Understanding Coronary Angioplasty: What You Need to Know

Before surgery

Before an angioplasty, the doctor will carefully review the patient’s medical history and conduct a physical examination. The patient may need to undergo tests like a chest X-ray, electrocardiogram, and blood tests before the procedure.

The doctor will also perform a coronary angiogram, an imaging test, to assess any blockages in the arteries supplying blood to the heart and determine if angioplasty is appropriate.

If a blockage is found during the coronary angiogram, the doctor may decide to proceed with angioplasty and stenting immediately while the catheter is still in place.

Informed consent is obtained from the patient or their relatives before performing a coronary angioplasty.

To prepare for the procedure, the doctor will provide the patient with specific instructions:

• The patient may need to adjust or temporarily stop taking certain medications like aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood thinners.
• The patient should provide information about all their medications, including herbal supplements.
• The patient will be asked not to eat or drink anything for six to eight hours before the angiography.
• The patient can take approved medications with only small sips of water on the morning of the procedure.
• The nurse will put an IV in the arm to give medicine that will relax the patient

During surgery

During a coronary angioplasty, the patient will be awake as it is done using local anesthesia. A small incision is made in the groin, wrist, or arm to insert a thin tube called a catheter into one of the arteries. The catheter is guided to the affected coronary artery using an X-ray video.

A thin wire is then passed through the artery, carrying a small balloon to the blocked section. The balloon is inflated to widen the artery, pushing fatty deposits against the artery wall, and allowing blood to flow freely once the balloon is removed.

Sometimes, a stent is used, which is placed around the balloon and expands to support the artery when the balloon is inflated and remains in place after deflation.

After the procedure, the doctor will remove the catheters and place a bandage over the site where they were inserted into the skin.

The procedure typically lasts between 30 minutes to 2 hours.

If treated for angina, the patient might go home on the same or the next day, but they should avoid heavy lifting, strenuous activities, and driving for about a week.

If a patient is admitted after a heart attack, they may stay in the hospital for a few days following angioplasty before being discharged.

After surgery

After a nonemergency angioplasty, the patient may stay overnight in the hospital for monitoring and medication adjustments. Typically, the patient can resume work or normal routine within a week.

Once back home, drink plenty of fluids to flush out the contrast dye. Avoid strenuous activities and heavy lifting for a day or as the doctor advises.

Contact the doctor or hospital immediately if experience any concerning symptoms.

• Bleeding or swelling at the catheter insertion site.
• Pain or discomfort at the catheter insertion site.
• Signs of infection include redness, swelling, drainage, or fever.
• Changes in temperature or colour of the leg or arm used for the procedure.
• Feeling faint or weak.
• Chest pain or shortness of breath.

Follow the cardiologist’s instructions regarding blood-thinning medications like aspirin and clopidogrel. Aspirin is usually taken indefinitely, while clopidogrel may be prescribed for six months to a year after stent placement. Always consult a cardiologist before making any changes to the medication regimen.

While serious complications after angioplasty are rare, some potential risks are associated with the procedure. These risks include:

• Heart attack.
• Abnormal heart rhythm.
• Blood vessel or kidney damage.
• Blood clots.
• Chest pain.
• Possibility of repeat blockage.

The risk of complications may be higher for older adults or individuals with multiple blocked arteries, kidney disease, or heart failure. Discussing these risks with a doctor before undergoing the procedure is essential.