All you Need to know about Coronary Angiography

Coronary angiography is a simple procedure to identify the blocks in the blood vessels supplying the heart muscle. These cholesterol or calcium blockages can lead to a heart attack or angina and need to be identified in time. Angiography is medically termed as Coronary artery angiography (CAG).

Symptoms of angiography:

  • Unstable angina or Chest pain (uncontrolled with medications or after a heart attack)
  • Heart attack
  • Before a bypass surgery
  • Abnormal treadmill test results (stress ECG)
  • To determine the extent of coronary artery disease
  • The disease of the heart valve causing symptoms (syncope, shortness of breath)
  • To monitor rejection in heart transplant patients
  • Syncope or loss of consciousness in patients with aortic valve disease

What does the angiogram test consist of?

Before starting the procedure, your healthcare provider will review your medical history- present and past, including allergies and medications you take. The physician will perform a physical examination and check your vital parameters — blood pressure and pulse, etc.

Next, you will be asked to empty your bladder and change into a hospital gown. You will remove any other accessories from you. You will be asked to be an empty stomach from midnight on the scheduled day of the surgery.

The procedure of angiography?

For the procedure, you will lie on an X-ray table and fasten the safety straps across your chest and legs. X-ray cameras will move over and around your upper body to take many pictures from different angles.

You may be given sedatives, other medications, and fluids through an intravenous (IV) line, which is inserted into a vein in your arm.

Your heart will be monitored throughout the procedure with the electrodes fixed on your chest. A blood pressure cuff will track your blood pressure, and a pulse oximeter will measure the amount of oxygen level in your blood.

Hair from a small area of your arm or groin will be shaved, washed, disinfected, and numbed with local anesthesia to insert a flexible tube catheter.

A small incision is made at the entry site, and a short plastic tube (sheath) is inserted into the radial artery in your arm or femoral artery in the upper thigh region. A thin catheter is then inserted into your blood vessel and carefully snaked up till they enter the coronary arteries. Threading the catheter into arteries is painless.

Dye (contrast material) is injected through the catheter, and this may cause a warm and flushing sensation. The color is easily seen on X-ray images. The flow of dye through your blood vessels is continuously observed by the doctor to identify any blockages or constricted areas in the arteries.

Depending on your doctor’s observation during the angiogram, you may have additional catheter procedures done simultaneously, such as balloon angioplasty or stent placement to open up a narrowed artery.

The procedure of angiogram takes about an hour but may get prolonged if other necessary cardiac catheterization procedures are incorporated. Preparation and post-procedure care will add some more time.

Care to be taken after the procedure

When the surgery is complete, the surgeon removes the catheter from the arm or groin area. The incision is allowed to close with manual pressure with the help of a clamp.

The patient is then shifted to a recovery room for observation and monitoring. When the condition is stable, the patient is admitted to the normal wardroom where he/she is continuously monitored. If the catheter is inserted in the groin area, you’d need to lie flat for several hours and relax to avoid bleeding.

Depending on your health condition, you may have to remain in the hospital overnight or may be able to go home the same day.

You will be advised to drink plenty of fluids to help flush the dye from your body. If you’re feeling hungry, you can munch on something healthy. Your consultant doctor will guide you further to resume your medications, working, and other routine activities. Though your puncture site is likely to remain tender, swollen, and bruised for a week till post-procedure.

 When should you reach out to your doctor?

  • You develop chest pain or shortness of breath.
  • You notice any new bruising or swelling or bleeding at the catheter site.
  • You have signs of infection, such as redness, drainage, or fever.
  • You develop increasing pain or discomfort at the catheter site
  • There’s a change in temperature or colour of the leg or arm that was used for the procedure.
  • You feel any numbness, tingling, or weakness in the leg or arm where the catheter was inserted.

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