Coronary Angiography
A cardiac imaging procedure used to identify blockages or narrowing in the coronary arteries and guide treatment decisions
Heart check camp at Vasavi Cardiology InstituteCardiac angiogram and pre-angiogram tests at camp prices, and the cardiologist’s consultation freeWhat is coronary angiography?
Coronary angiography is an X-ray study of the arteries supplying your heart. A fine tube is passed from an artery at your wrist or your groin up to where the coronary arteries leave the aorta, contrast dye is injected into each artery in turn, and moving X-ray images record how the dye fills them. A narrowing shows as a point where the column of dye pinches in; a blockage shows as a column that stops.
It remains the reference standard because it shows the arteries at high resolution from several angles, and because pressure and imaging measurements can be taken through the same catheter to judge whether a borderline narrowing is actually restricting flow.
The result is a map, and it is what the decision between medication, stenting and bypass surgery is made from. Where the findings are clear and treatment is appropriate, your cardiologist may treat the narrowing in the same sitting; consent for that is taken beforehand so the question does not have to be asked while you are on the table.
What it involves
You come in on the morning of the procedure having fasted for a few hours. Blood tests including kidney function and clotting are checked, and you will be told which of your regular medicines to hold, particularly blood thinners and certain diabetes tablets.
The skin over the wrist or the groin is numbed with local anaesthetic. You stay fully awake, and beyond a sting as the local goes in you should feel pressure and movement and no pain. The catheter itself is not felt inside the artery. When the dye is injected you may feel a brief warm flush through the chest, and you will be asked to hold your breath for a few seconds at a time while the images are taken.
It takes 15 to 30 minutes. Afterwards a compression band goes on the wrist and is loosened in stages over two to three hours, or pressure is applied to the groin and you lie flat for four to six hours. You are observed for a few hours and go home the same day with someone to accompany you. Your cardiologist will usually talk through the images with you before you leave.
Recovery
Most people are back to their usual routine the next day. Keep the puncture site clean and dry for 48 hours and look at it each day.
After a wrist puncture, do not lift anything heavy with that arm for a couple of days. After a groin puncture, avoid stairs, straining and lifting for two to three days, and no strenuous exercise for a week. Drink plenty of water on the day and the day after to help your kidneys clear the dye.
Do not drive on the day of the procedure. Desk work is reasonable the next day after a wrist puncture and after two to three days following a groin puncture. Restart the medicines you were told to hold on the schedule you are given.
Questions about coronary angiography
Does it hurt?
The only sharp sensation is the sting of the local anaesthetic going into the skin at your wrist or groin, which lasts a few seconds. After that you should feel pressure and movement and nothing sharp. The catheter itself is not felt inside the artery, since arteries have no sensation along their length. When the dye is injected most people feel a brief warm flush through the chest, and you will be asked to hold your breath for a few seconds while pictures are taken. You stay awake and can talk to the team throughout, so say if anything hurts, because more local anaesthetic can be given at any point.
Do I have to stay the night?
For a planned study, no. The examination itself takes 15 to 30 minutes. Afterwards a compression band on the wrist is released in stages over two to three hours, or pressure is held at the groin and you lie flat for four to six hours, and you are observed on a Day Care bed before going home the same evening. You do need a responsible adult to accompany you home, and you must not drive that day. An overnight stay is arranged where the study is done urgently, where treatment is carried out in the same sitting, or where you have kidney or heart problems that need watching.
What happens once the pictures are taken?
Your cardiologist reviews the images and usually talks you through them before you leave, showing you where the narrowing is and how severe it looks. The findings decide what follows: medication and risk-factor treatment alone, opening the narrowing with a balloon and stent, or bypass surgery where several arteries are heavily involved. Where a narrowing is borderline, a pressure wire or an imaging catheter passed through the same tube can measure whether it is actually restricting flow. If treatment in the same sitting is a possibility, consent for it is taken beforehand, so the decision does not have to be made while you are on the table.
Other cardiology treatments
A minimally invasive treatment used to open a narrowed or blocked coronary artery and improve blood flow to the heart
InpatientHeart bypass surgery creates a new route for blood to flow around severely narrowed or blocked coronary arteries
InpatientTalk to a care coordinator about coronary angiography
Leave a number and a care coordinator calls you back with what the treatment involves and which hospital it would be at. They book a consult only if you want one