MEDICATION GUIDE NEXIUM (nex-e-um) (esomeprazole magnesium) Delayed-Release Capsules NEXIUM (nex-e-um) (esomeprazole magnesium) For Delayed-Release Oral Suspension Read the Medication Guide that comes with NEXIUM before you start taking NEXIUM and each time you get a refill. There may be new information. This information does not take the place of talking with you
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Microsoft word - coronary angiogram patient information leaflet.doc
Why do I need an angiogram?
The heart is a muscle and like all muscles in the body it needs to have a good blood supply in order to work properly. Your heart gets blood from three main blood vessels called the coronary 0845 155 1000
arteries. Your doctors feel you may have a problem with the blood supply to your heart muscle and a coronary angiogram will What is a coronary angiogram?
The angiogram is an x-ray test used to show the blood flow in the coronary arteries. A special dye known as contrast fluid is Coronary Angiography
injected into the coronary arteries via an artery in your groin or your arm. The dye can be seen when x-rays are taken and this Information for patients
will show whether the coronary arteries are normal, narrowed, irregular or blocked. The procedure is performed under local anaesthetic and usually takes around 20 minutes. This leaflet tells you about the procedure known as Coronary Benefits of angiography
Angiography, (also known as having an angiogram or cardiac
catheter). Please ensure you have had sufficient explanation
The angiogram provides detailed information about your and you understand the procedure before you sign the
coronary arteries. The results of the angiogram are important to consent form.
help you and your doctor decide the best treatment option for What are the risks?
Although coronary angiography is a very safe procedure, the angiogram procedure cannot be performed without some element of risk. The majority of patients have no major problems but the following complications can occur. Bleeding at the puncture site; this usually settles with Kent & Sussex Hospital
Bruising around the puncture site; this is common and may take some weeks to go. Sometimes more pressure over the puncture site is necessary. Very rarely the bleeding or Maidstone Hospital
bruising is very severe and a minor operation may be needed. Some people may have an allergic reaction to the x-ray dye. PLEASE READ CAREFULLY
If you have any allergies you must tell your doctor and nurse.
Preparing for your procedure:
This reaction almost always responds rapidly to medical Take all medications (other than Warfarin and Metformin) as usual. Please bring your current medications with you (or a list of Major complications are extremely rare but can include what you are taking) so that we can prescribe these correctly. damage to the leg artery, heart attacks, strokes and death. If you are taking WARFARIN or PHENINDIONE this must
You will have the opportunity to discuss these risks and how they be stopped 4 days before your procedure
may affect you further prior to the procedure. If you are diabetic and take METFORMIN this must be
stopped 24 hours before your angiogram. This should not
Are there any alternatives?
affect your diabetes management. You can recommence your A number of other tests can be used to get an idea of the blood Metformin 48 hours (two days) after the procedure.
supply to the heart muscle including a treadmill test, a special If you are taking insulin you should miss your usual morning
exercise echo scan or a special exercise nuclear scan. You may dose. We will measure your blood sugar when you arrive and It is important to remember that the angiogram is the only test
On the day of admission:
that shows your coronary arteries in detail so that further treatments, if necessary, can be planned thoroughly. Take a bath or shower and carefully shave a patch of skin about 4 inches around the skin crease at the top of your right What happens before the procedure?
leg. Do not worry if you are unable to do this, it can be done Most angiogram procedures are carried out locally in the Cardiac Catheter Labs at either Kent and Sussex Hospital or Maidstone If you are coming for a morning appointment please have a Hospital. A small number of patients who require more complex light early breakfast and then nothing to eat or drink after that, investigations have these at a London Hospital. Most patients are admitted on the day of the procedure though You will be asked to put on a hospital gown and asked to very occasionally, some patients may need to come in the walk to the Catheter Lab - please bring a dressing gown and evening before. If you need to contact someone before your Please do not bring any money or valuables with you. The ward telephone will be available for you to use if required. Phone the admissions team in the Catheter Lab You must let the Catheter Lab staff know if:
Phone the secretary to your Cardiologist If you cannot attend your appointment please contact the You have had a previous reaction to intravenous contrast admissions team, as soon as possible, on the telephone number medium, (the dye used for kidney x-rays and CT scanning). You may be pregnant; if applicable you will be asked to confirm this on the day of your procedure. What can you expect in the laboratory and who will be
What happens after the angiogram?
