Angiogram

Coronary Angiogram is a diagnostic procedure performed to identify any narrowing or block in the arteries that supply blood to the heart. Coronary Angiogram is done by injecting a specific kind of dye to the blood vessels, the dye is observable by taking a continuous X-ray video. The images from the X-ray are analyzed to identify blockage or narrowing present in blood vessels carrying blood to the heart.

Your doctor may prescribe a Coronary Angiogram if you experience the following conditions

• Radiating pain in your chest, jaw, neck, or arms
• Abnormal results were seen in a heart stress test, ECG
• Problems related to blood vessel
• Injury to your chest
• Problems with valves of your heart may require surgical intervention

A Coronary Angiogram is a relatively safe procedure, but it has some complications such as:

• Stroke and cardiac arrest
• Damage to the catheterized blood vessel
• Cardiac arrhythmias
• Adverse reactions to the dye used for angiogram
• Kidney impairment
• Bleeding and Infection

General guidelines for patients preparing for Coronary angiogram

The patient is advised to avoid food and water intake after a specific time depending on the timing of the angiogram.

Do confirm with the doctor about the routine morning medication.

Certain blood investigations are required to be done to identify any problems in the clotting of the blood, kidney function, hemoglobin status, and the presence of any past/present viral infections.

Intravenous access is taken and IV fluids are started before the procedure usually.

Before the coronary angiogram, the patient is recommended to empty the bladder and remove wearables, contact lenses, spectacles, jewellery etc.

About the procedure

The procedure may take anywhere from 15 minutes to one hour or more, depending on other combined cardiac catheterization procedures. The patient is asked to lie on her/his back on an X-ray table. After cleaning and draping, a local anesthetic is infiltrated under the skin at the site of the puncture. Radial angiograms involve a puncture of the radial artery at the wrist while a femoral angiogram involves a puncture below the left or right groin, high on the thigh. A sheath is inserted into the artery of choice and the catheter(s) are threaded over a wire to reach the beginning of the aorta where the coronary arteries arise. Each artery is engaged selectively and dye injected under fluoroscopic video recording. The X-ray images taken at the Cath lab are analyzed by the specialist doctor for any blockage or narrowing of blood vessels. Upon removing the catheter, the puncture site is closed by manual pressure, a clamp, or a small plug.

The images are discussed with the patient and/or relatives so that a decision on further management of the problem can be taken. This might be continuation of medical management, coronary angioplasty, or coronary artery bypass surgery for significant blockages as seen on the angiogram (depending on the number, nature, severity, location and significance of the blockages in addition to patient-related factors).

After a radial Coronary Angiogram, the patient can rest a while and can walk, if required. He is observed for a period of time and can then be discharged with specific advice on further follow-up.

After the femoral angiogram, the patient is required to lie flat for at least 4 hours to avoid any local bleeding. The patient might need to spend the night in the hospital under observation and get discharged the next day.

It is recommended to increase the fluid intake as it helps to remove the dye used during a coronary angiogram.