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Coronary angiography is a diagnostic procedure that visualises the blood vessels (coronary arteries) supplying the heart muscle with blood. While invasive, this procedure provides essential information for understanding the extent of coronary artery blockages and determining the most appropriate interventions to restore optimal blood flow to the heart.
What Is Coronary Angiography?
Coronary arteries supply blood to the heart muscle and maintain its vital function. Narrowing of coronary artery occurs when fatty deposits accumulate in the arterial wall. Undetected, these blockages can be serious health threats causing heart attacks and even sudden death.
Coronary angiography is a medical procedure that visualises the blood vessels supplying the heart muscle with blood, and is currently regarded as the gold standard for the diagnosis of coronary artery disease. The procedure involves the insertion of a small tube through blood vessels in the arm or leg which is guided to the coronary arteries. A special ‘dye’ (contrast medium) is then injected into the coronary vessel and digital images are recorded using special X-ray cameras.
This procedure is crucial for diagnosing or confirming the presence of significant coronary artery disease (CAD), enabling healthcare professionals to identify blockages, narrowings, or other arterial abnormalities that may affect blood flow to the heart. Coronary angiography also guides interventional procedures such as angioplasty and stent placement to restore optimal blood flow to the heart.
Who Needs Coronary Angiography?
Coronary angiography is typically recommended for individuals who are having a heart attack or have symptoms from coronary artery disease (CAD) that have not responded well to treatment with medicines. Common symptoms include chest pain or discomfort, shortness of breath, and unexplained fatigue. Coronary angiography is also commonly utilised to exclude significant coronary artery disease in patients presenting with heart failure.
How Do I Prepare For Coronary Angiography?
To prepare for coronary angiography, inform your doctor of any allergies particularly to iodine, X-ray contrast medium, and pain-relieving medication particularly non-steroidal anti-inflammatory drugs including aspirin. Provide a detailed medical history, adhere to fasting requirements, and manage medications as directed. You may be instructed to withhold certain blood pressure and diabetic medications. Inform the healthcare team of any potential pregnancy, undergo necessary blood tests, and sign a consent form after addressing concerns.
What Happens During Coronary Angiography?
The procedure is performed in a cardiac laboratory. You will be placed on a portable table equipped with X-ray cameras and heart monitors. A nurse will clean your wrist or groin and cover you with a sterile sheet. During coronary angiography, a local numbing medicine is injected under the skin before a thin tube (catheter) is threaded through blood vessels in your arm (typically the right wrist) or leg to the coronary arteries. A contrast dye is injected into the coronary vessels, making the arteries visible on X-ray images. These images help to evaluate blood flow and identify any blockages or abnormalities in the coronary arteries.
The procedure is typically performed in a specialised cardiac catheterisation laboratory. Patients are typically awake but sometimes medicines can be given via a small cannula (tube) in your arm to reduce anxiety during the procedure. The procedure usually takes about 30 minutes. Based on the findings, a clinical decision will be made to either stop if no further treatment is needed, or to proceed with coronary angioplasty in the same setting or separate procedure. At the end of the procedure, the catheter is removed, and a dressing is applied.
What To Do After Coronary Angiography?
After coronary angiography, patients are usually monitored for a brief period to ensure stability. Following the procedure, follow the doctor’s instructions regarding physical activities and recovery. Patients may be advised to take it easy for a day or two, avoiding strenuous activities.
Based on the results, the healthcare team will discuss the angiography findings and recommend any necessary treatments, medications, or lifestyle changes. Regular follow-up appointments will be scheduled to monitor progress and address ongoing concerns or questions.
What are the Risks of Undergoing a Coronary Angiography?
Coronary angiography is generally considered safe, but it is an invasive procedure with a low risk of complications. Possible complications include bleeding or bruising at the catheter insertion site, an allergic reaction to the contrast dye used, kidney injury from the contrast used, vessel injury, stroke or heart attack. Overall the rate of complications for coronary angiography is low (<0.1%).
