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What is a coronary angiogram?

A coronary angiogram is a procedure that shows how the blood circulates in the arteries supplying blood to the heart. It allows your doctor to see areas where the blood vessels may be narrowed or blocked.

When is it used?

This procedure most often follows other tests that hint at problems in the heart arteries.

How do I prepare for a coronary angiogram?

Before the procedure, tell the doctor if you have had any kidney problems or reactions to iodine-containing substances, such as kidney contrast dye or seafood.

Follow the instructions provided by your doctor. Do not eat or drink anything after midnight on the day of the procedure except to take your medications.

What happens during the procedure?

The doctor injects a local anesthesia into your groin and inserts a needle into the artery that runs from your heart down the leg. The doctor puts a guide wire through the needle into the artery and places a catheter over the wire. A catheter is a long, slim, flexible tube used to inject fluid and measure blood pressure.

After removing the guide wire, the doctor guides the catheter to the opening of the left ventricle (the part of the heart that pumps blood to the body), records the pressures, and guides the catheter to the opening of the coronary arteries. Dye is put into each of the arteries and x-rays are taken to see if they are blocked or narrowed.

The doctor then puts a different catheter into the heart and injects dye into the left ventricle. This is done to see if the left ventricle is pumping well or if it has been damaged sometime in the past. Then the doctor removes the catheter and applies pressure over the groin to control any bleeding.

What happens after the procedure?

You will stay under observation for at least 6 hours to ensure there is no bleeding in the groin. Avoid all strenuous activity for 2 days.

Ask your doctor or nurse for specific instructions on how to care for yourself at home and when you should come back for a checkup.

What are the benefits of this procedure?

This procedure provides important information about the function of the left ventricle of your heart. It also identifies blocked or narrowed coronary arteries. It helps determine which arteries need immediate surgery, which blockages may eventually need surgery, and which blockages can be treated with diet, exercise, and medicine.

What are the risks associated with this procedure?

• You may have an allergic reaction to the dye. An allergic reaction may cause difficulty in breathing, a drop in blood pressure, loss of consciousness, or swelling of the skin.
• If you have kidney problems, the dye might make them worse. The doctor may recommend treatment before the angiogram to help protect the kidneys.
• Blood may form a clot around the catheter. This could block the artery and require surgery to reopen it.
• The catheter may puncture the artery and cause internal bleeding and might require surgical repair.
• With the insertion of the catheter, some debris on the wall of the artery may break off and pass down the artery, causing a stroke or blockage at some point. This might require immediate surgical correction.
• You may have heart rhythm problems as a result of this procedure.
• You may have a heart attack during the procedure because of the extent of the coronary artery disease.
• Any of the above could result in death.

You should ask your doctor how these risks apply to you. Most of these potential problems are rare. The benefits of this procedure greatly outweigh the possible risks associated with it.

When should I call the doctor?

Call the doctor immediately if:

• You have a swollen, tender, or bleeding groin.
• Your pattern of chest pain changes.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You need to make your follow-up appointment.