An angiogram is an X-ray image of blood vessels after they are filled with a contrast material. An angiogram of the heart, a coronary angiogram, is the "gold standard" for the evaluation of coronary artery disease.

A coronary angiogram can be used to identify the exact location and severity of coronary artery disease.

How is an Coronary Aniogram Performed?

Coronary angiography is performed with the use of local anaesthesia and intravenous sedation, and is generally not significantly uncomfortable. In performing a coronary angiogram, a doctor inserts a small catheter (a thin hollow tube with a diameter of 2-3 mm) through the skin into an artery in the groin.

Guided with the assistance of a special x-ray viewing instrument, the catheter is then advanced to the opening of the coronary arteries (the blood vessels supplying blood to the heart). Next, a small amount of radiographic contrast (a solution containing iodine, which is easily visualized with Xray images) is injected into each coronary artery.

The images that are produced are called the angiogram. The procedure takes approximately 20-30 minutes. After the procedure, the catheter is removed and the artery in the leg is either sutured, "sealed," or treated with manual compression to prevent bleeding. Often, if an angioplasty or stent is indicated, it will be performed as part of the same procedure.

What Does a Coronary Aniogram Demonstrate?

Angiographic images accurately reveal the extent and severity of all coronary artery blockages. For patients with severe angina or heart attack (myocardial infarction), or those who have markedly abnormal non invasive tests (such as stress tests/stress echocardiogram /thallium scan), the angiogram also helps the doctor select the optimal treatment.

What is After That?

Angiogram is a diagnostic test which could show normal or a narrowed coronary artery. Depending on the extent of the problem treatments may then include medications, balloon angioplasty, coronary stenting or bypass surgery.

Risks of cardiac catheterisation and coronary angiography Cardiac catheterisation and coronary angiography are generally considered to be safe procedures. However, as with all invasive medical procedures, there are some associated risks. Potential risks of coronary angiography include:

  • Haematoma(1/20) bleeding under the skin at the wound site — this should improve after a few days.

  • Bruising — it is common to have a bruise in your groin or arm afterwards allergy to the contrast dye used — this is rare.

Serious complications (1/1000) In very rare cases, more serious complications of coronary angiography can occur. These include:

  • Heart attack — a serious medical emergency where the heart's blood supply is suddenly blocked, usually by a blood clot.

  • Stroke — a serious medical condition that occurs when the blood supply to the brain is interrupted, damage to the artery in the arm or groin in which the catheter was inserted, with possible impairment of circulation to the limb deterioration in kidney function

  • Death.