Coronary angiogram

A coronary angiogram is carried out in a cardiac catheter laboratory, often known as a ‘cath lab’. Before the procedure you’ll be asked not to eat or drink a few hours. When you arrive, you will need to lie flat on a firm special table. The procedure usually takes about half an hour, although sometimes it can take a little longer.

In many cases, a very light sedative may be given but you will be awake throughout the procedure. To begin, a local anaesthetic will be injected into the skin around your wrist to numb the area. In a small number of cases, an anaesthetic may be injected into your groin. The doctor will then gently insert a thin, flexible tube called a catheter into one of your arteries. With the help of X-ray imaging, the catheter is gently guided through your blood vessels until it reaches your heart.

Once the catheter is in place, a special dye known as contrast is passed through it. As the dye moves through your hearts blood vessels, a series of X-ray images are taken. Your doctor will be standing with you throughout the procedure, observing your heart, the electrocardiogram (ECG) and the heart arteries. You may feel a brief hot, flushing sensation as the dye enters your bloodstream - this is completely normal and only lasts a few seconds. The dye helps highlight if of your arteries are narrowed or blocked.

You’ll be awake and able to talk to the medical team throughout the procedure. You’ll be connected to a heart monitor to track your heart rate and rhythm, and a small probe on your finger will measure your oxygen levels. If you feel anxious, you can ask for a mild sedative to help you relax.

As a coronary angiogram is a diagnostic procedure, in some cases the doctor can treat the heart arteries in the same procedure, which is known as a coronary angioplasty. During the coronary angiogram, further diagnostic information may be gained by using technologies such as a pressure wire that measures how well blood is flowing through your artery or intravascular coronary imaging that helps your doctor see exactly how much narrowing there is and what the artery looks like from the inside.

Once the procedure is complete, the tubes will be removed from your body and if your wrist has been used to access the artery, a special plastic bracelet will be placed around the hand area to help the area heal. In this instance, you can usually sit up very soon after the procedure. If your groin has been used to access the artery, a small collagen plug may be placed to stop any bleeding, and you will be asked to lie flat for a certain length of time.

Most people are able to go home on the same day as their coronary angiogram, once they’ve had some time to rest and be observed by the medical team. During this time, your observations will be taken and a routine ECG will be performed.

It’s important to arrange for a family member or friend to take you home, as you won’t be able to drive straight away.

It’s normal to feel a bit tired for a day or two after the procedure, and the area where the catheter was inserted, either your wrist or groin, may be tender for up to a week. Some bruising is normal and can last for a couple of weeks.

You’ll usually be advised to avoid certain activities, such as bathing and lifting heavy objects, for a day or two after the procedure. Driving should also be avoided until your medical team confirms it’s safe, which may be up to three days after your angiogram.

After your coronary angiogram, your medical team will use the images to see how well blood is flowing through the arteries of your heart. This test can help your doctor:

• identify any arteries that are narrowed or blocked

• assess how much blood flow to or from the heart is affected

• detect whether there are any build-up of fats, cholesterol, or other substances in the artery walls - a condition known as atherosclerosis

• check the results of previous heart surgery

All of this information helps your doctor decide on the best treatment plan for you, making sure you get the care that’s right for your heart.