Table 3

Variations in descriptions of risk by two different cardiologists (acute cases). P (patient); C (cardiologist)

Detailed risk description
(female acute patient 19 (P); cardiologist 7 (C):hospital 1)
Less detailed risk description (female acute patient 24 (P); cardiologist 15 (C):hospital 2)
C: "On average the risks of stretching an artery and putting a stent is about 1% or 2% risk. So one or two people in a 100 of us causing a problem, of causing a heart attack. On average the sorts of narrowing that we would treat would have a high risk of causing a heart attack if we didn’t treat. So there’s some risk for the procedure but there is as much or more risk without the procedure. There are other risks that I mentioned before things like strokes, allergic reactions, kidney problems are still very rare. So there’s still less than a 1% likelihood. So overall your risk of any major problems, stroke, heart attack, life threatening problem and dying from the procedure is very unlikely. The risk of us causing a bit of injury to a heart though and triggering a heart attack is maybe about 1% or 2%. It’s not usually a life changing event but it can happen during the procedure. We quote with an angioplasty about a 1 in 1000 risk of needing a bypass as an emergency. That’s still the case for you even though you’ve had a bypass because occasionally the catheter might injure the artery and you might need something done quite quickly, which might need surgery rather than stents. But it is very, very rare and it is 1 in 1000 less that needs that.
P: "Okay, yes."
C: "As in any procedure, there is always a risk.
P: "Just …just don’t burst my artery that is all [laughs].
C: "You do know…yes, certainly, you do know one of the risks but there are several risks but the risks are very small.
P: "Yes.
C: "So the risks are one, as you said, you can have bleeding from either the site, from the groin or from the arm; there is a small risk of you having a stroke or a heart attack during the procedure, it is very tiny.
P: "Yes.
C: "There is a tiny risk that the contrast that we inject can cause impairment of your kidney but that usually recovers in a few days with fluids. Very few people are allergic to contrasts, not many, but of course the benefit of this thing is tremendous, if you do have a blockage. The benefit of doing this procedure is tremendous, that is why we go ahead and do it."