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Coronary angiography
Cardiac angiography; Angiography - heart; Angiogram - coronary; Coronary artery disease - angiography; CAD - angiography; Angina - angiography; Heart disease - angiography
Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart.
How the Test is Performed
Coronary angiography is often done along with cardiac catheterization . This is a procedure which measures pressures in the heart chambers.
Cardiac catheterization
Cardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart. The catheter is most often insert...
Before the test starts, you will be given a mild sedative to help you relax.
An area of your body (the arm or groin) is cleaned and numbed with a local numbing medicine (anesthetic). The cardiologist passes a thin hollow tube, called a catheter, through an artery and carefully moves it up into the heart. X-ray images help the doctor position the catheter.
Once the catheter is in place, dye (contrast material) is injected into the catheter. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages in blood flow.
The procedure most often lasts 30 to 60 minutes.
How to Prepare for the Test
You should not eat or drink anything for 8 hours before the test starts. You may need to stay in the hospital the night before the test. Otherwise, you will check in to the hospital the morning of the test.
You will wear a hospital gown. You must sign a consent form before the test. Your health care provider will explain the procedure and its risks.
Tell your provider if you:
- Are allergic to any medicines or if you have had a bad reaction to contrast material in the past
- Are taking Viagra
- Might be pregnant
How the Test will Feel
In most cases, you will be awake during the test. You may feel some pressure at the site where the catheter is placed.
You may feel a flushing or warm sensation after the dye is injected.
After the test, the catheter is removed. You might feel a firm pressure being applied at the insertion site to prevent bleeding. If the catheter is placed in your groin, you will be asked to lie flat on your back for a few hours to several hours after the test to avoid bleeding. This may cause some mild back discomfort.
Why the Test is Performed
Coronary angiography may be done if:
- You have angina for the first time.
-
Your angina that is becoming worse, not going away, occurring more often, or happening at rest (called
unstable angina
).
Unstable angina
Unstable angina is a condition in which your heart doesn't get enough blood flow and oxygen. It may lead to a heart attack. Angina is a type of ches...
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You have
aortic stenosis
.
Aortic stenosis
The aorta is the main artery that carries blood out of the heart to the rest of the body. Blood flows out of the heart and into the aorta through th...
ImageRead Article Now Book Mark Article - You have atypical chest pain, when other tests are normal.
- You had an abnormal heart stress test.
- You are going to have surgery on your heart and you are at high risk for coronary artery disease.
-
You have
heart failure
.
Heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
ImageRead Article Now Book Mark Article - You have been diagnosed as having a heart attack.
Normal Results
There is a normal supply of blood to the heart and no blockages.
What Abnormal Results Mean
An abnormal result may mean you have a blocked artery. The test can show how many coronary arteries are blocked, where they are blocked, and the severity of the blockages.
Risks
Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.
Generally the risk of serious complications ranges from 1 in 1,000 to 1 in 500. Risks of the procedure include the following:
-
Cardiac tamponade
Cardiac tamponade
Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle and the outer covering sac...
ImageRead Article Now Book Mark Article - Irregular heartbeats
- Injury to a heart artery
- Low blood pressure
- Allergic reaction to contrast dye or a medicine administered during the exam
-
Stroke
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
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Heart attack
Heart attack
Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...
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Considerations associated with any type of catheterization include the following:
- In general, there is a risk of bleeding, infection, and pain at the IV or catheter site.
- There is always a very small risk that the soft plastic catheters could damage the blood vessels or surrounding structures.
- Blood clots could form on the catheters and later block blood vessels elsewhere in the body.
- The contrast dye could damage the kidneys (particularly in people with diabetes or prior kidney problems).
Considerations
If a blockage is found, your provider may perform a percutaneous coronary intervention (PCI) to open the blockage. This can be done during the same procedure, but may be delayed for various reasons.
References
Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol . 2014;64(18):1929-1949. PMID: 25077860 www.ncbi.nlm.nih.gov/pubmed/25077860 .
Kern M. Catheterization and angiography. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 57.
Popma JJ, Kinlay S, Bhatt DL. Coronary arteriography and intracoronary imaging. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 20.
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Cardiac cathertization - uses in diagnosis, evaluation and treatment
Animation
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Coronary angiography - illustration
Coronary angiography is performed to detect obstruction in the coronary arteries of the heart. During the procedure a catheter (thin flexible tube) is inserted into an artery in your arm or groin and then threaded carefully into the heart. The blood vessels of the heart are then studied by injection of contrast media through the catheter. A rapid succession of X-rays (fluoroscopy) is taken to view blood flow.
Coronary angiography
illustration
-
Coronary angiography - illustration
Coronary angiography is performed to detect obstruction in the coronary arteries of the heart. During the procedure a catheter (thin flexible tube) is inserted into an artery in your arm or groin and then threaded carefully into the heart. The blood vessels of the heart are then studied by injection of contrast media through the catheter. A rapid succession of X-rays (fluoroscopy) is taken to view blood flow.
Coronary angiography
illustration
Review Date: 4/20/2015
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Internal review and update on 07/24/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
