A stent is a small wire mesh tube that

looks like a spring. A stent

Stays permanently in the artery

Improves the blood flow through

the arteries and to the heart muscle

Your cardiologist will decide which

stent will work best for you.


9/16


Preparing for your angioplasty

Read your procedure booklet. The

instructions for the appointment

are on the envelope of Osler’s

“Cardiac Procedure Package”

Get your ECG (electrocardiogram)

or any blood tests your doctor

ordered done before the

angioplasty. If you have had reaction to x-

ray dye, tell your doctor prior

to this test

You will need someone to stay with

you for 24 hours after your

angioplasty . If you cannot find

someone to stay with you, tell your

doctor. Your angioplasty can be rescheduled

What happens during your angioplasty?

Prior to going to the Cardiac Catheterization Lab

A nurse will start an intravenous in your arm.

An intravenous is a needle attached to a tubethat brings fluids into your body.

A nurse will clip the hair at the insertion site. This could be your arm or groin.

The cardiologist doing the angioplasty will explain what is about to

happen and tell you about the risks and benefits.

You will need to sign a consent form. This is the form that lets the doctor

do this procedure. Make sure you understand the information before you

sign the form.

The nurse will give you a medication to relax, but you will be awake

during the procedure so that you can follow instructions.

8

Radialartery

Possible Cardiac Catheter Access Sites

Brachialartery

Femoralartery

access site


10/16

How is an angioplasty done?

A nurse will wash your groin or arm with antiseptic solution and cover the

area with sterile sheets. The doctor will freeze your groin or arm. A small

tube, known as a sheath, will be inserted into your coronary artery. A small

catheter with a tiny deflated balloon at its tip is inserted through the sheath.

It is advanced into the narrowed part of an artery.

The balloon is then inflated. This balloon presses the plaque against the

artery walls so that blood will flow more easily through the centre of the

artery.

Blood thinners are given during the procedure to prevent blood clots from

forming. The balloon is then deflated and removed.

If you have pain or discomfort in your chest or have trouble breathing, tell

your doctor or nurse. In most cases balloon angioplasty is followed by theplacement of a stent.


9

Deflated balloon

catheter

Inflated ballooncatheter

Compressed

plaque

Smooth bloodflow


11/16

What happens after the angioplasty?

You will need to remain in bed for two to eight hours after your procedure,

depending on the access site used (arm or groin).

If the tube is in your groin, it will remain for two to four hours. After that time,

the nurse will remove the tube, applying pressure to the site for about 20 minutes.

The cardiologist will decide how long you will be in the hospital.

Discharge:1. If you go home on the day you have your angioplasty, you need to have

someone take you home and stay with you for 24 hours.

2. If you are an inpatient from another hospital, you will go back there.

3. If you go home the next day you will be discharged at 6 a.m. A family

member needs to come to the unit to pick you up.

Going home after your angioplasty

During your angioplasty, the doctor places a tube in your artery. This area can

start bleeding after you leave the hospital. If this happens, you need someone

with you who can

Call “911”

Help stop the bleeding by putting pressure on the area

Do not stop taking your antiplatelet medication unless your Cardiologist

tells you to stop. If you stop this medication before your doctor tells you to

do so, it can result in the formation of clots in your stent.

You should not drive for 48 hours after your angioplasty.

Take showers instead of baths for one week after your angioplasty.

Do not go swimming or get into a hot tub for one week after your

angioplasty.

You can restart sexual activities two days after your angioplasty.


10


12/16

What to watch for after your angioplasty


11

Watch for: How to get help:

Sudden bleeding that soaks through

your clothes

Sudden swelling at the puncture site

Changes in your speech or eye sight

Call 911

If you are bleeding have someone

apply firm pressure over the

puncture site.

Bad pain at your puncture site

Weakness or numbness or coolness

in your arm of leg

Too much pain in your arm or leg

Call your nearest doctor or go to the

nearest Emergency Department.

Redness, warmth or other signs of

infection at your puncture site

See your family doctor.

