Coronary angiography is often done along with cardiac catheterization. This is a procedure which measures pressures in the heart chambers.
Before the test starts, you will be given a mild sedative to help you relax.
An area of your body (the arm or groin) is cleaned and numbed with a local numbing medicine (anesthetic). The cardiologist passes a thin hollow tube, called a catheter, through an artery and carefully moves it up into the heart. X-ray images help the doctor position the catheter.
Once the catheter is in place, dye (contrast material) is injected into the catheter. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages in blood flow.
The procedure most often lasts 30 to 60 minutes.
How to Prepare for the Test
You should not eat or drink anything for 8 hours before the test starts. You may need to stay in the hospital the night before the test. Otherwise, you will check in to the hospital the morning of the test.
You will wear a hospital gown. You must sign a consent form before the test. Your health care provider will explain the procedure and its risks.
Tell your provider if you:
Are allergic to any medicines or if you have had a bad reaction to contrast material in the past
Are taking Viagra
Might be pregnant
How the Test will Feel
In most cases, you will be awake during the test. You may feel some pressure at the site where the catheter is placed.
You may feel a flushing or warm sensation after the dye is injected.
After the test, the catheter is removed. You might feel a firm pressure being applied at the insertion site to prevent bleeding. If the catheter is placed in your groin, you will be asked to lie flat on your back for a few hours to several hours after the test to avoid bleeding. This may cause some mild back discomfort.
Why the Test is Performed
Coronary angiography may be done if:
You have angina for the first time.
Your angina that is becoming worse, not going away, occurring more often, or happening at rest (called unstable angina).
Considerations associated with any type of catheterization include the following:
In general, there is a risk of bleeding, infection, and pain at the IV or catheter site.
There is always a very small risk that the soft plastic catheters could damage the blood vessels or surrounding structures.
Blood clots could form on the catheters and later block blood vessels elsewhere in the body.
The contrast dye could damage the kidneys (particularly in people with diabetes or prior kidney problems).
If a blockage is found, your health care provider may perform a percutaneous coronary intervention (PCI) to open the blockage. This can be done during the same procedure, but may be delayed for various reasons.
Fihn SD, Blankenship JC, Alexander KP, Bittl JA, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014 Nov 4;64(18):1929-49. PMID: 25077860 www.ncbi.nlm.nih.gov/pubmed/25077860.
Popma JJ, Kinlay S, Bhatt DL. Coronary arteriography and intracoronary imaging. In: Mann DL, Zipes DP, Libby P, et al. eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 20.
Michael A. Chen, MD, PhD, Associate Professor of medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.