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Coronary Angiography


Coronary angiography is a procedure that uses a special dye (contrast material) and X-rays to see how blood flows through the arteries in your heart. Cardiac angiography is also known as Heart Angiography or Coronary Angiogram.

How is the test performed?

  • Coronary angiography is usually done along with cardiac catheterisation.
  • Before the test starts, you might be given a mild sedative to help you relax.
  • An area of your body, usually the arm or groin, is cleaned and numbed with a local numbing medicine (anaesthetic). The cardiologist passes a thin hollow tube, called a sheath is placed in the area. After this a catheter goes through the sheath into the artery and carefully moves it up into the heart. X-ray images help the cardiologist position the catheter.
  • Once the catheter is in place, dye (contrast material) is injected into the catheter. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages in blood flow.
  • The procedure may last 10 to 15 minutes.

How to prepare for the test?

  • You should not eat or drink anything for 4 hours before the test starts. You may need to stay in the hospital the night before the test in special situations. Most of the time you will check into the hospital in the morning of the day the test is scheduled for.
  • You will wear a hospital gown. You must sign a consent form before the test. Your healthcare provider will explain the procedure and its risks.
  • Tell your cardiologist if you have allergies, if you have had a bad reaction to contrast material in the past, or if you might be pregnant.

How will the test feel?

  • You will usually be awake during the test. You may feel some pressure at the site where the catheter is placed.
  • You may feel a flushing or warm sensation after the dye is injected.
  • After the test, the catheter is removed. You might feel a firm pressure at the insertion site, used to prevent bleeding. If the catheter is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding.

Why is the test performed?

Coronary angiography is performed if you have, or are suspected to have, coronary heart disease. Your doctor may recommend that you have the test if:

  • You have chest pain that your doctor suspects is caused by narrowed coronary arteries, but he or she wants to be sure
  • Your doctor wants to assess the degree of narrowing in your coronary arteries to see if you could benefit from a procedure such as angioplasty or bypass surgery, to relieve your symptoms and reduce your risk of further heart problems
  • You have had a heart attack—if you had treatment to dissolve the clot blocking your coronary artery, or you have continuing chest pain, or the results of an exercise test indicate the need for further investigation, your doctor will need detailed information about your heart and arteries.
  • Before surgery of valvular lesions

What does a normal result mean?

It means that there is normal supply of blood to the heart and there are no blockages.

What do abnormal results mean?

An abnormal result may mean you have a blocked artery. The test can show how many coronary arteries are blocked, where they are blocked, and the severity of the blockages.

What are the risks associated with the procedure?

Cardiac catheterisation carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.

Generally the risk of serious complications ranges from 1 in 1,000 to 1 in 500. Risks of the procedure include the following:
  • Irregular heart beats
  • Injury to a heart artery
  • Low blood pressure
  • Allergic reaction to contrast dye
  • Stroke
  • Heart attack
Considerations associated with any type of catheterisation include the following:
  • There is always a very small risk that the soft plastic catheters could actually damage the blood vessels.
  • The contrast dye could damage the kidneys (particularly in patients with diabetes).

What if a blockage is found in the results?

If a blockage is found, your healthcare provider may perform a Percutaneous Coronary Intervention (PCI) to open the blockage. This can be done during the same procedure, but may be delayed for various reasons. If there are multiple blockages then your cardiologist will refer you to a Surgeon.

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