Cochin Cardiac Club

Health Blog by Dr.Uday Nair

CORONORY ANGIOGRAPHY

                                               

Coronary angiography

Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through your heart.

Coronory Angiography is a technique in which a tube known as a catheter is introduced into either arm or leg artery and then navigated up to the main arteries supplying blood to the heart.
A Contrast dye is released from the catheter and blood vessels and heart is filmed.This will show if there are any blockages in vessels.

How the Test is Performed





Coronary angiography is usually done along with cardiac catheterization.
Before the test starts, you will be given a mild sedative to help you relax.
An area of your body, usually 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 may last 30 to 60 minutes.



Why the Test is Performed








Coronary angiography is done to find a blockage in the coronary arteries, which can lead to heart attack. It may be done if you have unstable angina, atypical chest pain, aortic stenosis, or unexplained heart failure.



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 doctor will explain the procedure and its risks.
Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material in the past, if you are taking Viagra, or if you might be pregnant.


How the Test Will Feel


You are awake during the test. You may feel some pressure at the site where the catheter is inserted.
Occasionally, a flushing sensation occurs after the dye is injected.
After the test, the catheter is removed. You might feel a firm pressure at the insertion site, used to prevent bleeding. If the catheter is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding. This may cause some mild back discomfort



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 arrhythmias
  • Cardiac tamponade
  • Trauma to the artery causing a hematoma
  • Low blood pressure
  • Allergic reaction to contrast medium
  • Hemorrhage
  • Stroke
  • Heart attack
Considerations associated with any type of catheterization include the following:
  • In general, there is a risk of bleeding, infection, and pain at the IV site.
  • There is always a very small risk that the soft plastic catheters could actually damage the blood vessels.
  • Blood clots could form on the catheters and later block blood vessels elsewhere in the body.
  • The contrast material could damage the kidneys (particularly in patients with diabetes).


Considerations


If a blockage is found, your doctor/interventional cardiologist may perform a percutaneous coronary intervention (PCI) to open the blockage. This can be done during the same procedure.





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