Coronary Angiography Catherterization

What is Coronary Angiography/Catheterization?
Cardiac angiography/catheterization is a diagnostic procedure that provides your doctor with precise information about your particular heart condition, allowing much more individualized treatment. Angiography is an examination of the blood vessels after they have been filled with a contrast agent (a type of fluid that makes the vessels visible on an x-ray image). Angiography is performed when your physician suspects blockages of arteries that may interfere with the normal flow of blood through the heart. 

Patient Preparation
Prior to your angiography examination, a number of blood test will be performed, and you will be asked about the medications you take, whether prescription or over-the-counter. You will be asked if you have any allergies. It is important to list all allergies to food and medicine, as well as hay fever or asthma. Existing allergies may indicate a possible reaction to the contrast agent that will be used during the examination. If you are a woman of childbearing age, you will be asked if there is any possibility that you are pregnant, because a fetus is sensitive to radiation. You will receive detailed instructions about how to prepare for your procedure. Including specific instructions about the food you may have. Generally, you will be allowed nothing to eat or drink six to eight hours before the procedure.

When you arrive for your angiogram you will be prepared for the procedure. You will be asked to remove all clothing and jewelry and to put on a hospital gown. The nurse will need to start an intravenous (IV) line for fluids and medications. When it is time for your procedure the Cath Lab staff will explain the procedure to you and answer any questions you might have. Staff members present for the procedure are a radiology technologist, scrub technician or scrub nurse, and a nurse to monitor and care for your needs. The Cardiologist will perform the procedure.

Some suggestions to help you prepare:

  • Pack a small bag of overnight clothing and for the next day.
  • Do not bring any valuables.
  • Bring a list of your medications (with exact names and dosages).
  • Arrange for someone to drive you home.
  • Empty your bladder for your own comfort.
  • You may wear your socks, dentures, hearing aids, or glasses.

During the examination
The staff will position you on the exam table and connect you to a blood pressure cuff, heart monitor and oxygen monitor. The Cardiologist (a physician who specializes in the diagnostic interpretation of cardiac results) will administer a local anesthetic and then make a small nick in your skin so that a thin catheter can be inserted into the artery. The catheter is a flexible hallow tube about the size of a strand of spaghetti. It usually is inserted into an artery in your groin, although in some cases your arm or another site will be selected for the catheter.

The Cardiologist will ease the catheter into the artery or vein and gently guide it to the area under investigation. The Cardiologist will be able to watch the movement of the catheter on a fluroscope, which is an x-ray unit combined with a television monitor. When the catheter reaches the area under study, the contrast agent will be injected through the catheter. By watching the fluroscope screen, the Cardiologist will be able to see the outline of your blood vessels and identify any blockages or other irregularities.

Angiography procedures can range in time from less than an hour to three hours or more. It is important that you relax and remain as still as possible during the examination. The staff and physician stay in the room with you throughout the procedure. If you experience any difficulty, let them know.

Therapeutic uses of Angiography
In addition to imaging the blood vessels, angiography can be used to help repair them. During a procedure known as balloon angioplasty, angiography is used to guide a balloon through the catheter to a blocked or narrowed area of an artery.

Post Examination Information
After the procedure is complete, you will be moved to a room where you can rest and recover. Depending upon your overall health and medical condition, you may be released after just a few hours or you may be admitted to the hospital for observation and recovery. Before you go home, you will be given instructions explaining how to care for the site where the catheter was inserted. Your physician also may recommend that you restrict your activities at home. Follow the physician's instructions carefully.

Your kidneys will excrete any contrast agent that remains in your system. You may be advised to drink lots of water to help flush the contrast from your system. The amount of contrast is very small, and it has no odor or color. You will not notice any discoloration of your urine. In addition, the radiation that you are exposed to during this examination, like the radiation produced during any other x-ray procedure, passes through you immediately.

Your angiogram will be reviewed by the Cardiologist, he will explain the results and discuss what further procedures, if any are needed. Your doctor will talk about the possibility of your symptoms returning. Prior to discharge your doctor will talk about any medications, restrictions, or changes in daily habits to reduce the risk of more arteries narrowing. You will be told when to return for follow-up visits.

What can I do when I return home?
Avoid heavy lifting and do only light activities for a few days and call your doctor if:

  • The insertion site bleeds.
  • You feel chest pain or discomfort
  • Your arm or leg (at the insertion site) feels numb or cold.
  • The bruising or swelling gets worse or increases.
  • lf you have a fever, or signs of infection (redness or oozing) appear at the insertion site. 
    Any other unusual symptoms.

What are the risks?
There can be some risk involved with certain diagnostic procedures. In most cases they are relatively minor. Please ask your doctor to discuss the risks and benefits so that you are fully informed about any tests you may have.