Coronary Angiogram

Medically Reviewed by Dr. K on 27 April 2021

Table of Contents:

  1. What is Coronary Angiogram?
  2. Uses
  3. Risks
  4. Preparation
  5. Results and Home Care

What Is Coronary Angiogram?

Coronary angiogram (also known as cardiac catheterization, cardiac cath or heart cath) is a procedure that allows the doctor to examine how well your blood vessels supply your heart. During the procedure, they insert a large, narrow tube called a catheter into a blood vessel in your arm or leg and use a special X-ray device to guide it to your heart. To take X-ray videos of your valves, coronary arteries, and heart chambers, doctors inject a contrast dye into your blood vessel via the catheter.

Uses

Your doctor uses coronary angiogram to:

  • Check for signs of heart disease; such as coronary artery disease, heart valve disease, or disease of the aorta
  • Examine how the heart muscle is functioning
  • Determine if you need further treatment; such as an interventional procedure or bypass surgery

Common uses of coronary angiogram

Coronary angiogram can be used by your doctor to diagnose and treat issues. After the diagnostic portion of the coronary angiogram, you’ll often receive a procedure to clear blocked arteries.

The following procedures may be performed during your coronary angiogram:

  • Angioplasty: A catheter with a small balloon at the tip is inserted by the doctor. When this balloon is inflated, it drives plaque out of the artery and widens it.
  • Biopsy: A small sample of tissue from your heart is taken by your doctor.
  • Repair of heart defects: A gap in your heart is closed or a valve leak is stopped by your doctor.
  • Stent placement: A small mesh tube called a stent is inserted into your artery by your doctor to help hold it open.

Risks

A coronary angiogram is generally considered to be risk-free. However, there are potential dangers much like any treatment that includes entering your body. Your doctor will go through the dangers with you and take precautions to reduce your chances of experiencing them.

Risks can include:

  • Perforation: a hole piercing your blood vessel
  • Air embolism (when air enters your blood vessel; this can be life-threatening)
  • Allergic reaction to dye
  • Bleeding
  • Blood clots
  • Bruise
  • Heart attack
  • Infection
  • Kidney damage due to the dye
  • Stroke
  • Erratic or irregular heart rhythm (arrhythmia)

Preparation

In most cases, this operation is carried out in a hospital. Blood tests and an ECG would be needed for most people. These are a few other things to bear in mind:

  • The doctor or nurse will advise you on what you can and cannot consume before the procedure
  • Tell the doctor about all of your medications, including herbal products, over-the-counter medications or supplements, and dietary supplements.
  • Inquire with your doctor on which drugs you should take on the day of the cardiac catheterization. Certain medications, especially blood thinners such as Coumadin, may need to be stopped for a few days before the procedure.
  • Ask your doctor how to adjust your diabetes medications on the day of your test if you have diabetes.
  • If you’re allergic to anything, particularly iodine, shellfish, X-ray dye, latex, rubber products (such as rubber gloves or balloons), or penicillin-type drugs, tell your doctor and nurses.
  • It’s possible that you won’t be able to leave the hospital on the day of the procedure. To make your stay more comfortable, bring personal items with you (such as a robe, slippers, and toothbrush). Make arrangements for someone else to drive you home.

How long does a coronary angiogram last?

A coronary angiogram procedure usually takes approximately 30 minutes (longer if you have an intervention), but preparation and recovery time add up to many hours. Plan on spending the whole day at the hospital.

What happens during a coronary angiogram?

You will change into a hospital gown. An intravenous (IV) needle will be inserted into your arm by a nurse to administer drugs and fluids.

The coronary angiogram room resembles an operating room. You’ll be placed at a special table. Over you would be a large camera and several TV displays. On the monitors, you can see the images from the cardiac cath.

The nurse will disinfect and possibly shave the area where the catheter will be inserted (in your arm or groin). Sterile cloths would be used to protect the area to avoid infection. To avoid moving the drapes, keep your arms and hands at your sides.

Electrodes (small, flat, sticky patches) will be placed on your chest by the nurse. The electrodes are connected to an ECG system, which records the electrical activity of your heart.

