Coronary Angiogram

1 What is a Coronary Angiogram?

A coronary angiogram is a procedure that utilizes X-ray imaging to see the heart's blood vessels.

Coronary angiograms are part of a general group of procedures known as heart catheterization. Heart catheterization procedures can be used in both the diagnosis and treatment of heart and blood vessel conditions.

A coronary angiogram, which can help diagnose heart conditions, is the most common type of heart catheterization procedure. During a coronary angiogram, a type of dye that is visible on an X-ray machine is injected into the blood vessels of your heart.

The X-ray machine takes a series of images (angiograms) rapidly, offering a detailed look at the inside of your body blood vessels.

If necessary, you doctor can perform procedures such as an angioplasty during your coronary angiogram.

2 Reasons for Procedure

Your doctor may recommend a coronary angiogram for the following reasons:

Symptoms of coronary artery disease

Pain in your

  • chest,
  • jaw,
  • neck,
  • arm

that cannot be explained by other tests.

Heart failure

A heart vale problem that requires surgery. Other blood vessel problems or a chest injury. A heart defect you were born with (congenital heart disease).

You may also need an angiogram if you are going to have surgery unrelated to your heart, but you are at a high risk of having a heart problem during that surgery.

Angiograms are usually done following nonevasive heart tests have been performed, such as electrocardiogram, an echcardiogram or a stress test.

3 Potential Risks

Although in coronary angiogram procedure major complications are rare, potential risks may include:

  • Heart attack.
  • Stroke.
  • Irregular heart rhythms.
  • Injury to the catheterized artery.
  • Allergic reactions to the dye or medications used during the procedure.
  • A tear in your heart or artery.
  • Infection.
  • Kidney damage.
  • Radiation exposure from the X-rays.
  • Kidney damage.

4 Preparing for your Procedure

In preparing for your coronary angiogram, you must follow your doctor’s orders. 

Sometimes coronary angiograms are performed on an emergency basis.

Commonly, though they are scheduled in advance, giving you enough time to prepare for them. Angiograms are performed in the catheterization (cath) lab of a hospital.

Usually, you go to the hospital in the morning of your procedure. You will be given specific instructions by your healthcare team and they will also talk to you about any medications you take.

General guidelines include the following:

  • Do not eat or drink anything after midnight the day before your angiogram, as angiograms are scheduled in the morning hours.
  • Take all your medications to the hospital  with you in their original containers.
  • If you have diabetes, ask your doctor if you should take insulin or any other oral medication before your angiogram.

Before your angiogram procedure begins, your health care team will review your medical history, including allergies and medications you take. The team may also perform a physical exam and check your vital signs. You then empty your bladder and change into a hospital gown. You may also be told to remove contact lenses, eye glasses, and hairpins.

5 What to Expect

Read on to learn more about what to expect before, during, and after your coronary angiogram.

During the procedure

You lie on your back on an X-ray table for the procedure. The table may be tilted during the procedure, safety strap may be fastened across your chest, as well as your legs. X-ray cameras may move over and around your head and chest to take pictures from many angles.

An intravenous lie is then inserted into a vein in your arm. You may be given a sedative through IV to relax you, as well as other medications and fluids. You will be conscious during the procedure so that you can follow instructions.

Throughout the procedure, you may be asked to take deep breaths, hold your breath, cough or place your arms in different positions.

Electrodes placed on your chest monitor your heart throughout the procedure. A blood pressure cuff keeps track of our blood pressure and another device called an oximeter, measures the amount of oxygen in your blood.

You may be given anticoagulants to prevent your blood from clotting on the catheter and in your coronary arteries. Some hair (small amount) may be shaved from your groin or arm where the catheter is to be inserted. The area is washed and disinfected and then numbed with an injection of local anesthetic.

A small incision is made at the entry site, and a short plastic tube (sheath) is inserted into your artery. The catheter is inserted through the sheath into your blood vessel and carefully threaded to your heart or coronary arteries. Threading the catheter shouldn't cause pain, and you shouldn't feel it moving through your body.

Tell your healthcare team if you experience any discomfort. Dye (contrast material) is then injected through the catheter. When this happens, you may have a brief sensation of flushing or warmth. But again, tell your health care team if you feel pain or discomfort.

The dye is easy to see on X-ray images, and as it moves through your blood vessels, your doctor can observe its flow and identify any blockages or constricted areas.

Depending on what your doctor discovers during your angiogram, you may have additional catheter procedures at the same time, such as a balloon angioplasty or a stent placement to open up a narrowed artery.

Having an angiogram takes about one hour, although it may be longer, especially if combined with other heart catheter procedures. Preparation and post-procedure care can add more time.

After the procedure

When the angiogram is over, the catheter is taken out from your arm or groin and the incision are closed with manual pressure, a clamp or a small plug. You'll be taken to a recovery area for observation and monitoring.

When your condition is stable, you return to your own room, where you're monitored regularly. You'll need to lie flat for several hours to avoid bleeding. During this time, pressure may be applied to the incision to prevent bleeding and promote healing. You may be able to go home the same day, or you may have to remain in the hospital for a day or longer.

Drink plenty of fluids to help flush the dye from your body. If you're feeling up to it, have something to eat. Ask your health care team when you should resume taking your medications, bathe or shower, return to work, and resume other normal activities.

Avoid strenuous activities and heavy lifting for several days. Your puncture site is likely to remain tender for a while. It may be slightly bruised and have a small bump. Call your doctor's office if:

  • You notice bleeding, new bruising or swelling at the catheter site
  • You develop increasing pain or discomfort at the catheter site
  • You have signs of infection, such as redness, drainage or fever
  • There's a change in temperature or color of the leg or arm that was used for the procedure
  • You feel faint or weak
  • You develop chest pain or shortness of breath

If the catheter site is actively bleeding or begins swelling, apply pressure to the site and contact emergency medical services.

6 Procedure Results

Understanding the results of your coronary angiogram will be made possible by your doctor.

An angiogram will make it possible for doctors to determine what is wrong with your blood vessels. It can:

  • Show how many of your coronary arteries are blocked or narrowed by fatty plaques (atherosclerosis).
  • Pinpoint where blockages are located in your blood vessels.
  • Show how much blood flow is blocked through your blood vessels.
  • Check the results of a previous bypass surgery.
  • Check the blood flow through your heart and blood vessels.

Having knowledge about this information will enable your doctor to determine what treatment is the best for you and how much danger your heart condition poses to your health.

Based on your results, your doctor may decide, for example, that you would benefit from having coronary angioplasty to help unclog blocked arteries. It is also possible that angioplasty or stenting could be done during your angiogram to avoid needing another procedure.

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