An angiogram is a medical imaging procedure that uses a catheter and X-rays to visualize blood vessels, most commonly to examine the arteries of the heart. A thin, flexible catheter is inserted into an artery, usually in the wrist or groin, and guided to the area of interest. A contrast dye is injected, allowing doctors to see how blood flows and identify any blockages or abnormalities. Guidance on safely returning to physical activity depends entirely on allowing the artery puncture site to fully heal.
Immediate Post-Procedure Precautions
The first 24 to 48 hours following an angiogram are the most critical period for preventing complications like bleeding from the access site. Precautions differ based on whether the catheter was inserted through the femoral artery (groin) or the radial artery (wrist). The femoral approach requires strict bed rest, typically four to six hours, where patients must lie flat to maintain pressure and ensure the artery seals properly.
Patients with radial artery access generally have a shorter recovery period and may be able to sit up sooner. However, movement of the affected arm is restricted, often requiring a wrist brace to prevent deep bending or straining. Regardless of the access site, all patients must avoid lifting anything heavier than 5 to 10 pounds for the first few days, as this exertion increases blood pressure and compromises the healing of the arterial puncture.
Resuming Light Daily Activity
Once the initial recovery period is over, the focus shifts to gradually reintroducing light daily movement without stressing the healing puncture wound. Walking short distances around the house or on a flat surface is encouraged soon after initial bed rest, as it helps promote circulation and overall recovery. If the groin was used, limit climbing stairs for the first one to two days, or ascend slowly by leading with the leg that was not used for the procedure.
Driving requires caution, as the physical demands of operating a vehicle can strain the access site. The recommendation for resuming driving is typically 24 to 48 hours after an angiogram, though this depends heavily on the specific access site. This light activity is necessary movement, not exercise, and patients should listen closely to their body to prevent any premature strain.
Timelines for Strenuous Exercise
The primary concern with strenuous exercise is the rapid increase in heart rate and blood pressure, which places undue stress on the artery that is trying to close itself. Most healthcare providers recommend avoiding heavy lifting, intense cardio, running, or any exercise that causes significant straining or breath-holding for at least five to seven days following the procedure. This period allows the small plug or closure device applied to the artery to achieve complete and stable healing, minimizing the risk of internal bleeding or forming a large hematoma.
Heavy lifting is specifically defined as anything over 10 pounds and should be avoided for a full week, especially if the procedure involved the groin. Activities that involve immersing the puncture site in water, such as swimming, taking a bath, or using a hot tub, must be avoided for one to two weeks, or until the external wound is completely closed. Soaking the wound before it is fully healed creates a direct path for bacteria to enter, leading to a risk of infection. When returning to exercise after the initial restriction period, it is important to start slowly and gradually increase the intensity, always stopping if any pain or discomfort is felt.
Warning Signs Requiring Medical Attention
It is important to monitor the access site closely for any signs that a complication may be developing, which would necessitate immediate medical attention. Excessive bleeding from the puncture site, where blood saturates the dressing or does not stop with firm pressure, is a serious concern. A rapidly growing or painful lump at the incision site, which may indicate a hematoma or pseudoaneurysm, also requires urgent evaluation.
Other complications to watch for include signs of infection. These signs include fever, increasing pain, swelling, warmth, or discharge from the wound. Furthermore, a change in the color, temperature, or sensation of the extremity used for access can signal a problem with blood flow. This includes symptoms like severe pain, numbness, or the limb feeling cold or looking pale. Any new or worsening chest pain or shortness of breath should also prompt immediate contact with a healthcare provider.