A coronary angiogram is a diagnostic procedure used to visualize the arteries that supply blood to the heart. It is commonly performed to detect blockages or narrowing that could be causing symptoms such as chest pain or shortness of breath. While the term may sound intimidating, the procedure is routine and carefully controlled. Understanding what to expect before, during, and after a coronary angiogram can help ease anxiety and prepare you for a smooth experience.
Why You Might Need a Coronary Angiogram
Your cardiologist may recommend a coronary angiogram if:
- You have symptoms of coronary artery disease, such as chest discomfort, pressure, or fatigue
- Noninvasive tests, such as a stress test or EKG, suggest reduced blood flow to the heart
- You have had a heart attack and your provider needs to assess the extent of the blockage
- You are being evaluated before a planned heart procedure, such as bypass surgery or stent placement
The goal of the procedure is to take detailed X-ray images of your coronary arteries using contrast dye, which makes the blood vessels visible on a monitor.
Before the Procedure
Preparation starts a day or two before your appointment. You will be given instructions about eating, drinking, and medications. In most cases:
- You may be asked not to eat or drink anything for several hours before the test
- Certain medications, such as blood thinners or diabetes medications, may need to be adjusted
- Your provider will review your medical history and ensure you are not allergic to the contrast dye used during the angiogram
On the day of the procedure, you will check in and change into a hospital gown. A nurse will start an IV line, and monitoring devices will be placed to track your heart rate, blood pressure, and oxygen levels.
During the Procedure
The coronary angiogram is performed in a special room called a catheterization lab, or cath lab. The entire procedure typically takes 30 to 60 minutes.
Here is what you can expect:
1. Local Anesthesia: You will be awake but relaxed during the procedure. A local anesthetic is used to numb the area where the catheter will be inserted, usually the wrist or groin.
2. Catheter Insertion: A small incision is made, and a thin, flexible tube called a catheter is inserted into a blood vessel. Using live X-ray guidance, the provider carefully threads the catheter through the artery and into the heart’s blood vessels.
3. Dye Injection and Imaging: Once the catheter is in place, contrast dye is injected. This dye makes the coronary arteries visible on the monitor. Your provider takes a series of images to look for any narrowing, blockages, or abnormalities in the arteries.
You may feel a brief warm sensation when the dye is injected, but it is generally not uncomfortable.
4. Evaluation and Possible Treatment: If a significant blockage is found, your provider may recommend immediate treatment, such as angioplasty or the placement of a stent. In some cases, a separate procedure will be scheduled for a later time.
After the Procedure
Once the imaging is complete, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding.
Recovery involves:
- Monitoring in a recovery area for a few hours
- Instructions on keeping the arm or leg still, depending on where the catheter was inserted
- Drinking fluids to help flush the contrast dye from your system
Most patients go home the same day, but you will need someone to drive you. You may be advised to avoid strenuous activity for a short period following the procedure.
Your provider will review the angiogram results and explain any findings. If blockages were found, they will discuss next steps for treatment or ongoing management.
Taking the Next Step
A coronary angiogram provides your care team with detailed information about the condition of your heart’s arteries and is an important step in diagnosing and managing cardiovascular disease.
Epic Cardiology has locations across the Greater Los Angeles area, including clinics that serve Chino, Pomona, San Dimas, Sherman Oaks, Lynwood, and Inglewood. Contact us today to schedule an appointment and learn more about services near you.