What Should You Know About Coronary Angiography?

What Is Coronary Angiography?

Angiography is a medical test used to detect abnormalities in the blood vessels of various organs such as the heart, brain, and legs. It uses X-ray and contrast dye such as iodine to identify blocked, malformed, narrowed, and enlarged blood vessels. The images formed through angiography are known as angiograms.

When the doctor performs an angiography to study the arteries of the heart, it is known as coronary angiography. Through coronary angiography, the doctor examines the extent and severity of heart disease. It also helps in evaluating cardiac function. Based on the results of coronary angiography, the doctor decides the further course of treatment.  

When Is Coronary Angiography Needed?

Coronary angiography is an invasive diagnostic method. The doctor performs non-invasive tests such as Electrocardiogram, stress test, or Echocardiogram before advising the patient for coronary angiography. Coronary angiography may be helpful in the following conditions:

  • Congenital heart disease (heart disease present by birth)

  • Unstable angina (increased chest pain)

  • Abnormal results in non-invasive tests such as stress tests or echocardiogram.

  • Symptoms indicating a coronary artery disease.

  • Pain in arm, chest, or jaw that has not been explained by other tests

  • Blood vessel problems

  • Chest injury

  • Valve disorders

Are There Any Risks Involved?

As with other invasive procedures, coronary angiography also has some risks. There will be a minimum risk if an expert performs the angiography. Following are some of the risk factors associated with coronary angiography:

Bleeding or bruising: As the procedure is invasive, the patient may experience minor bleeding at the site of injection. Because of the catheter, the patient may also have bruising. 

Allergic reactions: This procedure involves the use of dye. Patients may experience allergic reactions such as rashes due to dye. 

Arterial damage: The procedure may result in damage to arteries in groin or legs. It may affect the blood supply to lower extremities.  

Cardiac and neurological complications: The patient may have a heart attack, arrhythmia, and stroke.

Tissue damage: Due to prolonged exposure to X-rays, some patients may experience tissue damage. 

How to Prepare for Coronary Angiography?

Coronary angiography is a scheduled imaging test, thereby offering sufficient time to patients for preparation. However, in some cases, emergency coronary angiography is required. 

  • The patient should not eat or drink anything at least 8-hours before the procedure

  • The patient should be accompanied by a caregiver preferably, as dizziness may follow post-procedure 

  • If the patient is on medications, he/she should ask the doctor whether to take or skip them before angiography

  • Patients should strictly follow the instruction of the doctor at all time before and after the angiography

  • The preliminary evaluation of the patient may include BP, allergy, and blood sugar tests.

  • The patient will be asked to sign an informed consent form.

  • The patient will be asked to empty the bladder, remove jewellery, contact lenses, hairpin and change into a hospital gown

How Is CAG Performed?

  • The doctor will ask you to lay on your back on the X-ray table. 

  • The supporting staff inserts the IV line in your arm. Through the IV-line, sedative, fluids, and other required medications are administered. 

  • The team attaches various instruments to monitor your vital parameter. The oximeter measures the oxygen in the blood, while the blood pressure monitor tracks the BP. The doctor inserts the catheter in the groin or arm region.  A local anaesthetic is applied to avoid any pain during the insertion.

  • The catheter is guided towards the artery of the heart and the patient does not feel any movement inside the body. The doctor injects the dye through the catheter. 

  • X-ray monitors the flow of dye for identifying any narrowing or blockage in the artery. 

  • The complete procedure takes around one hour.

Recovery After Coronary Angiography

When the procedure gets over, the patient is shifted to the recovery area for monitoring of vital parameters. If the critical parameters are stable, the staff transfers the patient to a general room. The patient may be discharged either on the same day or the next day.

The team advises the patient to drink plenty of fluids for the early flushing of dye from the body. He should not lift heavy objects or perform strenuous activities for some days.

The patient should also ask the doctor regarding the resumption of daily activities and starting the medicines. The site of incision might be tender to touch, have a small lump, and may cause discomfort. The patient feels better within a few days after the procedure.

What the Results of Coronary Angiography Indicates?

The doctor studies the angiogram in detail. It will help him in evaluating the type and severity of the disease. The angiogram helps to: 

  • Determine the number of arteries blocked and the extent of the blockage.

  • Spot the location of blocked arteries.

  • Analyze the success of already done coronary bypass surgery.

During the angiography, if the doctor identifies a blocked artery, he may simultaneously perform the coronary angioplasty and may insert a stent to improve the blood flow. It will avoid the need for another procedure.

 

Dr. Bipin Dubey

Consultant - Cardiac Science

Manipal Hospitals, Dwarka, Delhi

 

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