Coronary Angiography

A coronary angiography is a test used to look at the blood vessels that supply blood to your heart (the coronary arteries). It helps doctors see whether any arteries are narrowed or blocked.

What Causes Blocked Coronary Arteries?

The heart receives blood through the coronary arteries. Over time, fatty deposits called plaque can build up inside these arteries. This is known as coronary artery disease.

Common risk factors include:

• Smoking
• High blood pressure
• High cholesterol
• Diabetes
• Obesity
• Lack of exercise
• Family history of heart disease
• Increasing age

Why Might I Need This Test?

Your doctor may recommend coronary angiography if you have:

• Chest pain (angina)
• Shortness of breath
• An abnormal exercise stress test or stress echocardiogram
• An abnormal CT coronary angiogram
• A suspected heart attack
• Known coronary artery disease
• Planned heart surgery or another major procedure

Before the Procedure

You may be asked to:

• Avoid eating or drinking for several hours beforehand
• Tell your doctor about any allergies, especially to iodine or contrast dye
• Inform staff about medications you take, including blood thinners or diabetes medicines
• Have blood tests or an ECG before the test

How is the Procedure Done?

1. You are taken to a cardiac catheterisation laboratory (“cath lab”) and lie on an X-ray table.
2. A doctor inserts a thin tube (catheter) into an artery in the wrist or groin.
3. The catheter is guided to the heart.
4. A special contrast dye is injected into the coronary arteries.
5. X-ray images are taken to show blood flow and any blockages.

The procedure usually takes 30 minutes to 1 hour, though you may be in hospital longer for preparation and recovery.

What Will I Feel?

Most people are awake during the procedure. You may notice:

• A calming effect from sedative medication given beforehand
• A brief sting when local anaesthetic is injected at the wrist or groin
• Pressure where the catheter is inserted
• A warm flushing feeling when the dye is injected

The test is usually not painful.

Possible Benefits

Coronary angiography can:

• Accurately identify narrowed or blocked coronary arteries
• Help doctors decide on the best treatment
• Guide procedures such as coronary angioplasty (PCI)
• Reduce uncertainty about heart symptoms

Risks and Possible Complications

Coronary angiography is generally safe, but risks can include:

Common minor risks:

• Bruising or bleeding at the insertion site
• Temporary soreness

Less common but more serious risks:

• Stroke
• Heart attack
• Allergic reaction to the dye
• Irregular heart rhythm
• Damage to blood vessels
• Kidney problems

After the Procedure

• You will be monitored for several hours.
• Staff will check the insertion site and your blood pressure.
• You may be asked to drink extra fluids to help clear the dye.
• Avoid heavy lifting for a few days, especially if the groin was used for access.

Seek urgent medical attention if you develop:

• Severe bleeding or increasing swelling at the insertion site
• Chest pain
• Fever
• Numbness or colour changes in the limb used for access