Coronary Angiogram: Why It Is Done and What to Expect

A coronary angiogram is a test that helps doctors see the arteries that supply the heart. It is often used when someone has symptoms such as chest pain, and sometimes treatment can follow in the same visit. This article explains what the NHS says about it.

What is coronary angiography?

The NHS describes coronary angiography as a type of X-ray test that checks the heart and nearby blood vessels. A contrast agent, which is a dye, is injected so the vessels show up on the X-ray images. The images are called angiograms.

Why is it done?

The NHS says it can help check the health of blood vessels and how blood flows through them, help diagnose or investigate conditions such as narrowed arteries (atherosclerosis) and angina, and sometimes help plan treatment. For example, the NHS says that after a heart attack, an angiogram can find the exact blockage, which may be treated during the same procedure.

What happens

The test is done in a hospital X-ray or radiology department. You are usually awake, though you may be given a sedative to help you relax. The NHS describes these steps:

1. You lie on an X-ray table.
2. A local anaesthetic numbs a small area, usually near the groin or wrist, where an artery is accessed.
3. A thin, flexible tube called a catheter is inserted and guided to the heart.
4. Contrast agent is injected through the catheter.
5. A series of X-rays is taken as the dye moves through the blood vessels.

The test takes 30 minutes to 2 hours. The NHS notes that the procedure is generally considered safe and painless.

Angioplasty

Sometimes a blockage found on an angiogram is treated straight away. The NHS describes coronary angioplasty as a procedure that widens narrowed coronary arteries using a balloon, and most modern procedures also insert a stent, a short wire mesh tube that stays in place. It says angioplasty is usually done under local anaesthetic and takes 30 minutes to 2 hours. Whether you need it is a decision for your doctor.

Recovery

It is a good idea to arrange for someone to travel home with you and to ask the team beforehand how long you should rest and when you can return to normal activities. According to the NHS, you can usually go home a few hours after an angiogram. For a few days or weeks, bruising, soreness and a very small lump or collection of blood near the incision are common. Follow the aftercare advice from the hospital, and contact your doctor if you are worried.

Risks

All procedures carry some risk, and the level of risk depends on the person. The NHS says rare but more serious complications include an allergic reaction to the contrast agent, stroke and heart attack. Tell your care team about any allergies before the test. Your doctor will explain the benefits and risks that apply to you, and you can ask any questions before you agree to the procedure.

When to see a doctor

See a doctor if you have chest pain, breathlessness or other symptoms that could be heart-related, so that they can decide which tests you need. After an angiogram, get medical advice if the area where the tube was inserted keeps swelling or bleeding, or if you feel unwell.

Call emergency services at once for chest pain that does not stop, pain spreading to the arms, neck or jaw, severe breathing difficulty, or chest pain with sweating or sickness. The NHS says not to drive yourself to hospital.

In an emergency, call your local emergency number (112 in India, 911 in the United States).