Coronary angiography is the most accurate way of determining whether a patient has significant coronary artery disease. By viewing the pictures or X-ray movies produced by this test, the doctor can clearly see if any blockages are present and, if so, their severity. With this information, the best type of treatment can be recommended.
How coronary angiography is done
In order to perform a coronary angiogram, the doctor must place a special tube or catheter into an artery in the patient's arm or leg, and then pass it to the blood vessels of the coronary arteries. A special X-ray dye is injected into the coronary arteries so that the doctor can see the details on a television monitor. At the same time, a permanent record is made on movie, video, or compact disc.
A coronary angiogram is performed in hospital, usually on a day-care, outpatient basis. The patient will receive a mild sedative, either as a pill or as an injection. Either the groin or arm will be scrubbed with antiseptic and covered with sterile sheets. You may be asked to place your hands behind your head for a portion of this procedure so that clearer pictures can be taken of the heart as the X-ray looks through the chest.
A local anesthetic is given with a small needle and the pain is usually mild or brief. When the doctor injects the dye into the coronary arteries there may be a feeling of warmth or pressure; sometimes you will be asked to cough. Occasionally you may be able to watch the pictures yourself.
Risks: Since the test involves passing a tube to the heart and injecting dye, there is an estimated risk of 1 in 500 of a heart attack, stroke, or major allergic reaction. The hospital will inform you of the specific risks involved.
Interpreting the results of an angiogram
Because the coronary angiogram provides detailed visual information of the state of the coronary arteries, it supplies important, accurate information that allows your doctor to identify exactly what the situation is, so that the appropriate treatment can be given.