An angiogram helps doctors look at the blood vessels of the heart,
specifically to see if there is any plaque in the coronary arteries. The
angiogram is performed by a catheter being inserted into the artery
through the skin in the leg and threaded up to the coronary arteries.
Dye is injected into the arteries and x-rays taken. If a blockage is
found, the doctor may try to open it with a balloon. This is called an
angioplasty. An angioplasty opens arteries that are too narrow for
adequate blood flow. The balloon is attached at the end of the catheter
and threaded up to the area of blockage. The balloon is then inflated to
break up the plaque, thus widening the artery and allowing more blood
to flow. A stainless steel mesh tube called a stent may be placed at the
site of the blockage to keep it open.
Introduction
Sometimes people have serious problems with their heart and the arteries that go into it.
An angiogram helps doctors look at the blood vessels of the heart. And, if needed, an angioplasty allows them to open arteries that are too narrow for adequate blood flow.
If your doctor recommends a coronary angiogram and possible angioplasty, the decision whether or not to have the procedures is also yours.
This patient education module will help you understand better the benefits and risks of these procedures.
An angiogram helps doctors look at the blood vessels of the heart. And, if needed, an angioplasty allows them to open arteries that are too narrow for adequate blood flow.
If your doctor recommends a coronary angiogram and possible angioplasty, the decision whether or not to have the procedures is also yours.
This patient education module will help you understand better the benefits and risks of these procedures.
Anatomy
The heart is the most essential muscle in the body.
Its main function is to pump the blood to the lungs and to the rest of the body.
Since the heart is living tissue, it needs blood like the rest of the body. So it pumps blood to itself through many blood vessels that go directly to the heart muscles. These are known as coronary arteries.
Its main function is to pump the blood to the lungs and to the rest of the body.
Since the heart is living tissue, it needs blood like the rest of the body. So it pumps blood to itself through many blood vessels that go directly to the heart muscles. These are known as coronary arteries.
Symptoms And Their Causes
Cholesterol deposits accumulate in the coronary arteries forming a ‘plaque’ that narrows the artery.
Narrowed arteries do not let enough blood go through. This causes blood flow to decrease, which could lead to heart attacks.
If blood flow is reduced enough by cholesterol deposits, the heart will not be able to keep up with exertion. If the condition worsens or the coronary arteries become blocked, the heart can be damaged.
An angiogram is a test that helps show the plaque in the coronary arteries and helps detect any narrowing or blockage.
Other tests such as EKGs or heart tracings and special CAT scans can cause the doctor to suspect blockage in the coronary arteries. However, these tests do not show the blood vessels. A coronary angiogram is the only reliable test that shows the blood vessels of the heart.
Narrowed arteries do not let enough blood go through. This causes blood flow to decrease, which could lead to heart attacks.
If blood flow is reduced enough by cholesterol deposits, the heart will not be able to keep up with exertion. If the condition worsens or the coronary arteries become blocked, the heart can be damaged.
An angiogram is a test that helps show the plaque in the coronary arteries and helps detect any narrowing or blockage.
Other tests such as EKGs or heart tracings and special CAT scans can cause the doctor to suspect blockage in the coronary arteries. However, these tests do not show the blood vessels. A coronary angiogram is the only reliable test that shows the blood vessels of the heart.
Procedure
Your healthcare provider may ask you not to eat or drink for several
hours before the procedure. If your surgery is in the morning, this
usually means no food or drink after midnight the night before.
During an angiogram, the doctor inspects the coronary arteries for blockage. If the angiogram shows blockage, while tubes and other instruments are in place, the doctor can correct it with an angioplasty (or an alternative procedure).
If the angiogram does not show a blockage in the arteries, you will probably be able to go home after the test is completed.
This procedure is done while you are awake. There is virtually no pain involved. You will be asked to lie down on an x-ray table.
During the procedure, the heart rate, blood pressure, and vital signs are continuously monitored.
The groin area is then disinfected and made numb with a local anesthetic.
