Coronary angiography

A coronary angiogram is a picture of the blood vessels supplying your heart obtained by injecting contrast (a type of dye) into the heart arteries that shows up on X-ray images. The pictures are taken with the patient lying on a flat table in a room called the catheterisation laboratory or “Cath Lab”.

 

Pictures from multiple angles are taken. Based on these pictures, your cardiologist will be able to determine if blockages are present in your heart arteries.  Your cardiologist may also use special additional tests to take high definition pictures of the insides of your heart arteries or pressure measurements to help determine if a blockage needs treatment. 

What’s involved in coronary angiography and coronary stent insertion?

The recommendation to perform a coronary angiogram is usually made by your cardiologist who will explain the procedure, including its risks and benefits and will get you to sign a consent form. Most people are admitted to the hospital Cathlab in the morning the same day of the procedure after fasting from midnight.

Nursing staff will greet you and prepare you for the procedure. You will lie on an examination table which is near an x-ray camera and be given a sedative through an intravenous drip to relax you and make you comfortable. A small amount of local anaesthetic is used to numb the area (wrist or groin) where the cardiologist will insert a thin tube called a sheath. The cardiologist will insert a catheter and guide it up to your heart. Dye is then injected so your cardiologist can examine the insides of your heart blood vessels. This information is recorded and shown on a TV screen. The coronary angiogram usually takes about 30 minutes.

If a severe blockage is found, your cardiologist may proceed to implant a stent. This is done through the same tubes and devices used to perform the angiogram. Additional procedures including Fractional Flow Reserve (FFR), Intravascular Ultrasound (IVUS) or Optical Coherence Tomography (OCT) may be performed by your cardiologist to help decide on the best course of treatment. The insertion of a coronary stent usually takes another 30 – 60 minutes depending on the complexity.

Once the procedure is finished you will move to a recovery room where you will need to rest for a couple of hours. Your cardiologist will then discuss the findings of your angiogram and organise a management plan for you depending on the results.

In most instances, patients will be discharged from hospital on the same day after a coronary angiogram. You will not be allowed to drive back, so there should be arrangements for your transport back home. If you receive a coronary stent then you will usually be discharged from hospital the next morning.