Coronary angiography (an-jee-OG-ra-fee) is a test
that uses dye and special x rays to show the inside of your coronary
arteries. The coronary arteries supply blood and oxygen to your heart.
A material called plaque (plak) can build up on the
inside walls of the coronary arteries and cause them to narrow. When this
happens, its called
coronary
artery disease (CAD). CAD can prevent enough blood from flowing to your
heart and can lead to angina (an-JI-nuh or AN-juh-nuh) (chest discomfort or
pain) and
heart
attack. Coronary angiography shows if you have CAD.
Most of the time, the coronary arteries cant
be seen on an x ray. During coronary angiography, a special dye is injected
into the bloodstream to make the coronary arteries show up on an x ray.
To deliver the dye to your coronary arteries, a
procedure called
cardiac
catheterization (KATH-e-ter-i-ZA-shun) is used. A long, thin, flexible tube
called a catheter is put into a blood vessel in your arm, groin (upper thigh),
or neck. The tube is then threaded into your coronary arteries, and the dye is
injected into your bloodstream. Special x rays are taken while the dye is
flowing through the coronary arteries.
Cardiologists (doctors who specialize in heart
problems) usually perform cardiac catheterizations in a hospital. Youre
awake during cardiac catheterization. The procedure usually causes little to no
pain, although you may feel some soreness in the blood vessel where your doctor
put the catheter.
Coronary angiography is a test for
coronary
artery disease (CAD). Your may need coronary angiography if you have signs
or symptoms of CAD. These include:
Angina.
This is unexplained pain or pressure in your chest. This chest discomfort may
only happen when youre active.
Sudden
cardiac arrest. This is when your heart suddenly and unexpectedly stops
beating.
Results from an
EKG
(electrocardiogram), exercise stress test, or other test that suggest you have
heart disease.
You also may need coronary angiography on an
emergency basis if youre having a
heart
attack. This test combined with a procedure called
angioplasty
can open the blocked artery causing the heart attack and prevent further damage
to your heart.
Coronary angiography also can help your doctor
decide how to treat CAD after a heart attack. This is especially true if the
heart attack caused major damage to your heart, or if youre still having
chest pain.
What To Expect Before Coronary Angiography
Before having coronary angiography, discuss with
your doctor:
The test and how to prepare for it
Any medicines youre taking, and whether you
should stop taking them before the test
Whether you have diabetes, kidney disease, or
other conditions that may require taking extra steps during or after the test
to avoid complications
Your doctor will tell you exactly which procedures
will be performed. For example, your doctor may recommend
angioplasty
if the angiography shows a blocked artery. You will have the opportunity to ask
questions about the procedure, and you will be asked to provide written
informed consent to have the procedures done.
It may not be safe to drive right after having
cardiac catheterization. If your doctor says you can go home the same day as
the test, you should arrange for a ride home from the hospital. You may have to
stay overnight for this test.
What To Expect During Coronary Angiography
During coronary angiography, youre kept on
your back and awake. That way, you can follow your doctors instructions
during the test. Youll be given medicine to help you relax. This medicine
may make you sleepy.
Your doctor will numb the area where the small
plastic tube (catheter) will enter the blood vessel through a small cut in the
arm, groin (upper thigh), or neck. The doctor then threads the catheter through
the vessel up to the opening of the coronary arteries. Special x-ray movies are
taken of the catheter as its moved up into the heart. The movies help
your doctor see where to position the tip of the catheter.
Your doctor will put a special dye in the catheter
when it reaches the correct spot. This dye will flow through your coronary
arteries and make them show up on an x ray. This x ray is called an angiogram.
If the angiogram reveals blocked arteries, your doctor may use
angioplasty
to restore blood flow to your heart.
After your doctor completes the angiography, or the
angiography and angioplasty, he or she will remove the catheter from your body.
The opening left in the blood vessel will then be closed up and bandaged. A
small sandbag or other type of weight may be put on top of the bandage to apply
pressure. This will help prevent major bleeding from the site.
