Angiogram and anticoagulants

I have to have an angiogram to determine whether I have angina or something like costachondritis. Will I need to stop taking Apixaban beforehand given that there is a risk of internal bleeding from the procedure? Is the procedure painful or uncomfortable?

[Hidden]

On the first part of your question I have no idea, I'd speak to your surgeons secretary if I were you and ask the question.The angiogram is not painful in any way.

The table you lay on isn't the most comfortable of things, in all honesty the ache on my back and bum after half an hour was getting to more than the occasional twinge I felt in my arm.

There's that much going on to distract you and the TV to watch showing the procedure the time flys by.

[Hidden in reply to Hidden]

Thanks for the reply. I had a call shortly after I posted to say they would do blood tests and discuss 5 days before the procedure, so I may have the chance to ask then. They did say there were risks associated with the procedure.

[ChoochSiesta in reply to Hidden]

There are also risks in not doing the procedure. It does take time to get your head around all this stuff. It's not easy.

[Hidden in reply to ChoochSiesta]

I just watched a YouTube video on the procedure and felt anxious just watching!

[ChoochSiesta]

I was told to take 8 Aspirin the day before as well as Clopidogrel.

[Hidden in reply to ChoochSiesta]

Thanks for your reply. Were you given a sedative?

[ChoochSiesta in reply to Hidden]

Just Fentolyn.

[Classicfan49]

I’d certainly expect to come off the anticoagulants, as they were very careful after my procedure to prevent further bleeding from where the canula was inserted. I wasn’t on anticoagulants at the time but I had a very impressive bruise at the sight of the insertion! (Not at all painful, but colourful.) i had to stay in hospital for some hours and be monitored. I was also told to have someone at home with me for 24 hours and to raise the alarm if I started to bleed. None of these things happened, but excessive blood loss is clearly something they watch for and is a possibility. Make absolutely sure they are aware you’re on anticoagulants.The whole experience for me was absolutely fine, not painful and rather interesting.

[Hidden in reply to Classicfan49]

Thanks for replying.

[Qualipop]

I doubt it very much. When I had my second one I had been on ticagrelor which made me so breathless it was frightening. As my GP had refused to change it, I stopped taking it about 3 days before I saw the cardiologist. He went up the wall and had to give me a big loading dose of clopidogrel before he could do the angiogram. Just give them a ring and ask but I'm pretty sure you will have to stay on your meds. NO it's not at all painful apart from lying on a hard metal trolley. Yes you will get a sedative. You may or may not be allowed to watch the monitors. I wasn't and I was really annoyed. I felt absolutely nothing, not even when they fitted the catheter into my wrist; back to recovery ward with a pressure bandage on my wrist which is eased of gradually and tea and toast provided. First one I had stents fitted; second one nothing done. Went in at 9 am, left at 12 and was home, an hour away by 1pm. Nothing to worry about at all. Remember they are doing this day in day out. Sure there are risks; there are risks in having a tooth filled, risks in getting to the hospital. They have to tell you that but there are probably bigger risks in not having it done.

[Hidden in reply to Qualipop]

Thanks for replying. Do you know if they plan in advance for the possibility that they might have to fit stents, or can they decide to do this on the spur of the moment? So far as I know mine is just investigational. Also, what level of consciousness of the procedure do you have when sedated?

[ChoochSiesta in reply to Hidden]

If they have the capability they will plan to stent immediately.

[Qualipop in reply to Hidden]

NO they can't possibly know in advance whether they will need to fit stents. It depends on what they find. That's the whole reason for the angiogram; to see if there is any furring of the arteries which could be restricting blood flow. The first I had was to open up a 99% blockage which had caused the heart attack. My second one was to investigate two more possible blockages that they had noticed but didn't have time to fix right then. Those turned out to be around 64% blocked but the angio showed that enough blood was getting through quite easily and the medication I was given should be keeping that stable. The amount of sedation depends on your level of anxiety and the cardiologist's preference. I was awake and pretty much aware of what they we re doing but I couldn't care less. They will keep a check on your BP and heart rate to see how much your anxiety is affecting it and can always top you up if necessary.After my first one I had a gigantic bruise from my wrist to my elbow because the nurse afterwards released the pressure bandage a bit too soon. Not a problem, just unsightly but it didn't hurt. Second time there wasn't even a pin prick mark where they put the catheter in my wrist. No bruising, no discomfort, nothing at all.

[Hidden in reply to Qualipop]

I realise they wouldn't know in advance whether a stent is needed. I was wondering whether-if they discovered a stent was needed when they conducted the angiogram-they would do it there and then or wait and conduct a seperate procedure at a later date?

[Qualipop in reply to Hidden]

Yes they would usually do it right away ; they did with mine. Mine was always going to be pretty obvious after a heart attack but the attack could have been caused by something else, it's not always a blockage. They will have a suspicion of what may be wrong before they start which is obviously why you've been sent for an angiogram. If they find a blockage that can be easily stented, they would do it However, not all blockages are in a place or of a size that can be fixed with a stent in which case they would make other plans and tell you. They didn't stent my other two blockages because they w ere along an artery they weren't investigating. After a heart attack they just do what's essential to fix the problem so I went back later to investigate the other artery.