The angiography laboratory can seem intimidating as it is full of You will be taken back to the recovery area on a trolley. Nurses medical equipment such as monitors and a big x-ray machine in recovery will carry out routine observations. Your pulse and within quite a small space. There is a team of three people who blood pressure will be taken and the pulse in your foot or arm will assist your Cardiologist with the procedure. They are a will also be checked. The nurses will monitor your groin or wrist specialist trained nurse, a radiographer to take the x-rays of your puncture point to make sure there is no bleeding. heart and a technician to watch the monitors. They will do You will generally stay in bed for an hour, although it may be everything they can to put you at your ease. longer, until you have recovered – the time period may differ for You may have to wait for a short time in one part of the lab until each patient and your nurse will tell you when you can get up. You may eat and drink once you are sitting up in bed. Most patients are allowed home on the same day after a What happens during the angiogram?
discussion with a member of the medical team. You must not
You will be asked to lie on your back on the couch while the drive for 48-72 hours after your procedure so you will need to
angiogram is carried out. First the doctor will give you a local arrange for a responsible adult to collect you and take you home. anaesthetic to make your skin numb, this stings to begin with but will soon settle. When you go home
If you are anxious before or during the procedure ask for some Before being discharged from the unit you will see your medication (sedation) to help you relax; this is given through the Cardiologist and given the results of the angiogram, as well as needle in your arm. You will be awake during the procedure and being given a discharge advice sheet by the nursing staff looking The doctor will then thread a small tube (sheath) into your artery Resuming Activities
using a needle. Thin tubes or catheters are then passed through You are advised to rest for the remainder of the day and you
this sheath into your arteries up to your heart. To make it should ensure that a responsible adult stays with you on the possible for the doctors to see your heart’s arteries in detail x-ray dye can then be injected into each of them. Pictures are taken After 24 hours you may be as active as normal but if you
from a number of different angles so that if there are narrowings have any concerns about exercise or returning to work after your procedure please discuss this with the ward staff. The whole procedure usually takes less than half an hour. When Avoid heavy lifting for a couple of days. the doctor is satisfied with the pictures taken the catheters and We advise you not to drive for a couple of days after your sheath are removed from the artery. The puncture hole in your groin is usually plugged with a special device called an Angio-Seal. You may bath or shower 48 hours after your procedure, earlier than this may encourage bleeding. If there is a plaster on your wound you may remove this the next day. If your foot /toe/arm/fingers becomes more pale or colder
You may eat and drink as usual when you get home but avoid than usual or you experience uncharacteristic tingling or numbness in these areas, contact your GP immediately or come to the A&E department You should also drink plenty of non-alcoholic fluids to clear DO NOT DRIVE YOURSELF – You must get someone to take
you to your GP or to the hospital.
Your doctor will advise you of any changes to your medications when they discuss your results with you on the You should also contact your GP if you have increased pain, day of your procedure or at your follow-up outpatient swelling, redness &/or discharge at the site. Chest Pain
If you are on Metformin please restart taking your Metformin You should NOT expect to experience any increase in chest pain two days after your procedure.
If you are on Warfarin your doctor will advise you on Any CHEST PAIN should be dealt with as below:
recommencing and dosage before you leave the department. Wound Care
If you have angina, stop, sit down and take 2 puffs of your
GTN spray. Wait 5 minutes. If you still have chest pain use
It is normal for your groin or arm to be tender for a few days after your spray again. Wait another 5 minutes. If you still have the angiogram. It is also normal for a bruise or tiny lump to pain after a further 5 minutes repeat once more (three times altogether) If the pain has not gone phone 999. The Angio-seal plug used to close your artery will dissolve within three months (90 days). Your nurse will give you an information If you do not have angina and you experience chest pain,
stop and sit down for 10 minutes. If the pain has not subsided
card about the Angio-seal and you should carry this with you for phone 999 and take 300mg of aspirin if you are not allergic to What to look out for
Who to contact if you have any queries or concerns?
A larger area of swelling is observed in your groin; apply firm
pressure to the puncture site for 10 minutes. If the swelling
does not disperse or continues to grow, contact your GP immediately, or come to the A&E Department. If bleeding at the site occurs, press fingers very firmly over
the site for 10 minutes or until bleeding stops. If bleeding persists, contact your GP immediately or come to the A&E
Patient Advice and Liaison Service (PALS)
If you would like to comment on Trust services, have concerns or need
information, you can contact the Patient Advice and Liaison Service (PALS).
PALS will listen to your views and using a wide range of contacts and
resources, help find ways of resolving any queries or difficulties. The PALS
Officers can be contacted at Maidstone or Kent and Sussex Hospitals where
the offices are situated in the main entrance, Monday to Thursday 9.00am to
5.00pm, Friday 9.00am to 4.30pm.
Telephone: Maidstone Hospital
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