Coronary Angiogram Test and Procedure
Overview
A coronary angiogram uses X-ray images to check for issues in the heart’s blood vessels, called coronary arteries. This test often looks for areas that might be narrowed or blocked, which can affect how well the heart works. Doctors use it as one of the main ways to find out if someone has a problem with their heart’s blood supply, such as coronary artery disease.
The process is an important part of a set of heart procedures known as cardiac catheterization. During angiography, a doctor inserts a thin tube (catheter) through a small cut in the arm or groin. The doctor guides the tube to the heart and injects a contrast dye, which makes the blood vessels easy to see on the X-ray images.
Common Reasons for Angiograms:
- Check for blocked or narrow arteries
- Investigate chest pain
- Plan for heart treatments
A table to show different types of coronary angiograms:
| Test Type | Uses a Catheter? | Treats Blockages? |
|---|---|---|
| Standard Angiogram | Yes | Yes |
| Coronary CT Angiogram | No | No |
During a standard angiogram, doctors may also fix blockages with angioplasty or place stents, which cannot be done with a CT angiogram.
Purpose of the Test
Doctors often recommend a coronary angiogram when someone has symptoms like chest pain (angina), unexplained pain in the jaw, neck, or arms, or if other tests (such as a stress test) gave unusual results. It may also be used when there are blood vessel problems, heart valve disease needing surgery, or a congenital heart condition.
Common Reasons
| Symptom/Condition | Why it’s relevant |
|---|---|
| Chest pain (angina) | Checks for blocked arteries |
| Heart attack symptoms | Finds the cause of symptoms |
| Irregular stress test results | Confirms or rules out disease |
| Known coronary artery disease | Assesses the severity |
Additional Details
Related health issues can include:
- Heart attack
- Angina
- Coronary artery disease
- Mitral valve prolapse
- Sudden cardiac arrest
Possible Dangers
A few risks can happen during or after a coronary angiogram. Some possible problems include:
- Blood vessel damage
- Heavy bleeding
- Infection
- Heart attack
- Arrhythmia (irregular heartbeat)
- Kidney injury from the dye
- Allergic reactions to the dye or medicines
- Stroke
Most complications rarely occur, but they are possible.
Getting Ready for the Procedure
Before the test, patients should avoid eating or drinking for several hours. The healthcare team will let them know the exact time to stop. Patients should share a full list of current medicines and their amounts. The team may ask patients to adjust certain medications, especially if they have diabetes.
Reviewing any medical history with the care team helps prevent issues. Usually, the groin or arm serves as the site where the team places the catheter. Wearing comfortable clothing and arranging a ride home can be helpful. The team offers clear instructions to help patients feel prepared.
What You Can Expect
Steps Before Your Exam
Most coronary angiograms take place in a special room called a cath lab. Before the procedure, the care team will talk to the patient about current medications and ask about any allergies. Patients will need to change into a hospital gown and remove all personal items such as jewelry, contact lenses, and glasses.
A restroom visit is usually needed beforehand. Next, the team will record blood pressure and pulse. They put sticky pads called electrodes on the chest, and sometimes on the arms or legs, to keep track of the heartbeat throughout the process.
In many cases, the team shaves, cleans, and numbs a small area of skin (usually on the wrist or groin) where the catheter will be inserted. This helps prepare for a safe and smooth procedure. Here is a basic checklist before the test:
| Step | Action |
|---|---|
| Discuss medicines & allergies | Inform about current drugs and any allergies you have. |
| Dress for the test | Change into a hospital gown, remove personal items. |
| Monitoring setup | Electrodes placed on skin for heart tracking. |
| Prep catheter site | Area shaved, cleaned, and numbed. |
During Your Test Procedure
During the angiogram, the care team makes the patient comfortable on a table with straps across the chest and legs to stay steady. A member of the team puts an IV into the arm or hand to give medicine that keeps the patient calm and relaxed. Some patients remain fully awake, while others may feel sleepy or even fully asleep, based on how much medicine is needed.
After numbing the skin, the doctor makes a small cut (an incision), usually in the wrist or groin. The doctor carefully inserts a thin, flexible tube called a catheter into a blood vessel and guides it toward the heart. The patient might feel some pressure, but usually no pain.
The doctor sends a special dye through the catheter into the heart’s blood vessels. Then, X-ray pictures are taken to see how the dye moves through these vessels. If a section does not show the dye moving properly, it might mean the artery is narrowed or blocked.
Sometimes, if the doctor finds a blockage, they may use the catheter to fix it. This can involve inflating a small balloon or placing a stent (a small mesh tube) to keep the artery open. Once finished, the doctor removes the catheter and closes the incision site with a clamp or tiny plug. The typical sequence during the test:
- Placement of straps and monitoring equipment.
- Administration of sedative through IV.
- Small incision made in wrist or groin.
- Catheter inserted and guided to the heart.
- Injection of dye and use of X-ray imaging.
- Blockages may be treated with additional steps.
- Catheter removed, and incision closed.
The procedure usually lasts from 30 minutes up to 2 hours, depending on if extra tests or treatments are needed.
What To Do After Test
After the angiogram, the care team brings the patient to a recovery area for careful observation. They closely watch heart rate, blood pressure, and oxygen levels for a period of time. If the catheter was put in the leg, the patient needs to lie flat without moving the leg for several hours to avoid bleeding.
The area where the catheter entered might feel sore, show a bruise, or develop a small lump for a short time. Some people can leave the hospital the same day, while others may stay overnight depending on the results and overall health. During recovery, the care team will share clear aftercare instructions.
General Recovery Guidelines
- Drink lots of fluids to help clear the dye out of your system.
- Avoid lifting heavy things or doing tough exercise for several days.
- Ask the care team when it is safe to bathe or shower again.
- Take any medicines exactly as directed by the medical providers.
When To Contact the Healthcare Team
- Chest pain or new shortness of breath.
- Bleeding, swelling, or increasing pain at the catheter site.
- Signs of infection, including fever or unusual drainage.
- Change in color, temperature, or feeling in the arm or leg used.
- Weakness or numbness in the limb used for the test.
If bleeding from the catheter site will not stop even with firm pressure, call 911 or your local emergency number right away. The care team will tell patients when they can return to work or normal activities. If there are any new or unusual symptoms, contact a healthcare professional promptly.
Findings
An angiogram gives detailed images of blood vessels in the heart. It helps to find if any of the heart arteries are blocked or narrowed. Doctors look at these results to see how well blood is flowing and if there is a buildup of substances such as fat or cholesterol.
Key Points from the Procedure
- Any narrowing or blockage in the arteries is noted.
- Reduced blood flow is measured.
- Presence of atherosclerosis is detected.
- Outcomes of earlier surgeries are checked.
| Test Aspect | What Is Evaluated |
|---|---|
| Blood vessel status | Blockage or narrowing |
| Blood flow | If it is enough for heart needs |
| Deposits in arteries | Fat, cholesterol, other substances |
| Past surgery results | If surgical repairs are working |
