Cardiology - Percutaneous Coronary Intervention (PCI) Discharge Information

How should I care for the puncture site?

Check the puncture site once a day, for the next seven days and contact the hospital if you have any concerns. Your nurse will explain what to look for and what is normal.

We do not expect any serious problems following your procedure, however if you notice any of the following:

• Excessive bleeding or swelling from your puncture site. Lie down and apply pressure. Dial 999 for an ambulance
• Coldness, blueness, numbness or excessive pain in the affected arm or leg. Dial 999 for an ambulance
• Bruising around the puncture site. This is fairly common. However, if it is excessive or if you are worried please contact ward 1 on 0161 778 2501 for advice

Do not do any heavy lifting for five days, for example carrying shopping bags, vacuuming or lawn mowing.

Wrist

If the wrist is used you will return to the ward with a TR (trans radial) band which is a special type of plastic bracelet, underneath which is a small balloon. The balloon will press hard on the artery to stop the bleeding.

The nurse will slowly deflate the balloon to make sure there is no bleeding. The bracelet will be taken off before you go home. Do not wear jewellery or a watch on the wrist for 5-7 days.

Groin

An angioseal (plug) may be put in the artery in the groin to stop any bleeding. This is made from collagen and will dissolve within 3 months.

The angioseal will feel like a small bead or pea sized lump in the groin, this is normal, and will slowly reduce as it dissolves. If an angioseal is not used, the nurse may press on the groin or use a special item of equipment to press on the groin to stop any bleeding.

You may shower the next day. The clear plaster should come off the next day.

• Do not put any cream or lotion on the puncture site
• Do not bathe, swim or soak the puncture site in water for 5-7 days
• Do not do any heavy lifting for five days, for example carrying shopping bags, vacuuming or lawn mowing

Day case patients

You will be contacted by telephone by a cardiology specialist nurse after your procedure.

For medical personnel only

The interventionist on call on the DAY of this patient’s procedure is:

Dr……………………………………………………………………………. Please contact via the hospital switchboard on 0161 624 0420.

Is chest pain normal afterwards?

Most people do not get chest pain after treatment such as stent, or balloon angioplasty.

Some people can experience coronary artery spasm afterwards, which can be like angina but usually settles. Some people may get further angina coming from other diseased arteries.

Use your GTN spray under your tongue for angina. If you get more and more angina you need to make an early appointment with your GP.

If you are concerned please contact:

Ward One - 24 hours - 0161 778 2501
Ward Two - 24 hours - 0161 778 3983
Cardiology Specialist Nurse - 0161 778 2450 for advice

If your chest pain is not relieved with your GTN spray - two sprays every five minutes for fifteen minutes, then you must telephone for an ambulance. Do not drive.

I am diabetic what should I do about my tablets?

Your ward nurse will advise you when to restart your diabetes medicines according to your individual diabetes care plan.

If you have diabetes and take certain diabetic medication you may be advised not to take these medications on the day of the procedure. You may be advised to stop the medications for 2 days after the procedure.

Please re-start on

Day………………………Date………..…….. Nurse………………

Continue with insulin and other medications as usual.

How long do I need to take the clopidogrel for?

Insert box

The ward nurses will tell you how long you need to take the clopidogrel tablets for, it may be six months or a year. Aspirin should continue usually for life.

You must inform your dentist and any other doctors or specialists who may care for you that you are taking the clopidogrel.
Clopidogrel reduces the risk of getting a blood clot in the stent.

Instead of Clopidogrel some people take Ticagrelor, this is usually after a heart attack.

It is extremely important that you do not stop taking these tablets unless advised to do so by your cardiologist.

When can I increase my activity and start exercise?

Do not start any new exercises for one week; continue with your usual routine. After one week, you can begin to increase your activity. You will be invited to your local cardiac rehabilitation programme.

If you have had a heart attack before undergoing stents do not do any new exercises for two weeks. It is usual to attend the exercise and cardiac rehabilitation programme after two weeks.

When can I return to work?

It is generally alright to go back to work after one week if you are returning to an office based job. If you are returning to a job that involves heavy lifting you will need to have two weeks off work. Speak to the nurses for advice or contact your G.P.

