Coronary Angiography (Heart Angiogram)
What is Coronary Artery Disease?
The heart is a powerful muscular organ requiring adequate supply of oxygen to function efficiently. Oxygen-rich blood is carried to the heart through three arteries that branch into a network of smaller vessels.
Coronary Artery Disease affects the blood vessels (arteries) on the surface of the heart. These arteries bring blood (rich with oxygen and nutrients) to the heart.
Ageing and other complex factors cause these ordinarily soft and compliant blood vessels to harden. In addition, fat, cholesterol and minerals from the blood are deposited on the inner surface of the coronary arteries. When this material builds up, it forms a plaque that may restrict the blood flow through the coronary artery. Such plaque may also change the surface of the artery from smooth to rough, and these rough surfaces may stimulate the formation of a blood clot, which may slowly build up and narrow the artery even more. A blood clot can also build up quickly and abruptly close off the artery.
What is Coronary Angiography?
Coronary Angiography is a special technique to visualize the arteries of the heart using X-rays. Normally, plain X-rays do not show coronary arteries. During Coronary Angiography, using a thin and flexible hollow tube known as a catheter, radio opaque dye is injected into the coronary arteries. X-rays taken at this time show the coronary arteries and their branches.
Coronary Angiography can show the exact site and severity of any narrowing of the coronary arteries. This helps the doctor to decide the modality of the treatment depending on the extent of involvement. If the narrowing of artery is mild, treatment will include intake of medicines. If the narrowing is severe, Coronary Artery Bypass Graft or Coronary Angioplasty may be required.
Why is the procedure performed?
A Coronary Angiogram shows where the arteries are narrowed or blocked
Coronary Angiography is performed to detect obstruction in the coronary arteries in patients with angina or chest pain. It may also be performed as next course of treatment when patient has had a heart attack. Sometimes patients with valve disease or holes in the heart undergoing heart surgery may be advised Coronary Angiography.
How will the procedure feel?
You will be awake and be able to follow instructions during the Coronary Angiogram. The procedure normally takes 15 to 20 minutes. Local anesthesia will be used to numb the site of the procedure, so the only sensation should be one of pressure at the site.
Occasionally, a flushing sensation occurs after the contrast media is injected. Discomfort may also arise from having to remain still during and immediately after the procedure.
After the procedure, you might feel firm pressure at the insertion site used to prevent bleeding. If the procedure is performed through the groin artery, you will usually be asked to lie flat on your back for a few hours after the procedure to avoid bleeding. This may cause some mild discomfort in the back.
How is Angiogram performed?
A thin, plastic tube called a ‘sheath’ is i nserted into an artery in your arm or leg. Catheters are passed through this sheath to the part of the aorta near the heart from which the coronary arteries arise. A special fluid called contrast medium or dye is injected through the catheter into the coronary arteries.
As the blood with the contrast medium flows through the arteries and the chambers of the heart, the doctor can see how they look using X-rays. A series of X-ray pictures are recorded as a film (Cine Angiogram). The doctor will need to make several injections of contrast medium so that the coronary arteries can be filmed from different angles.
Throughout the procedure you will be secure on the table. By connecting the catheter to a gauge, the pressure in the chambers of your heart and blood vessels can also be measured. Blood samples from those chambers may be collected for procedure. Your heart functioning and blood pressure will be continuously monitored throughout the procedure.
What about the result?
Normal result means adequate blood supply to the heart. Abnormal result is when Coronary Angiography shows the following:
- Blockage of coronary arteries
- Places of blockage
- Degree of each blockage
These results can help your doctor decide on the right treatment for your heart disease.
The information in this handout is not intended as a substitute for medical advice but is to be used as an aid in understanding ailment. Always consult your doctor about your medical condition.
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