A coronary angiography, also known as a coronary angiogram, is a procedure performed using x-rays imaging to view and evaluate the heart’s blood vessels. The goal of the procedure is to ascertain if the blood is flowing seamlessly from the heart to the rest of the body or if the blood vessels have a deformity like blockage or narrowing. A coronary angiography aids in identifying the severity of any heart condition, and is a part of a group of cardiac procedures known as heart catheterizations.
Why a Coronary Angiography is Done
A coronary angiography is recommended by your cardiologist if:
- You have a congenital heart disease
- You have symptoms of a cardiac episode which may include chest pain, neck pain, and jaw pain
- You have valve problems
- You have angina for the first time
- You experience heart failure
- Your heart stress test is abnormal
Benefits of Coronary Angiography
Some cardiac conditions are best diagnosed using coronary angiography because the X-rays done can clearly indicate what is affecting the flow of blood from the heart vessels. Additionally, other procedures such as angioplasty or stent installation can be safely performed at the same time as the coronary angiography.
For individuals diagnosed with any heart condition or aneurysm (weakness of the blood vessels wall causing a protrusion), the procedure plays a big role in helping the cardiology know which form of treatment to recommend. Also, birth defects, such as having a hole in the heart, can also be identified using coronary angiogram.
Preparing for a Coronary Angiogram
Before the coronary angiogram procedure, the cardiologist will first use a CT scan or MRI to pinpoint any complications that the heart may have. The doctor will also inquire about the medical history of the patient, advice on the medications to stop, and have knowledge on the allergies of the patient. The patient is advised not to eat anything for 8 hours before the procedure.
What to Expect During the Coronary Angiography
Before the procedure commences, the patient may be asked to empty his/her bladder. They will then change into a hospital gown and will be required to remove any jewelry including watch and hair pins.
The patient will then be required lay on the x-ray table; a sedative will be administered to help in relaxation. The procedure is usually done through the groin or arm, and the area chosen is numbed with a local anesthesia. The vital signs of the patient such as blood pressure and heart rate will be monitored during the procedure.
A needle is injected in the artery, then a catheter (a thin tube with a camera attached to it) is passed through the needle into the artery. The doctor will be able to view the entire process on a screen.
A dye is then injected through the catheter to show the blood flow as the x-ray of the arteries is being taken. This detects any problems with the vessels. After the dye is injected, the patient may feel a flushing sensation.
If any abnormalities such as blocked arteries are detected, they can be opened with a balloon or a stent (a small tube). For blood clots the doctor will dissolve them.
When the procedure is complete, the catheter will be removed, and the patient will feel some slight pressure and warmth. The doctor will then apply pressure on the incision to stop any bleeding.
Coronary angiography procedure when done together with stent installation may take a while longer than when done on its own, which lasts from 30 minutes to an hour.
Recovery and Care
After the coronary angiography procedure, the patient will not go home immediately. He/she will be monitored in a recovery room where he/she will lie down flat to avoid bleeding at the area where the catheter was inserted.
Vital signs will continue to be monitored such as blood pressure and heart rate, and the patient will remain in the recovery room for several hours or until the next day. It is recommended that the patient drinks plenty of fluids to flush out the dye from the body. Intravenous fluids may be given if the patient is unable to drink or eat by him/herself.
The test results may take up to a week depending on the complexity of the patient’s condition. The results can be explained over the phone by your doctor if they are not complex; however the doctor will always require that the patient visits the hospital for a detailed explanation.
Possible Complications of a Coronary Angiography
Coronary angiography is considered fairly safe if done by an experienced team. Some of the risks may include but are not limited to:
- Pain and swelling at the injection area
- Bruising and tenderness caused by the insertion of the catheter, but this should heal after few weeks
- Low blood pressure
- Heart arrythmia (irregular heartbeat)
- Allergic reactions from the dye
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