Coronary Angiogram

What is a coronary angiogram?

A coronary angiogram is an x-ray test that shows how the blood circulates in the arteries supplying blood to the heart. It allows your health care provider to see areas where the blood vessels may be narrowed or blocked.

When is it used?

Most often, you will have this procedure after you have had a stress test that shows some abnormal findings. It is also used when you go to the hospital because you are having a heart attack or unstable angina. The coronary angiogram helps pinpoint problems in the heart arteries.

How do I prepare for a coronary angiogram?

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

Follow your health care provider's instructions. You may be asked not to eat or drink anything after midnight on the day of the procedure. Ask your provider which medicines to take the morning of the procedure.

What happens during the procedure?

The health care provider injects a local anesthetic into your groin and inserts a needle into the artery that runs from your heart down the leg. The provider 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 health care provider guides the catheter to near the opening of the left ventricle (the part of the heart that pumps blood to the body), 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 health care provider then puts a different catheter into the heart, records the pressures, 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 provider removes the catheter and applies pressure over the groin to control any bleeding.

What happens after the procedure?

You will stay under observation for several hours to ensure there is no bleeding in the groin. Avoid all strenuous activity for 2 days. Your groin may be tender when you first go home.

Ask your health care provider 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 treatment. Your treatment might include balloon angioplasty, stenting, radiation, surgery, 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 trouble 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 health care provider 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.
• When the catheter is inserted, 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.

There is risk with every treatment or procedure. Talk to your provider for complete information about how the 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 my health care provider?

Call your health care provider immediately if:

• Your groin becomes more swollen and tender, or if you have any discharge or bleeding.
• Your pattern of chest pain changes.