I am student of diploma in cardiology nursing.

1.  Presented by
Faisal Joel
Presented to
Sir.Tanseer Ahmed

2. After this presentation student will be able to
explain
 Coronary angiography
 Indication of Angiography
 Steps of angiography
 Complications of Angiography
 Post procedure care

3.  Coronary angiography is a procedure that
uses a special dye (contrast material) and x-
rays to see how contrast material filled blood
flows through the coronary arteries of the
heart.

4.  Coronary angiogram, is the "gold standard“
for the evaluation of coronary artery disease
(CAD).
 A coronary angiogram can be used to
identify the exact location and severity of
CAD.

5.  Acute MI
 Unstable angina
 Chronic stable angina (uncontrolled by
medication)
 Abnormal stress test
 Ventricular arrythmias
 Left ventricular dysfunction

6.  Preoperative coronary assessment for
cardio vascular surgery
 Periodic follow up after cardiac
transplantation
 Valvular heart disease

7.  Step 1 ( pre cath):
 Written consent.
 Fasting for at least 4 hours
 Pre cath investigations.
 Selection of arterial access point.
 Shaving of the groin/ wrist according to the
choice.
 Connect the cardiac monitor.

8.  Step 2:
 Radiation protection for the health care personnel.
 An area of the arm or groin, is cleaned and numbed
with a local numbing medicine.
 Draping of the patient.
 Using local anesthetics around the puncture site.
 Puncture and introducing the short guide wear
through the puncture needle.
 Introducing the sheath and removal of dilator
along with short guide wire.
 Flush the channel with heparinized solution.

9.  Step 3:
 The cardiologist passes a thin hollow tube,
called a catheter, through an artery and
carefully moves it up into the heart.
 X-ray images help the doctor positioning the
catheter.
 Once the catheter is in place, dye (contrast
material , better to use <30 ml to prevent CIN)
is injected into the catheter. CIN = contrast-
induced nephrotoxicity.

10.  X-ray images are taken to see how the dye
moves through the artery.The dye helps
highlight any blockages in blood
flow.
 The procedure may last 30 to 60 minutes

11.  1. MI
 2. Stroke
 3. Renal failure
 4. Aortic or coronary dissection
 5. Cardiac rupture
 6. Air embolism
 7. Arrythmias
 8. Peripheral vascular damage

12.  1. Haematoma (at the puncture site)
 2. Angina
 3.Vaso vegal reaction
 4. Allergies to contrast agents and drugs

13.  Check for the peripheral pulses, local
temperature of the limbs and any abnormal
feelings like numbness,coldness etc.
 Check for the body temperature.
 Check for the hematoma, rashes,pain.

14.  Ask the patient for any chest pain or
discomfort.
 Check for the urinary out put.
 Advice the patient to immobilize the limb
where the procedure was done for several
hours