Coronary Angiography

Summary

For facilities that do angiographies but not angioplasties, this version takes patients through the angiography procedure only. It reviews how the heart works, what atherosclerosis is, the risks of the procedure, and recovery.

Details

Coronary angiography is a diagnostic procedure used to find out if the symptoms you've been experiencing are caused by coronary artery disease.

The heart is a muscle which pumps blood throughout the body. The heart needs oxygen and nutrients. These are supplied by large blood vessels, called coronary arteries. The arteries and their branches wrap around the surface of the heart.

Fatty deposits called plaque can build up on the artery wall. The artery can become partially blocked, reducing the flow of blood to the heart. This narrowing of the artery is called atherosclerosis.

Reduced blood flow can cause chest discomfort, called angina pectoris, especially during physical activity. It's a warning sign that you may be at risk for a heart attack.

Coronary angiography allows your doctor to take moving pictures of your arteries to find out if there are places where and artery has narrowed.

To do this, a long thin tube, called a catheter, is inserted into your arm or leg and guided to your heart.

Then a contrast material, containing iodine, is injected. Using an x-ray camera, the doctor can see where an artery has become narrowed, how much it has narrowed, and if there is any damage to the heart.

Risks:

• small risk of a heart attack, stroke or death
• excessive bleeding or a blood clot at the site where the catheter was inserted
• impaired kidney function, which may be reversed
• an allergic reaction to the iodine in the contrast material
• arrhythmia, or irregular heartbeat, which can be corrected during the procedure

Tests before procedure:

• a blood test
• a chest x-ray
• an electrocardiogram

It is important to let your health care team know if you are allergic to iodine or to shellfish. Iodine is in the dye used in the procedure and also in shellfish.

The procedure room may be called a catheterization or cath lab. The procedure usually takes about one to two hours. Throughout it you'll be relaxed, but not asleep.

You'll be given a local anesthetic to numb the area of your leg or arm where the catheter will be inserted.

A device called an introducer sheath will be inserted into your arm or leg.

The catheter will be threaded through the sheath into an artery and guided towards your heart.

The doctor will then inject contrast material which will travel through the arteries.

The x-ray camera will be moved around you so that your doctor will be able to identify any places where the arteries have narrowed.

The catheter will be guided into the heart’s main chamber, called the left ventricle. A larger amount of contrast material will be injected to evaluate the heart's pumping action.

As the contrast material flows away from your heart, you may feel a warm sensation move through your body for about twenty to thirty seconds.

After all the necessary pictures have been taken, your doctor will withdraw the catheter. The introducer sheath may be temporarily left in place. The site will be bandaged and, to prevent bleeding, firm hand pressure may be applied or a closure device may be used.

Your doctor will talk to you about the results of the angiography at a later time.

Back in the post-procedure area, you'll be asked to keep the leg the catheter was inserted into still and straight for a few hours. You can bend your other leg to make your back more comfortable.

As you recover, your pulse and blood pressure will be carefully monitored.

You may be advised not to drive, so arrange to have someone take you home.

In the first day or two at home, you may feel somewhat tired and experience mild discomfort at the catheter insertion site. A bruise may also appear.

In a few days you can get back to your regular activities.