Coronary Angiography

What is coronary angiography?

Coronary angiography is a minimally invasive procedure and test, which allows doctors to detect any narrowed or blocked blood vessels in the heart's arteries. It involves injecting dye into the blood vessels of the heart, followed by taking X-ray images of the heart. It is a fast and effective way to provide definitive evidence of any abnormalities that may be present.

Coronary Angiography – Benefits

What are the benefits of coronary angiography? 

Coronary angiography offers several advantages in diagnosing and managing coronary artery disease (CAD) compared to other diagnostic tests:

Accurate Assessment

Coronary angiography provides detailed and accurate information about the extent and severity of blockages in the coronary arteries, helping cardiologists plan appropriate treatment strategies.

Direct Visualisation

Unlike other imaging tests, such as CT scans or stress tests, coronary angiography allows direct visualisation of the coronary arteries, enabling precise identification of blockages or abnormalities.

Guidance for Treatment

The results of coronary angiography can guide treatment decisions, such as the need for angioplasty, stent placement, or coronary artery bypass graft (CABG) surgery, based on the severity and location of blockages.

Immediate Intervention 

In cases where significant blockages are detected during angiography, immediate treatment options such as angioplasty and stenting can be performed at the same setting, avoiding the need for the patient to come back another day for the angioplasty.

Comprehensive Evaluation

Coronary angiography provides a comprehensive evaluation of the coronary arteries, including the ability to assess the function of the heart muscle and the presence of any congenital anomalies or other structural abnormalities.

Effective Risk Stratification

Coronary angiography can help in risk stratification, identifying patients at high risk of future cardiac events who may benefit from aggressive medical therapy or invasive interventions.

Coronary Angiography – Limitations

What are the limitations of coronary angiography? 

• Invasive procedure: Involves insertion of a small catheter into the blood vessels.

• Radiation exposure: Uses X-rays.
  

Coronary Angiography – Considerations and Risks

What are the considerations and risks associated with coronary angiography?

- Allergic Reactions: Individuals with known allergies to X-ray contrast or iodine compounds should not undergo coronary angiography, as it involves the injection of dye into the blood vessels.

- Unstable Health Conditions: Patients with unstable health conditions, such as severe heart failure, severe respiratory failure, or severe kidney failure, may not be suitable candidates for coronary angiography due to the potential risks involved.

- Bleeding Disorders: Individuals with bleeding disorders or who are on blood-thinning medications may have an increased risk of bleeding complications during or after the procedure, making them unsuitable candidates for coronary angiography.

- Pregnancy: Coronary angiography is generally not recommended for pregnant women due to the potential risk to the fetus from the X-ray exposure and contrast dye.

- Renal Impairment: Patients with severe kidney impairment may be at an increased risk of complications from the contrast dye used in coronary angiography, and alternative diagnostic methods may be considered.

- Unstable Angina: Individuals experiencing unstable angina, a type of chest pain that occurs at rest or with minimal exertion, may not be suitable candidates for coronary angiography until their condition stabilises.

​How can you prepare for coronary angiography?

You will be asked whether you have any allergic reactions to medicines or food, especially to X-ray contrast or iodine compounds. You are advised to inform the doctor of your allergies.

You may be asked to abstain from food six hours before your angiography. Generally, you should continue all your medicines unless informed otherwise by your doctor. If your procedure is in the afternoon, a full breakfast may be taken.

The day before the procedure, you should try and get a good night’s sleep. If necessary, ask for some sleeping medication.

What can you expect during coronary angiography?

On the day of procedure, you will be asked to remove your dentures, contact lenses and any jewellery. Please do not bring any money or valuables on the day of your procedure.

During the Procedure
Local anaesthetic will be given to numb the area of injection, you may be slightly sedated but awake. A soft plastic tube around 2mm in diameter will then be inserted through a blood vessel in the groin or wrist. This tube will be passed towards the heart using x-ray guidance.

After the tube enters the blood vessels of the heart, dye will be injected into both the right and left blood vessels of the heart via the tube. Moving images of the arteries would be taken using X-ray. Another tube may also be passed into the left heart to assess the heart function.

What can you expect after coronary angiography?

Your doctor will evaluate the results and then advise you on the most appropriate treatment. You may be discharged on the same day after the procedure.

If there is severe narrowing in your artery, the cardiologist may perform coronary angioplasty for you immediately after the angiography. Otherwise, you will be asked to return another day for the procedure or for coronary artery bypass graft surgery.

Watch our video on coronary angiography:

What is a Coronary Angiography and Angioplasty?