CORONARY ANGIOGRAM

Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues.

Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease.

WHAT IS A CORONARY ANGIOGRAM?
  • Coronary angiography is an imaging test that uses X-rays to view your heart blood vessels. The X-rays provided by an angiography are called angiograms
  • Coronary angiogram can help doctors detect blood vessel abnormalities, including weakened blood vessels, plaque deposits, and blood clots in the heart.
  • This shows the extent and severity of heart disease and can help you to figure out how well your heart is working
  • Coronary angiograms are part of a general group of procedures known as heart (cardiac) catheterizations
  • Cardiac catheterization procedures can both diagnose and treat heart and blood vessel conditions
WHEN IS CORONARY ANGIOGRAM INDICATED?
  • Chest pain related to heart (angina)
  • Pain in your jaw, neck or arm that can’t be explained by other tests
  • New or increasing chest pain (unstable angina)
  • Congenital heart disease (childhood heart disease)
  • Abnormal results in a non-invasive heart stress test (TMT)
  • A heart valve problem that requires surgery
  • Other blood vessel problems or a chest injury
TESTS TO BE DONE BEFORE ANGIOGRAM
  • Electrocardiogram (ECG)
  • 2D-Echocardiogram (2D-Echo)
  • Stress test (TMT)
  • Chest x-ray
USES OF CORONARY ANGIOGRAM
  • Aneurysm (abnormal expansion of the blood vessel wall)
  • Heart arrhythmias (irregular heartbeat)
  • Birth defects in the heart
  • Blocks in the blood vessels
  • Defects in heart valves
MEDICAL ISSUES TO CONSIDER BEFORE THE PROCEDURE
  • Past medical history
  • Past medication history
  • Allergic history to any drugs
  • Current medication history

Procedure

Before the procedure

  • You may need to discontinue certain medications before the test, such as medications that thin the blood
  • Fasting – you need to fast four to six hours prior to your test
  • Other tests – you may undergo various tests before the angiogram, including blood tests, an ECG, and chest x-ray.
  • Remove metal objects that will interfere the test
  • Empty the bladder

During the procedure

  • You may be given medicine to relax you, but you will stay awake
  • You go to the hospital’s heart/cardiac catheterization laboratory (“Cath lab”)
  • You lie on a table near a C-arm and other equipment
  • Your doctor numbs a spot on your groin or arm and inserts a thin tube (catheter) into an artery and up to the heart. This will hurt no more than a blood test.
  • Special fluid (dye/contrast) goes through the catheter, so arteries show up well on the X-ray.
  • X-rays are taken as the fluid goes through the artery
  • You may be asked to hold your breath or cough for better angiographic views
  • By studying the X-ray images, the doctor can see any problems with your coronary arteries.
  • If you wish, you can see the X-ray pictures on the screen after the test.
  • If necessary, your doctor can open clogged heart arteries (angioplasty) during your coronary angiogram, if necessary.

Discomforts during the procedure

  • Slight pressure as the catheter is put in
  • Rarely, some chest discomfort as the fluid (dye) goes in
  • An urge to urinate
  • Nausea
  • You’ll feel a hot flash sensation from head to toe that will last for 20 seconds as the special fluid is injected
  • During the angiogram, you’ll be awake so you can do as your doctor asks.

After the procedure

  • When the angiogram is over, the catheter is removed from your arm or groin and the incision is closed with manual pressure, a clamp, or a small plug.
  • You will be taken to a recovery area for observation and monitoring.
  • When your condition is stable, you return to your own room, where you are monitored regularly.
  • You will need to lie flat for few hours to avoid bleeding if the catheter was inserted in the groin.
  • You may be able to go home the same day, or you may have to remain in the hospital overnight.
  • Drink plenty of fluids to help flush the dye from your body
  • Ask your healthcare team when to resume taking medications, bathing or showering, working, and doing other normal activities.
  • Avoid strenuous activities and heavy lifting for few days (a week)
  • Your puncture site is likely to remain tender for a while. It may be slightly bruised and have a small bump.
Results
  • The fluoroscopy pictures show how many of your coronary arteries/heart blood vessels are blocked or narrowed by fatty plaques (atherosclerosis)
  • Pinpoint where blockages are in your blood vessels
  • Show how much blood flow is blocked through your blood vessels due to blockages
  • Check the results of previous coronary bypass surgery grafts
  • Check the blood flow through your heart blood vessels
Complications
Minor
  • Bleeding
  • Bruising
  • Allergic to the contrast dye
Major
  • Heart attack
  • Stroke
  • Injury to the catheterized artery
  • Irregular heart rhythms (arrhythmias)
  • Kidney damage
  • Excessive bleeding at the puncture site
  • Infection at the puncture site
Self Care after the Procedure
  • Try to rest as much as you can
  • Avoid standing for more than a few minutes at a time
  • Avoid heavy lifting for at least a week after the procedure
  • See your doctor if you suspect infection at the puncture site. Symptoms include redness, heat, swelling or discharge from the wound site.
  • Drink plenty of fluids eight hours after the procedure (unless told otherwise by your cardiologist) to help flush the contrast from your body.
  • Don’t take bath, use a hot tub, or use a pool for at least three days. You may shower.
  • Don’t apply lotion near the puncture site for three days.
  • You’ll need to see your heart doctor a week after the test or as instructed by the doctor.

  • "Dr. Sharath Reddy is the best cardiologist in Hyderabad. We underwent the heart treatment under him. We are very happy with the treatment."

    SREE VATSAVA - HEART PATIENT

  • I would like to thank Dr Sharath Reddy and his team for the excellent cardiac care and treatment provided to me. I have been given all the information and advice to lead my life in a comfortable way after the procedure. I can’t thank you enough for all your time, hard work, and patience. I truly appreciate your caring dedication.

    Narayana E

  • My brother had severe dyspnoea (shortness of breath) and it was difficult for him to walk for even very small distances. He had severe pedal oedema (feet swelling) and was not able to do routine activities on his own. But after TAVI procedure he is able to breathe well and walk comfortably for small distances without any difficulty. Within a short time after the TAVI procedure he is performing his routine own activities. We are grateful to the cardiac team at Medicover Hospitals.

    Hanumantha Rao