Coronary Angiogram Consent 🫀

🔍 Procedure

  • Coronary angiogram – coronary artery imaging using iodine contrast via catheter (radial or femoral access).
  • May include IVUS, OCT or FFR during the same session.

💡 Indications

  • Investigation of chest pain, suspected angina/ACS, or prior to cardiac surgery/intervention.
  • Evaluate symptoms not responsive to medical therapy.

🧾 Preparation

  • Nil by mouth for specified hours pre-procedure.
  • Continue most meds with water unless instructed (e.g. stop blood thinners if advised).
  • Inform clinician of conditions: diabetes, hypertension, allergies (contrast, iodine, shellfish), renal impairment, pregnancy/breastfeeding, anticoagulants.

💉 Procedure Walkthrough

  • Local anaesthetic ± sedation; catheter inserted into radial or femoral artery.
  • Contrast and X‑ray imaging of coronary arteries. You may feel warm flushing.
  • Optional IVUS/OCT/FFR may be performed.
  • May proceed to angioplasty/stenting in same session if indicated.
  • Arterial puncture closed with pressure, band, or vascular closure device; recovery bed rest follows.

⚠️ Risks & Complications

  • Common (>5%): bruising, bleeding, infection at puncture site; mild contrast reaction.
  • Uncommon (1–5%): arrhythmias needing treatment, arterial damage requiring surgical repair, acute kidney injury.
  • Rare (<1%): stroke, heart attack, severe contrast allergy, vessel rupture, radiation burns, acute nerve injury.
  • Very rare (<0.01%): death.

💬 Common Patient Questions

  • Will it hurt? — Local anaesthetic is used; sedation may be available.
  • Can I eat before? — Fast as instructed (usually 4–6 h prior).
  • Can I go home? — Usually day‑case unless complications or PCI performed; you must have someone to escort you.

✅ Benefits

  • Direct visualization of coronary arteries; identifies narrowing/blockages, guides PCI/surgery.

🔄 Alternatives

  • CT coronary angiography
  • Medical management without invasive imaging

🧠 Special Considerations

  • Renal impairment → check renal function, possible IV fluids, hold nephrotoxic drugs.
  • Allergy history (contrast, iodine, shellfish).
  • Consent to possible student involvement and/or audio/video recording.
  • Advance Health Directive / substitute decision‑maker procedures if lacking capacity.

🗣️ Example Consent Script

  • "We’re recommending a coronary angiogram to investigate your heart symptoms using a catheter inserted into an artery to visualize your coronary vessels."
  • "It’s performed under local anaesthetic and usually sedation, and may include techniques like IVUS, OCT, or FFR."
  • "Risks include puncture-site bleeding, contrast reactions, arrhythmias, kidney effects, stroke or heart attack in rare cases."
  • "If indicated we may proceed with balloon angioplasty or stenting immediately."
  • "A trainee may assist during the procedure and images or video may be captured — is that okay?"
  • "Do you have any questions or concerns before consenting?"

🔗 External Resources