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 cardiologist see if you need treatment such as angioplasty or stent, coronary artery bypass surgery (CABG) or medical therapy.
It is done in a special angiography suite. This is similar to an operating theatre, with the addition of the X-ray machine. You will be taken to the Angiography theatre on a bed. Once there, you will be asked to transfer to the procedure table.
Your Cardiologist is recommending you have a coronary angiogram either because your non-invasive testing has indicated that you may have coronary artery disease.
Coronary angiograms are done under conscious sedation. Most coronary angiograms are performed via the wrist (the radial artery), so you will also receive local anaesthetic (lignocaine) at your wrist. If you need to have your procedure performed through the groin (the femoral artery), you will have local anaesthetic injected into this area. When this area is numb, an introducing sheath (a narrow tube) is inserted into your artery. A thin flexible tube (a catheter) is then threaded through the sheath. This catheter is then guided through the artery until X-ray imaging until it reaches the coronary arteries.
Coronary arteries do not show up on normal X-rays, so a special X-ray contrast medium is used, which shows up the coronary arteries.
You will need to alert the Cardiologist or nurses if you start to feel flushed or develop chest pain. It is not uncommon to experience the following sensations:
Slight pressure as the catheter is inserted.
Mild discomfort in the lower and upper arm (with the radial approach only).
Occasional missed heart beats/palpitations. Don’t worry about this, your heart rate and rhythm is being monitored throughout the entire procedure.
You may feel the need to urinate, but if this test is going to be done, the Cardiologist/nurses will let you know.
Very rarely, an allergic reaction to the X-ray contrast fluid can happen. It is therefore very important to let the staff know if you have had a reaction to contrast before. If you develop any itching or welts, medications will be given to stop the reaction immediately.
As the screens will be positioned parallel to you, it is likely that you will see some of the imaging (if you are sufficiently awake!). However, some of the X-ray machine angles will block your view. Your Cardiologist will go through these images with you afterwards.
No, the X-ray machine does not enclose the patient. It is a good idea to let your Cardiologist know if you have these concerns, as you may require extra sedation for your procedure.
The angiogram will take approximately 30 minutes.
The sheath in your groin or wrist will be taken out at the end of the procedure, and pressure applied. If the procedure was performed via your groin, you will need to lie flat for several hours.
When you return to the ward the nursing staff will be regularly checking the catheter insertion site, your blood pressure, pulse, and the circulation of your leg or arm, depending where the insertion site was.
You will need to stay in hospital for at least 4 hours after your angiogram.
Your Cardiologist will perform your angiogram, with the assistance of the Angiography nurses, and a radiographer.
You are welcome to have a support person with you until you enter the Angiography Theatre.
You will need to ask a friend/relative to drive you home and you should not be alone on the night following your procedure.
If the angiogram shows a narrowing (blockage) that can be treated immediately, your Cardiologist may decide to continue and perform an angioplasty, using balloons and stents.
Alternatively, an angioplasty/stenting procedure may be scheduled for a later date, or coronary artery bypass graft surgery (CABG) may be recommended.
A letter will be sent to your GP giving the results of your coronary angiogram.