01.06 Cardiovascular Angiography

During the cardiovascular angiography the doctor inserts a catheter into the inner-upper leg near the groin and threaded to the vessels supplying the heart. Contrast dye is inserted into the catheter and an X-ray is used to view the vessels. Intervention is provided by the doctor as needed like stent placement to open the arteries. Let’s discuss the purpose of this test.

The procedure helps to view the blood vessels supplying the heart to diagnose disease in the coronary arteries or the valves. The doctor will be able to see any obstructions or blockage to the blood flow that may cause a myocardial infarction. Here’s a picture from a cardiovascular angiography showing blockage here and here. Let’s discuss why this test is done. 

The doctor may choose to order this test if the patient has chest pain, heart disease like coronary artery disease, valve issues, or heart defects. Let’s talk about what to do before the procedure. 

Before the procedure, the patient will be kept NPO meaning no food or drink for 6-8 hours. Ask the patient if they have any allergies to contrast because if they do they may not be able to have the test. If the patient is on anticoagulants, ask the doctor if they want the medication held and for how long before the procedure to prevent bleeding. Explain the procedure and have the consent signed by the patient. The consent may be done right before the procedure so the doctor may explain any risks.

During the procedure, you will clean and shave the site on the upper-inner leg near the groin. You will provide an IV sedative to relax the patient before the doctor places and threads the catheter to use for the contrast. You will monitor the vital signs for any deviations from normal while the catheter is in the main arteries. 

After the procedure the doctor will remove the catheter and you will hold pressure for 10-15 minutes. A closing device may be used. Keep the patient flat for 2 hours and keep the leg straight for 6 hours. Assess the site for bleeding, and hold pressure if it does. Next let’s talk about patient education. 

Let the patient know when they are able to restart anticoagulants per doctor order after the procedure. They may resume their normal activities the next day. Tell them to let you know if they notice any red or pain at the injection site. 

The priority nursing concepts for the patient with a cardiovascular angiography are safety, perfusion, and patient education.