What is a Coronary Angiography?

Modern diagnostic testing such as  Coronary Angiography allow for early detection.   Coronary Angiography is the name for a diagnostic procedure that is designed to visualize the small arteries of the heart.   These tiny blood vessels are only 1 to 3 millimeters in diameter. Thus it takes special x-ray equipment and techniques to obtain images of sufficient quality for diagnosis and surgical decision making.  Coronary angiography is usually performed in conjunction with cardiac catheterization. 

How the test is performed:
Prior to the procedure, lab work and an ECG may be performed.   You will be placed flat on the catheterization  table.  You must lay motionless on the x-ray table, with their hands to the side or overhead.   The nurse or technician will shave and wash your groin (or arm) to reduce the risk of infection. You will receive some medication to help you relax, but you will not be given general anesthesia. Your vital signs will be monitored throughout the procedures.  A local anesthetic (numbing medicine) will be injected where the sheath (a short tube) will be inserted.  You may feel a brief burning or stinging sensation during the injection, but then you should not have any further pain.   The cardiologist places a needle into the main artery in the upper leg, called the femoral artery. Through this needle, a flexible wire is passed and threaded backward into the arterial tree until the wire reaches the main aorta (as confirmed by x-ray fluoroscopy). Over the wire, a long plastic tube (also known as angiogram catheter) is threaded into the aorta. The initial wire serves as a guiding system to ensure that the catheter tracks into the aorta properly. 

With careful maneuvering, the tip of the catheter can be positioned at the mouth of the main coronary arteries.  Once positioned, specialized contrast agent, or angiogram dye is selectively injected into the mouth of the coronary artery.  This allows your physicians to gain images of the inside of your coronary artery in order to better diagnosis potential blockages.  

How to prepare for the test:
High-risk patients (e.g., those with unstable angina, diabetes, kidney disease) may be admitted to the hospital the night before the procedure to receive intravenous hydration and a steroid to lower the risk for complications. Do not eat or drink anything 4 hour before the procedure. You may take your medications, with a small sip of water. Do not take your insulin or other diabetic medications prior to the procedure. Please take all of your medications to the hospital with you, or an exact list of the medications, doses, and times you take them. Please be certain to tell us if you have any allergies to drugs or to contrast (x-ray dye). The test can take 30 minutes to an hour. Please have your family remain in the waiting room during the procedure. Be aware that the hospital and your doctor provide care for emergency situations. Although we make every effort to perform your procedure on time, it is possible that some delays may occur.

How the test will feel:
You will be awake and able to follow instructions during the test.

You may feel some discomfort at the site where the IV is placed. Local anesthesia will be used to numb the site, so the only sensation should be one of pressure at the site. You may experience some discomfort from having to remain still for a long time.

Once the procedure is completed, the sheath is removed by a nurse or technician. Pressure is applied to the puncture site, usually in the right groin. Patients should not drive for 2 days, and should not lift anything more than 10 pounds for 5 days after the procedure. Call your doctor for any pain, swelling, bleeding, or fever post-procedure.