Percutaneous Transluminal Coronary Angioplasty (PTCA)

Discharge Instructions

Medications

Your physician may order medication(s) for you to take after your PTCA procedure. If a stent has been inserted, these medications may include, but are not limited to, blood-thinning medications such as aspirin, ticlopidine (Ticlid), or Clopidogrel (Plavix). Prior to your leaving the hospital, you will be given a list of medications that are being ordered by your physician, and your nurse will explain the dose, medication schedule, and possible side effects. delete to you. You will also be given prescriptions to take to your pharmacy.

It is important to note that if aspirin, Ticlid, or Plavix are prescribed for you, you will need to follow the instructions closely:

• Take the medication with food to avoid stomach discomfort.
  
  
• Use extra caution when shaving or using sharp objects, as these medications affect the blood's ability to clot. Any breaks in the skin may bleed more than usual.
  
  
• Any occurrence of one or more of the following should be reported to your physician immediately:
  
  
  • any unusual blood from your gums or mouth
    
    
  • any coughing up or vomiting of blood
    
    
  • any dark maroon-colored or tarry bowel movements
    

Even though your pharmacist may recommend that you do not take aspirin and Ticlid at the same time, do take the medications as ordered in order to prevent any clotting at the stent site.

Risk Factors

There are three primary risk factors for coronary artery disease and heart attack:

• high blood cholesterol levels
  
• high blood pressure (hypertension)
  
• cigarette smoking

Additional risk factors include:

• diabetes
• obesity
• a sedentary lifestyle (lack of exercise)
• stress
• a family history of heart disease

Your physician and nurse will help you to identify the risk factors that apply to you and assist you in making changes in your lifestyle to reduce the effects of those risk factors.

Some important lifestyle changes may include:

• a low-fat, low-cholesterol diet
• an exercise regimen
• smoking cessation classes
• relaxation techniques to reduce stress

You should discuss any lifestyle changes with your physician, particularly when beginning an exercise program.

Diet

Your physician may recommend that you follow a low-cholesterol, low-fat diet. If you have questions about any dietary changes, ask if a dietitian is available to assist you in understanding your new food plan. You will be given materials to help you plan your meals.

Activity

Your physician will instruct you as to when you can return to your usual daily routine. The period of time before returning to normal activities may range from two to three days to a longer period, depending on whether you have had heart damage from a heart attack. Your physician will give you specific instructions. In addition, you should not do any lifting until your physician advises you to do so.

Sexual Activity

Your physician will instruct you as to when you may resume sexual activity.

Bath Care

Once you are out of bed, you will most likely be allowed to take a shower. Some precautions related to taking a shower for the first few days after a PTCA procedure may include, but are not limited to, the following:

• You may use your usual soap and water. However, do not scrub or apply pressure at the site in the groin or arm where the catheter was inserted.
  
  
• Remember to pat the catheter site dry with a towel and do not rub.
  
  
• You should not take a tub bath for the period of time your physician specifies, which may be for a week after your procedure. Sitting in a tub of water, which includes a hot tub, can cause infection at the catheter site.

Site Care

• Pat the catheter site dry after taking a shower, instead of rubbing.
  
  
• Keep the site clean and dry by placing a Band-aid® on it until it is healed.
  
  
• You should change the Band-aid® every day until healing occurs.
  
  
• Check the site at least once a day. Report any additional bruising, swelling, drainage, redness, or warmth at the site to your physician immediately.
  
  
• It is not unusual to see bruising around the catheter site, or even a raised, hard, bruised area, called a hematoma. Bruising and hematomas usually fade away within a week or two.

Driving a Vehicle

Your physician will give you instructions as to when you may resume driving. It is very important that you make arrangements for someone to drive you home from the hospital following your procedure.

Return to Work

Your physician will give you instructions as to when you may return to work. The type of work you do, as well as your health condition and degree of recovery will affect the physician's decision as to how long you will need to remain out of work.

Office Visit

Your physician will schedule a follow-up office visit within a week to a month after your procedure. Your condition and the extent of any heart damage will determine the length of time until your appointment.

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging (MRI) is a diagnostic procedure used for many different conditions. Because of the magnet used in the MRI machine, the presence of metal in or on a patient can affect the quality of the test. If you receive a stent, you may still undergo MRI without damage to your stent. Your physician will most likely suggest that you not undergo an MRI for a month or so after your PTCA, unless there is an emergency situation.

Warning Signs/Symptoms to Monitor

The presence of any of the following warning signs should be reported to your physician immediately:

• chest pain/pressure, nausea and/or vomiting, profuse sweating, dizziness and/or fainting
  
  
• any symptoms in the leg or arm where the catheter was inserted, such as pain, coolness, numbness, and/or weakness
  
  
• bleeding from the catheter site in the groin or arm, increased pain at the site, or increased bruising and/or hematoma

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