Coronary Angiogram

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Definition

What is Coronary Angiogram?

A coronary angiogram is a procedure that uses X-ray imaging to see your heart’s blood vessels.

During a coronary angiogram, a type of dye that’s visible by an X-ray machine is injected into the blood vessels of your heart. The X-ray machine rapidly takes a series of images (angiograms), offering a look at your blood vessels. If necessary, your doctor can open clogged heart arteries (angioplasty) during your coronary angiogram.

Why is Coronary Angiogram performed?

The test is generally done to see if there’s a restriction in blood flow going to the heart. Coronary angiograms are part of a general group of procedures known as heart (cardiac) catheterizations. Cardiac catheterization procedures can both diagnose and treat heart and blood vessel conditions. A coronary angiogram, which can help diagnose heart conditions, is the most common type of cardiac catheterization procedure.

Your doctor may recommend that you have a coronary angiogram if you have:

  • Symptoms of coronary artery disease, such as chest pain (angina)
  • Pain in your chest, jaw, neck or arm that can’t be explained by other tests
  • New or increasing chest pain (unstable angina)
  • A heart defect you were born with (congenital heart disease)
  • Abnormal results on a noninvasive heart stress test
  • Other blood vessel problems or a chest injury
  • A heart valve problem that requires surgery

Because there’s a small risk of complications, angiograms aren’t usually done until after noninvasive heart tests have been performed, such as an electrocardiogram, an echocardiogram or a stress test.

Precaution/Warnings

What should I know before receiving Coronary Angiogram?

An angiogram isn’t right for everyone.

  • It’s usually not suggested if you have a low risk of a heart attack or you don’t have angina symptoms.
  • You probably don’t need the test if you can control your angina with medicines and lifestyle changes.
  • You may not need it if other tests (such as a cardiac stress test) gave your doctor enough information to guide your treatment.
  • You might choose not to have the test if you already know that you don’t want to have angioplasty or bypass surgery.

Most of the side-effects are minor and may include:

  • A bruise, which may form under the skin where the small, flexible tube (catheter) was inserted (usually the groin). This is not serious but it may be sore for a few days.
  • The small wound where the catheter is inserted sometimes becomes infected. Tell your GP if the wound becomes red and tender. A short course of antibiotics will usually deal with this if it occurs.
  • Some people have a short angina-type pain during angiography. This soon goes.
  • The dye may give you a hot, flushing feeling when it is injected. Many people also describe a warm feeling in the groin when the dye is injected – as if they have ‘wet themselves’. These feelings last just a few seconds (and the operator will tell you when they are about to inject the dye). Rarely, some people have an allergic reaction to the dye.

As with most procedures done on your heart and blood vessels, a coronary angiogram has some risks, such as radiation exposure from the X-rays used. 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
  • Kidney damage
  • Excessive bleeding
  • Infection

Process

How to prepare for Coronary Angiogram?

Don’t eat or drink anything for eight hours before the angiography. Arrange for someone to give you a ride home. You should also have someone stay with you the night after your test because you may feel dizzy or light-headed for the first 24 hours after the cardiac angiography.

In many cases, you’ll be asked to check into the hospital the morning of the test, and you’ll be able to check out later the same day.

At the hospital, you’ll be asked to wear a hospital gown and to sign consent forms. The nurses will take your blood pressure, start an intravenous line and, if you have diabetes, check your blood sugar. You may also have to undergo a blood test and an electrocardiogram.

Let your doctor know if you’re allergic to seafood, if you’ve had a bad reaction to contrast dye in the past, if you’re taking sildenafil (Viagra), or if you might be pregnant.

What happens during Coronary Angiogram?

The procedure can be expected to take approximately 30-45 minutes.

For the procedure, you lie on your back on an X-ray table. Because the table may be tilted during the procedure, safety straps may be fastened across your chest and legs. X-ray cameras may move over and around your head and chest to take pictures from many angles.

An IV line is inserted into a vein in your arm. You may be given a sedative through the IV to help you relax, as well as other medications and fluids. You’ll be very sleepy and may drift off to sleep during the procedure, but you’ll still be able to be easily awakened to follow any instructions.

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.

A small amount of hair may be shaved from your groin or arm where a flexible tube (catheter) will 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 health care team if you have any discomfort.

Dye (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.

The dye is easy to see on X-ray images. 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 cardiac catheterization procedures. Preparation and post-procedure care can add more time.

What happens after Coronary Angiogram?

When the angiogram is over, the catheter is removed from your arm or groin and the incision is 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 if the catheter was inserted in the groin. 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 overnight. 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 to resume taking medications, bathing or showering, working, and doing 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.

If you have any questions about the Coronary Angiogram, please consult with your doctor to better understand your instructions.

Explanation of results

What do my results mean?

An angiogram can show doctors what’s 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 previous coronary bypass surgery
  • Check the blood flow through your heart and blood vessels

Knowing this information can help your doctor determine what treatment is best for you and how much danger your heart condition poses to your health. Based on your results, your doctor may decide, for instance, that you would benefit from having coronary angioplasty or stenting to help clear clogged arteries. It’s also possible that angioplasty or stenting could be done during your angiogram to avoid needing another procedure.

 

Depending on the laboratory and hospital, the normal range for Coronary Angiogram may vary. Please discuss with your doctor any questions you may have about your test results.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: October 12, 2018 | Last Modified: October 12, 2018

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