A catheter is then inserted into the artery through the skin in the leg and threaded all the way up into the coronary arteries.
Sometimes, depending on the doctor’s preference and the state of your arteries, the catheter may be inserted in a big artery in the underarm or the upper arm instead of the groin.
Dye is then injected in the arteries and x-rays are taken. You should stay very still during the x-rays to allow good, sharp images to be taken.
If a blockage is found, the doctor will decide whether it can be opened using either a balloon or another device. The procedure that uses a balloon is called angioplasty.
The balloon is attached at the end of the catheter and is threaded up to the area of the blockage through the artery used for the angiogram.
The balloon is then inflated to break up the plaque, which widens the artery, allowing more blood to flow through.
The balloon is then deflated and withdrawn.
Following the angioplasty, your doctor may choose to place a ‘stent,’ a stainless steel mesh tube, at the site of the blockage to keep it open.
If a stent is used, it is attached at the end of the catheter and placed at the site.
A stent may also be used without a balloon to open a blocked artery.
Another way to open blocked arteries without angioplasty is a small, mechanical device, instead of a balloon, that breaks the plaque into pieces. This decision is made by the doctor at that time.
In addition to breaking up the plaque, a stent could be placed.
After the angiogram and the angioplasty, if it is needed, the catheter is taken out. In order to prevent bleeding from the puncture site, you will be instructed to lie flat and not bend your leg.
If your cardiologist uses a closure device, you will lie flat for about 1 hour; if not, you will lie flat for up to 8 hours. You should not bend the leg on the side of the groin that was catheterized.
You will probably not be able to drive and will therefore need somebody to drive you back home.
During an angiogram, the doctor inspects the coronary arteries for blockage. If the angiogram shows blockage, while tubes and other instruments are in place, the doctor can correct it with an angioplasty (or an alternative procedure).
If the angiogram does not show a blockage in the arteries, you will probably be able to go home after the test is completed.
This procedure is done while you are awake. There is virtually no pain involved. You will be asked to lie down on an x-ray table.
During the procedure, the heart rate, blood pressure, and vital signs are continuously monitored.
The groin area is then disinfected and made numb with a local anesthetic.
A catheter is then inserted into the artery through the skin in the leg and threaded all the way up into the coronary arteries.
Sometimes, depending on the doctor’s preference and the state of your arteries, the catheter may be inserted in a big artery in the underarm or the upper arm instead of the groin.
Dye is then injected in the arteries and x-rays are taken. You should stay very still during the x-rays to allow good, sharp images to be taken.
If a blockage is found, the doctor will decide whether it can be opened using either a balloon or another device. The procedure that uses a balloon is called angioplasty.
The balloon is attached at the end of the catheter and is threaded up to the area of the blockage through the artery used for the angiogram.
The balloon is then inflated to break up the plaque, which widens the artery, allowing more blood to flow through.
The balloon is then deflated and withdrawn.
Following the angioplasty, your doctor may choose to place a ‘stent,’ a stainless steel mesh tube, at the site of the blockage to keep it open.
If a stent is used, it is attached at the end of the catheter and placed at the site.
A stent may also be used without a balloon to open a blocked artery.
Another way to open blocked arteries without angioplasty is a small, mechanical device, instead of a balloon, that breaks the plaque into pieces. This decision is made by the doctor at that time.
In addition to breaking up the plaque, a stent could be placed.
After the angiogram and the angioplasty, if it is needed, the catheter is taken out. In order to prevent bleeding from the puncture site, you will be instructed to lie flat and not bend your leg.
If your cardiologist uses a closure device, you will lie flat for about 1 hour; if not, you will lie flat for up to 8 hours. You should not bend the leg on the side of the groin that was catheterized.
You will probably not be able to drive and will therefore need somebody to drive you back home.
Risks and Complications
This procedure is safe. There are, however, several possible risks and
complications. These are very unlikely but possible. You need to know
about them just in case they happen. By being informed you may be able
to help your doctor detect complications early.
