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Coronary angiography

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Coronary angiography is a common procedure used to diagnose heart problems. This technique involves use of X-ray imaging to observe the blood vessels, that is coronary arteries of the heart. The coronary angiography is part of the cardiac catherization procedure used for diagnosis of heart ailments.

Coronary angiography uses a dye that helps in illuminating the cardiac blood vessels. The X-ray machine picks up these images and gives the doctor a clear view of the cardiac vessels.

Why is Coronary Angiography Carried Out?

The coronary arteries are very important as they supply blood to the heart muscles. With time, these arteries get blocked with unwanted cells, cholesterol and plaque. This causes narrowing or complete blockage of the coronary arteries. Thus, reducing the blood flow to the heart. Presence of blood clots or complete blockage of the arteries can lead to heart attacks.

Coronary angiography is a minimally invasive, specialized X-ray test. It helps the doctor know which arteries are blocked or have become narrow. One can also know the exact site and severity of the blockage. Coronary angiography is also carried out after a heart attack to know where the blockage is. Patients with a complain of angina are also asked to undertake this test. The test also helps the doctor know if the patient requires an angioplasty, coronary artery bypass surgery (CABG) or any other type of medical treatment.

How is Coronary Angiography Performed?

Coronary angiography is carried out under local anesthetic. The following instructions will help you understand the procedure for coronary angiography.

Before the procedure

In most cases, it is carried out as an emergency test. In other cases, one is asked to refrain from eating and drinking at least 8 hours before the day of scheduled angiogram. One should inform the doctor in advance about any medications that you are taking. Diabetics should ask for instructions regarding the intake of their scheduled insulin medications. Also, inform the doctor about any allergies that you may have. The patient will have to change into a hospital gown and remove any jewelry, piercings, etc.

During the procedure

Coronary angiography is carried out in specialized Cath labs. The patient is asked to lie on a table that moves side to side. Probes will be connected to the patient that monitors the heartbeat.

The local anesthetic will be given either in the groin, arm or wrist. This depends on the location of the catheter to be inserted. The catheter is a thin, flexible tube. Once the catheter is inserted it will be gently eased though the arteries into the aorta. At the same time the dye is injected into the bloodstream through the catheter. The entire process is observed on the monitor. As the dye flows through the coronary artery, X-ray images are clicked.

It's very rare to feel the movement of the catheter through the arteries. One may complain of slight nausea and chest discomfort on injection of the dye. More than one catheter may have to be inserted through the same site. It takes about 30 to 40 minutes for the procedure to complete.

After the procedure

Once the procedure is over, the catheter is removed. Pressure is applied on the site of insertion. The patient is moved to a day care ward and asked to lie down for at last 4 hours. Normally, the patient is allowed to go home in about 6 hours. Or else admitted if they have undergone stent placement or angioplasty.

The patient is asked to drink plenty of fluids all day long to remove the dye from the body. One can eat something, if they feel like it. Avoid picking heavy weights or strenuous activities for a few days. Follow any specific instruction given by the doctor.

If you notice any bleeding, swelling, infection, pain, redness at the site of insertion or fever, make sure to call the doctor immediately.

Result of coronary angiography

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The doctor will know if there is something wrong with the coronary arteries. It may help him know how many coronary arteries are blocked or narrowed. It will even help locate the blockage and help to know how much blood flow passes through the arteries. The procedure will also help to know if the previous surgery was successful. Many times, angioplasty or stenting can be carried out during an angiogram.

Risks of coronary angiography

There are certain risks involved with coronary angiography. These risks include myocardial infarction, stroke and even death. But, they occur is less than 1% of the cases. This is a safe procedure and risks or complications arise very rarely.

This was all about coronary angiography. It is considered as a gold standard for coronary artery disease. Speak to your doctor regarding any doubts related to the procedure, before you undergo one.

Written by: Batul nafisa

Date last updated: January 16, 2015