What Is a Coronary Angiogram?
The coronary arteries supply your heart muscle with blood. They can become clogged from a buildup of cholesterol, cells or other substances (plaque). This can reduce the flow of blood to your heart. If a blood clot forms and blocks blood flow through that artery, a heart attack may occur.
Why do I need this test?
A coronary angiogram is a special X-ray test. It’s done to find out if your coronary arteries are blocked or narrowed, where and by how much. An angiogram can help your doctor see if you need treatment such as angioplasty or stent, coronary artery bypass surgery (CABG) or medical therapy.
- Procedures aren’t necessary for all blockages. Sometimes all you need to do is take medicines and:
- Lower your blood pressure.
- Stop smoking.
- Reduce the cholesterol in your blood.
- Eat a healthy diet.
- Stay physically active.
What happens during an angiogram?
- You may be given medicine to relax you, but you will stay awake.
- You go to the hospital’s heart catheterization laboratory (“cath lab”).
- You lie on a table near a camera and other equipment.
- Your doctor numbs a spot on your groin or arm and inserts a thin tube (catheter) into an artery and up to the heart. This will hurt no more than a blood test.
- Special fluid goes through the catheter so arteriesshow up well on the X-ray.
- X-rays are taken as the fluid goes through the artery.
- You may be asked to hold your breath or cough.
- By studying the X-ray images, the doctor can see any problems with your coronary arteries.
- If you wish, you can see the X-ray pictures on the screen during or after the test.
What are the risks?
As with many medical tests there are some risks, although a coronary angiogram is generally considered to be quite a safe test. Serious problems during a coronary angiogram are rare (i.e. < 1 in a 100) but include heart attack, stroke, death, the need for urgent coronary bypass surgery (CABG) or a rapid heart rhythm disturbance causing you to faint. The possible complications of a coronary angioplasty are the same as for a coronary angiogram but the chances of having a heart attack or requiring urgent coronary bypass grafts are slightly higher.
Approximately one patient in 100 suffers a heart attack, two patients in every 500 need urgent bypass surgery, and death in hospital occurs in about 4 patients in 1,000. These risks may vary, depending on individual circumstances. The risk of a complication is higher with advancing age, >75, recent large heart attack, diabetes, kidney failure and heart failure. The risks will be comprehensively explained by the doctor before the procedure.
What happens after my test?
You will need to lie flat for two hours, keeping your leg straight, to minimize bruising in the groin. Or often a collagen plug is inserted under the skin prior to removing the tube. This plug will dissolve over the next 90 days, you will be able to sit up shortly. Next you will need to sit up for a further two hours, and drink plenty of fluids to flush the kidneys. You should then be able to go home.
How will I get my results?
The coronary angiogram +/- angioplasty will be discussed with you after the test, and with any family or others as you dictate. Ongoing treatment will also be discussed and the need for any further follow up. Your referring doctor and local doctor will often get the results by fax that day and a completed letter sent to arrive for them within 5 working days.
Please consult your doctor and lab for details on your particular case.