Heart disease is a common type of disease in clinical practice, with many different symptoms during its onset. Coronary heart disease is one of the more common heart diseases, and coronary angiography is currently recognized as the "best standard" for diagnosing coronary heart disease.
Under what circumstances is coronary angiography necessary? High risk individuals, including those with three highs, frequent smokers, and those who have been experiencing abnormal physical symptoms such as chest tightness, chest pain, dizziness, headache, and shortness of breath for a long time, with increasingly strong and prolonged sensations, require timely coronary angiography. For patients with coronary heart disease, if angina symptoms persist for a short period of time, whether during rest or activity, they will frequently experience angina, and the duration of each attack will gradually prolong, with the pain index increasing continuously. In this case, it is also necessary to arrange coronary angiography to avoid serious arterial occlusion. In addition, in critical situations, it can also serve as an important basis for assisting in the diagnosis of diseases, such as sudden strong chest pain that has lasted for more than half an hour. In this case, to avoid more dangerous situations for patients, timely coronary angiography is also necessary. Some suspected coronary heart disease patients, or those who suspect significant coronary artery disease, may need to undergo coronary angiography to help diagnose their condition even after some simple examinations have not been confirmed.
During coronary angiography, preoperative and postoperative care are crucial:
1. Preoperative diet: Patients can eat and drink water before coronary angiography, but it is important to avoid foods that are prone to gas production, such as potatoes, sweet potatoes, taro, and pumpkin. Don't eat too much, 70% full is enough.
2. Preoperative dressing: Change into clean and tidy clothes before surgery, and do not wear tight fitting clothes. Try to choose cardigans with cuffs that are not too tight and can be easily rolled up to the elbow. And remove all metal objects and removable dentures from your body and hand them over to your family for safekeeping.
3. Preoperative medication: Before surgery, medical staff should routinely instruct patients to take aspirin and clopidogrel, but in special circumstances, they should treat them differently.
2、 Postoperative complications may occur after coronary angiography, including bleeding or hematoma at the puncture site, contrast agent allergy, vagus nerve reflex, retroperitoneal hematoma, pseudoaneurysm, etc. Therefore, postoperative care is also essential.
1. Observe whether there is bleeding, pain or swelling at the puncture site of the patient, and communicate with the attending physician in a timely manner if there is any abnormal change in skin color.
2. Drink water reasonably. Advise patients to drink 800-1000ml of water within 4 hours after surgery, with a urine output of ≥ 500ml within 4 hours after surgery. Patients with heart failure should drink small amounts multiple times. The purpose is to reduce or avoid adverse reactions of contrast agents, such as dizziness, headache, urticaria, renal dysfunction, etc.
3. Medical staff should release the pressure bandage at the arterial puncture site on time.
4. Pay attention to a reasonable diet. The patients who were punctured through the radial artery (at the wrist) had the same diet as usual. The patients who were punctured through the femoral artery (at the root of the thigh) had to stay in bed for 10 to 12 hours, so they should not use gas producing foods, such as milk, soybean milk, eggs, etc. After getting out of bed, they could eat normally (low salt and low-fat or diabetes diet).
5. If there is pressure from sandbags at the site of femoral artery puncture after surgery, the patient should pay attention to lying flat with straight legs to avoid sandbags falling off. The unperforated limb can move normally, but the punctured limb cannot bend, but it needs to practice dorsiflexion and extension of the foot to avoid the formation of blood clots during prolonged bed rest. Follow the arrangements of medical staff before moving. If there is difficulty urinating or bleeding, medical personnel should be notified immediately.
6. Precautions after removing the dressing at the puncture site. The next morning after the surgery, the nurse went to fetch the dressing at the puncture site and instructed the patient and their family not to touch the puncture site with water for three days, not to lift heavy objects for a month, and to minimize movement of the operated limb as much as possible.