After a coronary angioplasty

A coronary angioplasty is a procedure used to treat a narrowing or blockage in 1 or more of your coronary arteries. They are vessels that supply blood to the heart muscle.

The treatment:

• uses a small balloon to stretch open a narrowed or blocked artery
• usually also involves inserting a small wire mesh tube called a stent that stays in place to keep the artery open

This information explains what to expect after your coronary angioplasty and when you leave hospital. 

If you have any questions or concerns when you have left hospital, please contact us.

What happens after the procedure

After your coronary angioplasty, we look after you in the recovery unit before we transfer you back to the ward. We check and record your pulse and blood pressure during this time.

It is important to tell the healthcare professionals treating you if you feel unwell at any time after the procedure.

If the sheath was inserted into your groin

If the sheath was inserted into your groin during the procedure, a nurse or doctor might apply pressure for up to 10 minutes to stop the bleeding. They do this after the sheath has been removed. It can sometimes be uncomfortable.

The doctor doing the procedure sometimes inserts a small surgical plug or uses a special stitch to seal the wound. In this case, it would not be necessary to apply pressure to the wound.

This is not always possible if you have had lots of blood-thinning medicine to prevent blood clots. The sheath might then have to remain in place for anything up to a couple of hours after the procedure.

We ask you to lie flat until:

• at least a couple of hours after the sheath is removed
• the bleeding has stopped

You may need regular examinations of your groin area. This is likely to include a doctor or nurse touching the area to make sure that there is no evidence of bleeding.

If you are OK, we will ask you to sit up after a few hours. You should then be able to get up and walk around shortly afterwards.

If the sheath was inserted into your arm

If the sheath was inserted into your arm during the procedure, we might put a small pressure cuff around your arm. We can then decrease the pressure gradually over several hours.

A nurse checks if there is any bleeding where the sheath was inserted. You should be able to sit up immediately but might have to stay in bed or in a chair for a couple of hours.

Going home

If you have been booked as a day case, you will usually leave hospital on the same day. However, if circumstances change on the day of your procedure, we might recommend that you stay overnight to be monitored. 

It is a good idea to be prepared in case this happens and bring a few overnight items.

You need to plan how you will get home when you leave hospital.

You need to make sure that you have a responsible adult to accompany you home.

Your follow-up appointments

Your heart specialist (cardiologist), or a doctor doing the coronary angioplasty, should talk to you about whether it was successful after the procedure.

Before you go home, we tell you if and when you will have a follow-up appointment with your heart specialist. This appointment is usually after about 6 weeks. It might be at your local hospital if
St Thomas’ Hospital is not the closest hospital to you.

How to care for your wound

It is normal for your wound to be tender for a few days after the coronary angioplasty. It is also common to get a bruise.

If you have a dressing on your wound site, this will normally be left in place for 24 to 48 hours and can then be removed.

If your wound starts to bleed, you need to put pressure on the area:

• If your groin was used, keep your leg as straight as possible (lie down if you can).
• If your arm was used, raise your hand across your chest.

If the bleeding stops within 10 minutes, keep your leg or arm as still as possible for the next 4 hours. If the bleeding starts again, go to A&E but do not drive yourself there for safety reasons.

You can have a shower when you get home but need to avoid rubbing the wound site or having a bath for 5 days.

Do not put creams, talcum powder or soap directly onto the wound site for up to a week after the coronary angioplasty. This helps to:

• avoid irritation
• reduce the chance of infection

Chest pain

Your chest is likely to feel tender after the procedure. This is normal and should settle within a few days. 

Standard pain medicine, such as paracetamol, is usually effective at treating this pain. Always follow the instructions on the packet and never take more than the recommended amount (dose).

If you get severe chest pain or pain like your angina pain, you can use your glyceryl trinitrate (GTN) medicine as prescribed. This is medicine to treat chest pain by relaxing and widening blood vessels.

Eating and drinking

After a coronary angioplasty, you can eat as usual. You need to drink plenty of fluids (especially water) but avoid alcohol for 24 hours.

Returning to your usual activities

If you have recently had a heart attack, you need to talk about issues like returning to work and driving with your doctor or nurse. It is likely that you will need to wait before resuming these activities.

You can usually return to work within 1 week, unless you have a manual job that involves heavy lifting. Before you leave hospital, it is a good idea to check with your doctor or nurse when you can return to work.

You should be able to self-certify for up to 7 days but should contact a GP if you need a fit note (sick note).

It is best to avoid heavy lifting and exercise that involves a lot of effort (like running, hill climbing, swimming and competitive sports) for at least 5 days.

You are not allowed to drive for 1 week after a coronary angioplasty. This is a requirement set by the Driver and Vehicle Licensing Agency (DVLA). You need to contact the DVLA if you have a heavy goods vehicle (HGV) or public service vehicle (PSV) licence.

It is also important to check with your insurance company to make sure that you are covered to start driving again.

It is usually safe to fly 1 to 2 weeks after the procedure. You can check this with your airline and insurance companies.

Otherwise, you can return to normal activities (including sex) when you feel ready.

Cardiac rehabilitation

We refer you to a local cardiac rehabilitation service. They should invite you to a cardiac rehabilitation programme, which you can start shortly after leaving hospital.

A cardiac rehabilitation programme involves exercise, information sessions, support and relaxation. The aims are help you:

• return to everyday life as quickly as possible
• adapt to living with heart disease