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 oxygen-rich blood to your heart.
A material called plaque (plak) can build up on the
inside walls of the coronary arteries, causing them to narrow. When this
happens, it's called
coronary
heart disease (CHD) or coronary artery disease.
CHD can prevent enough blood from flowing to your
heart and can lead to
angina
(an-JI-nuh or AN-juh-nuh) and
heart
attack. (Angina is chest pain or discomfort.) Coronary angiography shows
whether you have CHD.
Most of the time, the coronary arteries can't be
seen on an x ray. During coronary angiography, special dye is injected into the
bloodstream to make the coronary arteries show up on an x ray.
A procedure called
cardiac
catheterization (KATH-e-ter-i-ZA-shun) is used to get the dye to your
coronary arteries. 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 (heart specialists) usually do cardiac
catheterization in a hospital. You're awake during the procedure. It usually
causes little to no pain, although you may feel some soreness in the blood
vessel where your doctor put the catheter.
Your doctor may recommend coronary angiography if
you have signs or symptoms of
coronary
heart disease (CHD). Signs and symptoms include:
Angina.
This is unexplained pain or pressure in your chest. You also may feel it in
your shoulders, arms, neck, jaw, or back. Angina may only happen when you're
active. Emotional stress also can trigger the pain.
Sudden
cardiac arrest. This is a condition in which 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 you're having a
heart
attack. This test, combined with a procedure called
angioplasty
(AN-jee-oh-plas-tee), can open the blocked artery that's causing the heart
attack and prevent further damage to your heart.
Coronary angiography also can help your doctor
decide how to treat CHD after a heart attack. This is especially true if the
heart attack caused major damage to your heart, or if you're still having chest
pain.
What To Expect Before Coronary Angiography
Before having coronary angiography, talk to your
doctor about:
How the test is done and how to prepare for it
Any medicines you're 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 done. For example, your doctor may recommend
angioplasty
if the angiography shows a blocked artery.
You will have the chance to ask questions about the
procedure. Also, you'll be asked to provide written informed consent to have
the procedures done.
It may not be safe to drive after having
cardiac
catheterization, which is part of coronary angiography, so you must arrange
for a ride home.
What To Expect During Coronary Angiography
During coronary angiography, you're kept on your
back and awake. That way, you can follow your doctor's instructions during the
test. You'll be given medicine to help you relax. The medicine may make you
sleepy.
Your doctor will numb the area where the catheter (a
small plastic tube) 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 it's moved up into the heart. The movies help your
doctor see where to position the tip of the catheter.
Your doctor will put 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 coronary angiography.
What To Expect After Coronary Angiography
After coronary angiography, you'll be moved to a
special care area, where you'll rest and be checked for several hours or
overnight. During this time, you'll need to limit your movement to avoid
bleeding from the site where the catheter was inserted.
While you recover in the special care area, nurses
will check your heart rate and blood pressure regularly and see whether you're
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. Let your doctor know if you develop problems
such as:
A constant or large amount of blood at the
catheter insertion site that can't be stopped with a small bandage
Unusual pain, swelling, redness, or other signs
of infection at or near the catheter insertion site
Talk to your doctor about whether you should avoid
certain activities, such as heavy lifting, for a short time after the
test.
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 at the site where
the catheter was inserted.
Damage to blood vessels. This is a very rare
complication. It may occur if the catheter scrapes or pokes a hole in a blood
vessel as it's threaded up to the heart.
An allergic reaction to the dye used.
Other less common complications of the test
include:
An
arrhythmia
(irregular heartbeat) that 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 stroke,
heart
attack, 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 be fatal. However, this is rare with coronary
angiography.
The risk of complications from coronary angiography
is higher if you have diabetes or kidney disease, or if you're 75 years old or
older. The risk of 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 heart's 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.
A procedure called
cardiac
catheterization is used to get the dye into your coronary arteries. Your
doctor will put a thin, flexible 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
heart disease (also called coronary artery disease). You also may need
coronary angiography on an emergency basis if you're 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, you're kept on your
back and awake. That way you can follow your doctor's instructions during the
test. You'll be given medicine to help you relax.
After the test is over, you'll be moved to a
special care area, where you'll 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 after the test, so
you must arrange for a ride home.
A small bruise may develop at the site where the
catheter inserted. That area may feel sore or tender for about a week. 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
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