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What will the patient experience?
  • 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 artery injections.
  • 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.

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  • 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 complication rate.
  • 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.
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