Advice after coronary angioplasty

Advice after coronary angioplasty

CARDIAC CATHETER SUITE/ CORONARY CARE UNIT

Please read this leaflet and follow the instructions carefully.

You have had a test with a thin tube inserted into the artery at the top of your leg or wrist.

After the test:-

• It is best to have someone with you for 24 hours.
• Have a quiet time for 24 hours. Movement of the leg / arm should be minimised to reduce the risk of rebleeding from the groin / wrist.
• Ordinary walking around your home and garden is fine.
• Keep the puncture site clean and dry.
• Do not bath or shower until the following day after your procedure, use wipes on leg and groin area on the day.

Angioseal:
If you have an angioseal keep your information card in your purse/ wallet for 90 days. Keep the plaster on the wound side for 2 days. NO BATH for 3 days but you may shower the day following your procedure.

PROBLEMS ARE NOT COMMON BUT YOU NEED TO KNOW WHAT TO DO IF THEY OCCUR

1. Chest Pain
   As explained to you post procedure you may experience pain in your chest, maybe a dull ache in nature, this should settle. If you experience more severe pain take 2 puffs of your GTN spray; if the pain persists you can take your GTN spray again but if the pain has not gone within 15 minutes dial 999.
2. Bruising
   A small bruise around the puncture site is common and sometimes this may spread down the leg over the next few days. This does not need any action. It is also common to develop a small lump (about the size of a pea) at the puncture site. This will gradually disperse. Paracetamol can be taken to relieve any minor discomfort. If a larger lump develops, or there is swelling around the puncture site and particularly if this is increasing or is painful; you should contact your GP so that it can be checked.
3. Bleeding
   If this happens it is important to apply very firm pressure over the puncture site. This is not easy to do yourself and is best done by someone else. The nurses will show you how to do this before you leave. Pressure should be applied for at least 10 minutes. If bleeding continues whilst pressure is being applied, if it continues after 10 minutes pressure, or if you start to feel faint or unwell, you should get urgent medical help – either call an ambulance (999) or get someone to take you to the A&E department of your nearest hospital, maintaining pressure over the puncture site during the journey. If you are at all worried about any aspect of your recovery at home, please contact your GP.

LEAVING HOSPITAL

Length of Stay
You will usually go home the same day, directly from the cardiac catheter suite. In some cases you will stay in hospital overnight after your angioplasty and discharged the following day if all is well. You will need to have blood tests taken the following morning, either at the hospital or at your GP surgery.

Medication when you leave hospital
Before you leave hospital, the pharmacy will give you any extra medication that you need to take when you are home. If you have had a stent inserted you will be given a supply of Clopidogrel, which prevents blood clots forming on the stent and blocking it. You will be advised how to take this drug.
Clopidogrel and aspirin are vital in ensuring that your stent remain open. You will need your GP to provide a repeat prescription of Clopidogrel before your hospital supply runs out. You will probably need Clopidogrel for 12 months after your stent – if anyone advises you to stop this, you must tell him or her to consult with your cardiologist first.

Convalescence
How long it takes for you to fully recover from your test varies from person to person. Once home, it is important to rest quietly for the remainder of the day. Some people feel a slight bruised sensation where the tube was inserted. You can take a simple painkiller such as Paracetamol.

Wound
For the first few days after you get home, check your puncture site. You can expect to have some bruising, but if there is any redness, if you have swelling, or if the bruising is very widespread, contact your GP (family doctor) or the cardiac catheter suite.

Exercise
It is best to avoid doing any demanding activities, like heavy lifting, for at least a week. Ordinary walking, for example round the house, garden or place of work should not be a problem. However, if you get chest pain when you are being active, avoid further exercise and tell your GP about the pain immediately.

Driving
If you have an ordinary driving licence, you should not drive in the first week after having an angioplasty. If you have an LGV (large goods vehicle) or PCV (passenger-carrying vehicle) licence, you need to let the DVLA know you have had an angioplasty. Usually you will not be allowed to drive for 6 weeks and you will need to have further tests before you can drive an LGV or PCV again.

Work
When you return to work will depend partly on your job, but you should probably expect to be off work for a week after your angioplasty.

Procedure results
We will usually explain the results and any recommendations about your treatment to you before you leave the hospital. Many people find it helpful to have someone with them when their results are explained. A full report of your procedure will be sent to your doctor (GP) within a few days.

CONTACT DETAILS
If you have any specific concerns that you feel have not been answered and need explaining, please contact the following:-

Nursing Staff
Cardiac Catheter Suite
Worcestershire Royal Hospital
Monday to Friday 7.00am to 8.00pm
Tel: 01905 733205
Coronary Care Tel: 01905 760561
Cardiac Rehabilitation Tel: 01905 733710

ADDITIONAL INFORMATION
The following internet websites contain additional information that you may find useful:-

www.patient.co.uk
Information fact sheets on health and disease

www.nhsdirect.nhs.uk
On-line Health Encyclopaedia and Best Treatments

www.bhf.org.uk
British Heart Foundation

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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