You’ll be given a mild sedative to help you relax, but you’ll be conscious throughout the procedure. A local anaesthetic will be used by the doctor to numb the spot where the catheter will be inserted. This could be at your groin (called the femoral approach) or on your wrist (called the radial approach).

A small cut will be made across the blood vessel by the doctor. A device called an introducer sheath will be inserted, and the catheter will be threaded through it into the arteries of your heart. You may experience some discomfort, but you should not be in any pain. Inform the health-care providers if you experience any pain.

They’ll dim the lighting and inject a small volume of dye (also known as contrast material) through the catheters into your arteries and heart chambers once the catheter is in position. Your vessels, pipes, and chambers are outlined by the contrast material.

You may feel hot or flushed after the doctor injects the dye into your heart. This is perfectly normal and will pass in a matter of seconds. If you feel itching or tightness in your throat, nausea, chest discomfort, or any other signs, tell your doctor or nurse.

Your arteries and heart chambers will be photographed with an X-ray camera. During the procedure, your doctor might ask you to take a deep breath, hold your breath, or cough. You’ll have to hold your breath while the X-rays are being taken. The team will remove the catheter and switch on the lights once all of the pictures have been completed.

What happens after a coronary angiogram?

Your doctor will remove the catheter as well as the sheath if it was inserted in your wrist. They’ll seal and bandage the cut. You’ll be able to move around freely.

The doctor will keep an eye on you for a couple hours to make sure you’re well. If you suspect you’re bleeding or feel numbness or tingling in your fingertips, tell your nurse. You may be prescribed medicine to alleviate the discomfort in your arm. You’ll even be sent instructions for how to take care of your arm after you’ve returned home.

If the catheter went into your groin, the doctor will extract it and seal the cut with stitches, collagen seal, or pain. A collagen seal is a protein material that helps in the formation of a clot in your artery by working with your body’s natural healing processes. In some cases, your doctor may stitch the introducer sheath in place until the bleeding has stopped.

A sterile dressing will be applied to the wound to help avoid infection. To prevent bleeding, you’ll need to lay flat and keep your leg straight for 2 to 6 hours. You’ll need to keep your head low (no more than two pillows high) to avoid putting pressure on your abdomen and groin. During this time, you will be unable to sit or stand. The nurse will check the bandage frequently, so let them know if your toes tingle or feel numb, or if you think you’re bleeding (have a wet, warm sensation). After the anaesthetic wears off, you will be given medication to deal with discomfort. When it’s safe for you to get out of bed, the nurse will assist you.

Your doctor’s instructions should let you know once you are able to get out of bed and go to the toilet. The nurse will assist you to sit up and dangle your legs over the side of the bed

Drink lots of water to flush the dye from your system.

You may find yourself needing to urinate more often than usual. This is perfectly normal. You’ll need to use a bedpan or urinal until you’re ready to get out of bed if you didn’t get a urinary catheter during the procedure.

The doctor will inform you if you are able to return home or if you will be required to stay overnight.

Your doctor will discuss recovery options with you before you go home, including medications, dietary changes, exercise, and future procedures. They’ll also go into how to take care of the wound site, as well as activity and follow-up care.

Results and Home Care

Your doctor will explain what they discovered during the surgery and whether any further treatments, such as an angioplasty or stent, are needed.

When you get home, make sure you follow all of your doctor’s guidelines on your activity level and prescriptions. A bruise at the wound site is possible. If you have any other concerns, contact the doctor.

Sources

Referenced on  26/4/2021 

  1. Cleveland Clinic Heart & Vascular Institute.
  2. American Heart Association: “Cardiac Catheterization.”
  3. National Institutes of Health, U.S. National Library of Medicine, MedLine Plus: “Cardiac catheterization."
  4. Johns Hopkins Medicine: “Cardiac Catheterization.”
  5. Mayo Clinic: “Cardiac catheterization.”
  6. National Cancer Institute: “invasive procedure.”
  7. https://www.webmd.com/heart-disease/guide/cardiac-catheterization1#1

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