- Coronary angiography (an-jee-OG-rah-fee) is a test that uses contrast and special x-rays to show the insides of your coronary arteries. The coronary arteries supply oxygen-rich blood to your heart.
- A waxy substance called plaque (plak) can build up inside the coronary arteries. The buildup of plaque in the coronary arteries is called coronary heart disease (CHD).
- Over time, plaque can harden or rupture (break open). Plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina (an-JI-nuh or AN-juh-nuh).
- If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. This is the most common cause of a heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries.
- During coronary angiography, special dye is injected into the bloodstream. The dye makes the coronary arteries visible on x-ray pictures. This helps doctors see blockages in the arteries.
- A procedure called cardiac catheterization (KATH-eh-ter-ih-ZA-shun) is used to get the dye into the coronary arteries.
- Cardiac catheterization rarely causes serious complications.
INSTRUCTIONS
- Don’t eat or drink anything after midnight the day before your angiogram.
- Take all your medications to the hospital with you in their original bottles. Ask your doctor about whether or not to take your usual morning medications.
- If you have diabetes, ask your doctor if you should take insulin or other oral medications before your angiogram.
- Talk to your doctor about whether you have diseases or conditions that may require taking extra steps during or after the test to avoid complications. Example of such a condition is kidney disease.
- Your doctor will tell you exactly which procedures will be performed. For example, your doctor may recommend percutaneous (per-ku-TA-ne-us) coronary intervention (PCI) (coronary angioplasty) if the angiography shows a blocked artery.
- You will have a chance to ask questions about the procedures. Also, you’ll be asked to provide written informed consent to have the procedures.
HOW THE PROCEDURE IS PERFORMED
- During coronary angiography, you’re kept on your back and awake. This allows you to follow your doctor’s instructions during the test. You’ll be given medicine to help you relax. The medicine might make you sleepy.
- Electrodes on your chest monitor your heart throughout the procedure. A blood pressure cuff tracks your blood pressure and another device, a pulse oximeter, measures the amount of oxygen in your blood. You may receive medication (anticoagulants) to help prevent your blood from clotting on the catheter and in your coronary arteries.
- A small amount of hair 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. Your doctor will numb the area on the arm, groin (upper thigh), or neck where the catheter will enter your blood vessel. Then, he or she will use a needle to make a small hole in the blood vessel. The catheter will be inserted in the hole.
- Next, your doctor will thread the catheter through the vessel and into the coronary arteries. Contrast material is 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.
- Special x-ray movies are taken of the catheter as it’s moved into the heart. The movies help your doctor see where to place the tip of the catheter.
- Once the catheter is properly placed, your doctor will inject a special type of contrast into the tube. The contrast will flow through your coronary arteries, making them visible on an x-ray. This x-ray is called an angiogram.
- If the angiogram reveals blocked arteries, your doctor may use PCI to restore blood flow to your heart.
- 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
- After your doctor completes the procedure(s), he or she will remove the catheter from your body. The opening left in the blood vessel will then be closed up and bandaged.
- You’ll be taken to a recovery area for observation and monitoring. When your condition is stable, you’ll return to your own room, where you’re monitored regularly. You’ll need to lie flat for several hours to avoid bleeding.
- A small sandbag or other type of weight might be placed on the bandage to apply pressure. This will help prevent major bleeding from the site.
- 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
RISKS
- As with most procedures done on your heart and blood vessels, a coronary angiogram has some risks. Major complications are rare, though. Potential risks and complications include:
- heart attack
- stroke
- injury to the catheterized artery
- irregular heart rhythms (arrhythmias)
- allergic reactions to the dye or medications used during the procedure
- a tear in your heart or artery
- kidney damage
- excessive bleeding
- infection
- radiation exposure from the x-rays
- There may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand why the procedure is recommended and what the potential risks are.
