What is coronary angiography?
Coronary angiography is a procedure in which a contrast material
that can be seen using X-ray equipment is injected into one of the
arteries of the heart. This allows the doctor to view the flow of
blood through the heart.
How is the test performed?
Coronary angiography is usually performed in conjunction with
cardiac catheterisation. A mild sedative is given prior to the
test to help the patient relax. The study is carried out in a
laboratory by a trained cardiologist or radiologist and
technicians or nurses. An intra-arterial line is inserted into one
of the blood vessels in the arm or groin after the site has been
cleansed and numbed with a local anaesthetic. A catheter is then
inserted through the arterial puncture, usually from the groin.
The catheter is carefully threaded into the heart using an X-ray
machine that produces real-time pictures (fluoroscopy). Once the
catheter is in place, contrast material is injected and pictures
are taken.
Why is the test performed?
Coronary angiography is performed to detect obstruction in the
coronary arteries, which can lead to heart attack. It may be
performed if the patient has unstable angina, atypical chest pain,
aortic stenosis, or unexplained heart failure. The test may also
be performed for other reasons.
How to prepare for the test?
Food and fluid are restricted 6 to 8 hours before the test. The
procedure takes place in the hospital and the patient is asked to
wear a hospital gown. Sometimes, admitting the patient a night
before the test is required. Otherwise, the patient will be
admitted as an outpatient or an inpatient the morning of the
procedure. The doctor explains the procedure and its risks. A
witnessed, signed consent for the procedure is required. The
doctor needs to be informed if the patient is allergic to seafood,
if he has had a bad reaction to contrast material in the past, or
if he is taking sildenafil (viagra), or if she is pregnant.
What happens during the procedure?
The patient is awake and able to follow instructions during the
coronary angiogram. A mild sedative is usually given 30 minutes
before the procedure to help him relax. The procedure may last
from one to several hours. He may feel some discomfort at the site
where the catheter is placed. Local anaesthesia will be used to
numb the site, so the only sensation should be one of pressure at
the site. Occasionally, a flushing sensation occurs after the
contrast media is injected. Discomfort may also arise from having
to remain still for a long time. After the test, the catheter is
removed. The patient may feel a firm pressure at the insertion
site, used to prevent bleeding. If the puncture is placed in the
groin, he will usually be asked to lie flat on his back for a few
hours after the test to avoid bleeding. This may cause some mild
back discomfort.
What are the results?
An adequate blood supply to the heart is a normal finding with a
coronary angiogram. Coronary angiography shows the following:
* How many coronary arteries are blocked
* Where are they blocked
* The degree of each blockage
These results can help the cardiologist make decisions regarding
treatment for the patient’s heart disease.
Cardiac Catheterisation
Coronary Artery Disease
Plaque Buildup in Arteries
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