Chest pain Follow the usual steps you take when

you have angina

Take one nitroglycerin every five

minutes If the pain does not go away

after three doses of nitroglycerin,

call 911 or go to the nearest

Emergency Department

Skin rash Call your doctor. Your rash might becaused by your medication or a dye

reaction.


13/16

PART III – CARDIAC REHABILITATION PROGRAM

Now that you’ve had your angioplasty procedure, you’ll begin a program of

cardiac rehabilitation. This program will help you modify or change some ofthe risk factors that led to your coronary artery disease.

At this program you will be guided to:

Quit smoking

Control your diabetes

Control your blood pressure

Choose healthy foods low in fat and cholesterol Maintain a healthy body weight

Exercise

Avoid excessive alcohol consumption

All these life style modifications will prevent your coronary arteries from

getting blocked

William Osler Heart Smart Cardiac Rehabilitation Program

Individualized counselling, group exercise and education to get your heart in

shape and put your mind at ease, twice a week for six months at our state-of-

the-art rehab facility at Brampton Civic Hospital. The Cardiac Rehabilitation

phone number is (905) 494-6479.

Take charge and manage your own heart health

Build your self-confidence as you get heart smart Improve your physical strength, endurance and energy levels

Improve your blood pressure and cholesterol levels

Adopt healthy eating habits

Reduce your stress levels

Lose weight if needed

Quit smoking

Register for Osler’s Kick it! Quit Smoking Program.

Download useful Quit Smoking information and kits from the Canadian

Cancer Society, www.cancer.ca


12

http://www.cancer.ca/http://www.cancer.ca/


14/16

Learn more about Healthy Heart Habits

Visit the Heart and Stroke Foundation web site at www.heartandstroke.ca.

PART IV – FREQUENTLY ASKED QUESTIONS ABOUT

ANGIOPLASTY

1. Can I wear jewellery during the procedure?

You should not bring or wear rings, earrings, a watch or other items that

could get lost. Please leave your valuables at home.

2. Can I eat after the angioplasty procedure?

Yes. The nurse will give you a snack after the procedure. You may choose

to bring your own snack.

3. Can I have a visitor immediately following the angioplasty procedure?

You can have one visitor while you are resting after the procedure. Please

talk to the nurse before your procedure about where you will be restingafter the procedure so you can inform your visitor. Please note that

visitors are not allowed to stay in the recovery area.

4. How long will I be in the hospital after the angioplasty?

Your doctor will decide if you can go home the same day or whether you

will stay in the hospital overnight. If you stay overnight, you will go home

at 6:00 a.m. the next morning.

5. Do I take my antiplatelet medication with a stent?

Continue taking your antiplatelet medication unless your Cardiologist

tells you to stop. If you stop this medication before your Cardiologist tells

you to, it can result in the formation of clots in your stent.

6. Can I take herbal medications and/or vitamin supplements with astent?

Tell your cardiologist about any herbal medications and/or vitamin

supplements you are taking. He or she will tell you whether to continue or

to stop taking them.


13

http://www.heartandstroke.ca/http://www.heartandstroke.ca/


15/16

7. Can I have an MRI (Magnetic Resonance Imaging) with a stent?

You should wait six weeks after your stent procedure before having an

MRI. In case of emergency, the emergency doctor will decide what to do.

8. Will my stent affect or be affected by airport security?

No, your stent will not trigger alarms at security checkpoints. Metal

detectors will not harm your stent.

9. Can I go an a vacation or fly?

There may be certain restrictions to driving or flying based on the adviceof your doctor.


14


16/16

William Osler Health System is a hospital system ‘Accredited with Exemplary Standing’

that serves 1.3 million residents of Brampton, Etobicoke, and surrounding communities

within the Central West Local Health Integration Network. Osler’s emergency

departments are among the busiest in Ontario and its labour and delivery program is one

of the largest in Canada. William Osler Health System Foundation builds and fostersrelationships in order to raise funds to support William Osler Health System’s capital,

education and research priorities at Brampton Civic Hospital, Etobicoke General

Hospital and Peel Memorial Centre for Integrated Health & Wellness (targeted for

completion in 2015-16).

Angioplasty Information

Documents

Transcript of Angioplasty Information