The angioplasty may not succeed in relieving the blockage. Even if relieved, the blockage could happen again or the stent could get moved out of position. This could lead to a heart attack.
X-rays are used during this procedure. The amount of radiation during this test is deemed safe. However, this same amount could be dangerous for unborn children. It is therefore very important to make sure you are not pregnant prior to an elective radiological test.
The coronary angiogram can, rarely, lead to a heart attack, requiring an unforeseen angioplasty or even open heart surgery.
The catheter placed in the artery can rarely injure that artery or other arteries of the body. This may cause decreased blood to the leg or arm involved, which may require an operation to reestablish blood flow.
The insertion can also cause injury to a nerve in the leg or arm depending on where the initial puncture was done.
Some people have allergies to the iodine dye used in this test. Make sure to tell your doctor about your allergies and about any past possible reactions to any sort of dye used on you in the past.
In some people dye can cause kidney failure. Let your doctor know if you have kidney problems. You might be at a somewhat higher risk.
Kidney failure is more likely in patients taking glucophage, a diabetes medication.
So it is important that you inform your doctors about all the medications you are taking.
The angioplasty may not succeed in relieving the blockage. Even if relieved, the blockage could happen again or the stent could get moved out of position. This could lead to a heart attack.
X-rays are used during this procedure. The amount of radiation during this test is deemed safe. However, this same amount could be dangerous for unborn children. It is therefore very important to make sure you are not pregnant prior to an elective radiological test.
The coronary angiogram can, rarely, lead to a heart attack, requiring an unforeseen angioplasty or even open heart surgery.
The catheter placed in the artery can rarely injure that artery or other arteries of the body. This may cause decreased blood to the leg or arm involved, which may require an operation to reestablish blood flow.
The insertion can also cause injury to a nerve in the leg or arm depending on where the initial puncture was done.
Some people have allergies to the iodine dye used in this test. Make sure to tell your doctor about your allergies and about any past possible reactions to any sort of dye used on you in the past.
In some people dye can cause kidney failure. Let your doctor know if you have kidney problems. You might be at a somewhat higher risk.
Kidney failure is more likely in patients taking glucophage, a diabetes medication.
So it is important that you inform your doctors about all the medications you are taking.
After the Angiogram
After the angiogram, you will need to stay flat for 6 to 8 hours and not
move the leg on the side of the groin that was catheterized.
The nurse will give you discharge instructions, which include a number to call in case of an emergency. Make sure to call this number in case of any new symptoms such as redness, fever or numbness, weakness, swelling or bleeding at the puncture site. If you experience chest pain, you should go to the ER.
You should also go to the nearest emergency room if you have chest pain, difficulty breathing, arm pain, or irregular heart beat.
The nurse will give you discharge instructions, which include a number to call in case of an emergency. Make sure to call this number in case of any new symptoms such as redness, fever or numbness, weakness, swelling or bleeding at the puncture site. If you experience chest pain, you should go to the ER.
You should also go to the nearest emergency room if you have chest pain, difficulty breathing, arm pain, or irregular heart beat.
Summary
A coronary angiogram test helps your doctors look at the blood vessels
of the heart. In this procedure, the doctor injects dye into the
coronary arteries so that they can be x-rayed. An angiogram is the best
way to find out if arteries are blocked or restricted by plaque.
If a coronary artery is blocked, a coronary angioplasty is a procedure that allows your doctor to open narrowed arteries of the heart. This procedure uses a balloon to open arteries so that blood flow to the heart can be increased.
Coronary angiograms and angioplasties are very safe. Risks and complications are very rare. Knowing about them will help you detect them early if they happen.
If a coronary artery is blocked, a coronary angioplasty is a procedure that allows your doctor to open narrowed arteries of the heart. This procedure uses a balloon to open arteries so that blood flow to the heart can be increased.
Coronary angiograms and angioplasties are very safe. Risks and complications are very rare. Knowing about them will help you detect them early if they happen.
