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?"