The patient may feel a transient stinging localized sensation when
the groin is infiltrated with local anesthesia.
During the procedure, the patient may be asked to hold his/her
breath or cough. The former improves the quality of the x-ray movies
when the diaphragm partially obscures a certain portion of the coronary
artery. A deep breath improves the quality of the picture. A brisk
cough may be occasionally needed to wash out contrast material from
the coronaries when it induces a significant arrhythmia
Fleeting chest discomfort may also be felt during some coronary
After completion of the diagnostic procedure, which usually takes
10 to 15 minutes, the patient is taken to the recovery room, where
the sheath is removed from the groin. Firm pressure is applied (manually
or with a mechanical clamp or compression device) for approximately
10-15 minutes (the time may vary) to stop/prevent bleeding from the
needle insertion point.
A dressing is then placed on the groin and a sand bag or ice bag
may be used on top of the dressing. The patient will have to lay flat
for three to four hours. In interventional cases, where heparin is
used, the arterial sheath is discontinued only after serial measurements
of the ACT confirms an acceptable vale (usually less than 150).
Some cardiac centers use closure devices in the cath lab. In such
cases, the arteriotomy is sealed before the patient leaves the lab
and application of pressure is not usually needed. This increases
the cost of the procedure and carries a very small and acceptable
When the anesthesia wears off, the patient may experience mild groin
discomfort. The nurse can provide pain medication to take care of
this problem. The blood pressure and pulse rate are monitored during
the recovery phase.
After bed rest is completed, the patient is made to sit up and then
stand with assistance. After further observation, the patient is discharged,
if there are no problems or persistent bleeding.