If you have had a heart attack before undergoing stents it is usual to be off work for at least six weeks.

When can I drive?

Inform your insurance company that you have had PCI, as many insurance policies need to be updated with details of any changes to your health.

The DVLA state:

Do not drive your car or motorcycle for at least one week. You do not need to notify the DVLA.

The DVLA state:

Bus and lorry drivers must not drive and must inform the DVLA. Licence will be refused or revoked. Driving may be relicensed after six weeks if the requirements for exercise or other functional tests can be met and there is no other disqualifying condition.

After a heart attack, the DVLA state:

Driving may resume after one week after successful percutaneous coronary intervention, provided no other urgent percutaneous coronary intervention is planned, that the LV ejection fraction is at least 40% before discharge from hospital and there is no other disqualifying conditions.

Your cardiac rehabilitation nurse will have discussed this with you, if you have any questions please call your rehabilitation team telephone numbers are in the back of this leaflet.

When can I have a holiday?

You can travel within the British Isles after one week to two weeks.

The cardiologists recommend not travelling outside the British Isles for four weeks.

After a heart attack check with your travel operator, airline and travel insurance company before you fly, as they might have their own policies on flying.

Things you should think about when planning to travel:

• It is highly recommended that you have up to date travel insurance
• Make note of emergency numbers are how to get medical help
• Stay in accomodation that's easy to get to and close to amenities
• Plan a relaxing holiday - don't go to destinations that are too hilly or do activities that are too vigorous unless you're confident that you've recovered and are fit enough for that level of activity

It's not recommended to take a long-haul flight soon after having a stent fitted but if you are generally well, and have chatted through your circumstances with your doctor, you may be fit to fly:

• Two days after a planned, uncomplicated angioplasty
• Three to ten days after an uncomplicated heart attack
• Four to six weeks after a complicated or major heart attack

Stents are not affected by security systems at airports or MRI scans.

Remember flying is only a small part of a trip, please consider your journey through the airports, stress, carrying luggage, heat and access to emergency medical care.

What can I do to help?

• If you smoke, stop smoking
• Control your blood pressure
• Lower your cholesterol by eating a healthy diet and usually by taking cholesterol lowering tablets called statins
• Control your weight
• Be more physically active
• Aim for five portions of fruit and vegetables each day
• Reduce stress
• If you are diabetic it is important for your heart and your health that you control your diabetes

Some of the lifestyle causes of heart disease can be changed to reduce your risk of further heart problems in the future. The cardiac rehabilitation programme you will be invited to can help you begin these lifestyle changes. Even if you have had a heart attack, or been diagnosed with coronary heart disease, you can help your heart to stay healthy and reduce your risk of further problems.

Notes/questions to ask page

 

 

 

 

 

Some people think of questions to ask us when they are at home, and then sometimes forget the questions when they come to hospital.

Please write any questions you have on this page for when you come to the hospital or for when you telephone us.

Contact numbers, useful numbers and website addresses

Ward 1 - 0161 778 2501
Ward 2 - 0161 778 3983
Cardiology Specialist Nurse - 0161 778 2450

Northern Care Alliance NHS Foundation Trust (NCA) Switchboard - 0161 624 0420

Cardiac Rehabilitation Teams and Cardiology Specialist Nurses
Fairfield General Hospital - 0161 778 2450
North Manchester General Hospital - 0161 720 2395
Royal Oldham Hospital - 0161 627 8059

British Heart Foundation
Heart Helpline: 0300 330 3311 or email hearthelpline@bhf.org.uk
www.bhf.org.uk

DVLA
DVLA drivers medical enquiries - 0300 790 6806
www.dvla.gov.uk

NHS Choices
Helpline - 0845 606 4647
www.nhs.uk
 
Stop Smoking
NHS smokefree national helpline - 0300 123 1044

Local smoking cessation numbers

Rochdale, Heywood and Middleton - 01706 751190
Bury - 0161 253 7575
Oldham - 0161 960 0255
In Greater Manchester contact your GP receptionist for further information

Diabetes UK
Diabetes care line - 0345 123 2399
www.diabetes.org.uk