Coronary angiography is a procedure that uses contrast dye, usually containing iodine, and x ray pictures to detect blockages in the coronary arteries that are caused by plaque buildup. Blockages prevent your heart from getting oxygen and important nutrients. This procedure is used to diagnose coronary heart disease and coronary microvascular disease after chest pain, sudden cardiac arrest, or abnormal results from tests such as an electrocardiogram (EKG) of the heart or an exercise stress test. It is important to detect blockages because over time they can cause chest pain, especially with physical activity or stress, or a heart attack. If you are having a heart attack, coronary angiography can help your doctors plan your treatment.
Cardiologists, or doctors who specialize in the heart, will perform coronary angiography in a hospital or specialized laboratory. You will stay awake so you can follow your doctor’s instructions, but you will get medicine to relax you during the procedure. You will lie on your back on a movable table. Often, coronary angiography is done with a cardiac catheterization procedure. For this, your doctor will clean and numb an area on the arm, groin or upper thigh, or neck before making a small hole in a blood vessel. Your doctor will insert a catheter tube into your blood vessel. Your doctor will take x ray pictures to help place the catheter in your coronary artery. After the catheter is in place, your doctor will inject the contrast dye through the catheter to highlight blockages and will take x ray pictures of your heart. If blockages are detected, your doctor may use percutaneous coronary intervention, also known as coronary angioplasty, to improve blood flow to your heart.
After coronary angiography, your doctor will remove the catheter, possibly use a closure device to close the blood vessel, and close and bandage the opening on your arm, groin, or neck. You may develop a bruise and soreness where the catheter was inserted. You will stay in the hospital for a few hours or overnight. During this time, your heart rate and blood pressure will be monitored. Your movement will be limited to prevent bleeding from the hole where the catheter was inserted. You will need a ride home after the procedure because of the medicines or anesthesia you received.
Coronary angiography is a common procedure that rarely causes serious problems. Possible complications may include bleeding, allergic reactions to the contrast dye, infection, blood vessel damage, arrhythmias, blood clots that can trigger a heart attack or stroke, kidney damage, and fluid buildup around the heart. The risk of complications is higher in people who are older or who have certain conditions such as chronic kidney disease or diabetes. An imaging test called coronary computed tomography angiography, or coronary CTA, may be preferred over coronary angiography to detect blockages in the heart. Although coronary CTA still uses contrast dye, it does not require the invasive cardiac catheterization procedure that causes many of the complications of coronary angiography.
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