The animation below shows the process of coronary
angiography. Click the "start" button to play the animation. Written and spoken
explanations are provided with each frame. Use the buttons in the lower right
corner to pause, restart, or replay the animation, or use the scroll bar below
the buttons to move through the frames.
The animation shows the step-by-step
process your doctor will follow to do a coronary angiography.
What To Expect After Coronary Angiography
After coronary angiography, you will be moved to a
special care area, where you will rest and be monitored for several hours or
overnight. During this time, your movement will be limited to avoid bleeding
from the site where the catheter was inserted. While you recover in this area,
nurses will check your heart rate and blood pressure regularly and see if there
is any bleeding from the tube insertion site.
A small bruise may develop on your arm, groin (upper
thigh), or neck at the site where the catheter was inserted. That area may feel
sore or tender for about a week. Be sure to let your doctor know if you develop
problems such as:
A constant or large amount of blood at the site
that cant be stopped with a small bandage
Unusual pain, swelling, redness, or other signs
of infection at or near the insertion site
Talk to your doctor about whether you should avoid
certain activities, such as heavy lifting, for a short time after the
procedure.
What Are the Risks of Coronary Angiography?
Coronary angiography is a common medical test that
rarely causes serious problems. But complications can include:
Bleeding, infection, and pain in the arm, groin
(upper thigh), or neck where the catheter was inserted.
Damage to blood vessels. This is a very rare
complication caused by the catheter scraping or poking a hole in a blood vessel
as it is threaded up to the heart.
An allergic reaction to the dye used.
Other less common complications of the test
include:
An
arrhythmia
(irregular heartbeat), which often goes away on its own, but may need treatment
if it persists.
Damage to the kidneys caused by the dye
used.
Blood clots that can trigger strokes,
heart
attacks, or other serious problems.
Low blood pressure.
A buildup of blood or fluid in the sac that
surrounds the heart. This fluid can prevent the heart from beating
properly.
As with any procedure involving the heart,
complications can sometimes, although rarely, be fatal. The risk of
complications with coronary angiography is higher if you have diabetes or
kidney disease, or if youre 75 years old or older. The risk for
complications also is greater in women and in people having coronary
angiography on an emergency basis.
Key Points
Coronary angiography is a test that uses dye and
special x rays to show the inside of your hearts arteries (the coronary
arteries). Coronary angiography can reveal any blocked or narrowed areas in
your coronary arteries that might be limiting blood flow to your heart.
To deliver the dye to your coronary arteries, a
procedure called
cardiac
catheterization is used. Your doctor will put a thin tube (catheter) into a
blood vessel in your arm, groin (upper thigh), or neck and thread it through
your coronary arteries.
You may need coronary angiography if you have
signs or symptoms of
coronary
artery disease. You also may need coronary angiography on an emergency
basis if youre having a
heart
attack. This test combined with a procedure called
angioplasty
can open blocked arteries and prevent further damage to your heart.
Before having coronary angiography, discuss with
your doctor how to prepare for the test and any special instructions you need
to follow.
During coronary angiography, youre kept on
your back and awake. That way you can follow your doctors instructions
during the test. Youll be given medicine to help you relax.
After the test is over, you will be moved to a
special care area, where you will rest for several hours or overnight. During
this time, your movement will be limited to avoid bleeding from the site where
the catheter was inserted.
It may not be safe to drive right after the test.
If your doctor says you can go home the same day as the test, you should
arrange for a ride home from the hospital.
A small bruise may develop at the site where the
catheter inserted. That area may feel sore or tender for about a week. You need
to let your doctor know if you have a lot of bleeding from that area or signs
of infection. You may have to avoid doing certain activities, such as heavy
lifting, for a short time after the test.
Coronary angiography is a common medical test
that rarely causes serious complications. The risk of complications is higher
in people who have diabetes and kidney disease, and in older people and
women.
Links to Other Information About Coronary
Angiography