What is Angiography?

Angiography also referred to as arteriography or coronary angiogram is a medical imaging technique, a kind of X-ray used to check blood vessels, arteries, veins and heart chambers.

In angiography a special dye is needed and is injected into your blood first. This dye highlights your blood vessels, and other details allowing the doctor to see any problems. The X-ray images created during angiography are called angiograms. An angiogram can show if your coronary arteries are narrowed, where they are narrowed, and by how much. If necessary, your doctor can open blocked or narrowed heart arteries through angioplasty procedure during your coronary angiogram.

Coronary angiograms are part of a general group of procedures known as heart (cardiac) catheterizations that help to diagnose heart conditions. It is the most common type of cardiac catheterization procedure.

Why it’s done?

Doctor may recommend you to go for a coronary angiogram, angiography if you have the following symptoms of coronary artery disease:

• Chest pain (angina), pain in your chest, jaw, neck or arm that can’t be explained by other tests
• Congenital heart disease, i.e. defect in heart since birth
• Abnormal results of heart stress test
• A heart valve problem that may require surgery
• Heart’s blood vessel problem or a chest injury

Cardiac angiography is usually done only after non-invasive heart tests have been performed, such as an electrocardiogram, an echocardiogram or a stress test.

How you will be prepared for angiography?

Mostly angiography is scheduled in advance giving you time to prepare mentally and physically. But, in some cases, due to the urgency of the situation coronary angiograms are performed on an emergency basis. Angiography is performed in the catheterization (cath) lab of a hospital. It may last for 1 to 2 hours.

Before your angiogram procedure starts, your health care team may perform a physical exam and check your vital signs — blood pressure and pulse. They will review your medical history, including allergies and medications you take. The doctor will give you general guidelines which include:

Fasting – Not to eat or drink anything after midnight before your angiogram.

Ask your doctor about whether to take your routine or normal morning medications.  If you are diabetic, ask if you should take insulin or other oral medications before your angiogram. Take all your medicines with you to the hospital.

During the Angiography Procedure

You’ll usually be awake, local anaesthetic will be used to numb the area so it does not hurt and a small incision, cut is made at the entry site, usually near your wrist or groin. A short sheath (plastic tube) will be inserted into your artery. The catheter is inserted through the sheath into your blood vessel and carefully threaded or guided to your heart or coronary arteries. You won’t feel the catheter moving through your body.

Special dye is injected through the catheter. As the dye moves through the blood vessels, doctors can observe its flow and identify any blockages in the concerned areas. Depending on the doctor’s observation during the angiogram, and if required, you may have to go for an additional catheter procedure at the same time, such as an angioplasty or a stent placement to open up a narrowed, blocked artery.

After the Angiography Procedure

When the angiogram test is over, the catheter is removed and you’ll be taken to a recovery ward where you will be monitored and when your condition is stable you will be discharged from the hospital. You may be able to go home the same day, or you may have to remain in the hospital overnight.

You will be asked to drink plenty of fluid to flush the dye out of the body. Your puncture site is likely to have a small bump and will be slightly bruised for a few days.

Risks

Major complications are rare, though but potential risks and complications may include:

• Injury to the catheterized artery
• Irregular heart rhythms (arrhythmias)
• Allergic reactions to the dye or medications used during the procedure, Excessive bleeding and infection.

Results after Angiography

Doctors use angiograms to evaluate the flow of blood to the heart, brain, and other organs.

Angiographies are effective in detecting problems with the blood vessels such as an arteriovenous malformation (AVM), blockages, aneurysm (bulge in the wall of an artery), arterial stenosis from plaque build-up, clots, tumours etc. In such cases, the doctor may choose appropriate treatments. Depending on the seriousness of the diseases the doctor can recommend the following heart treatments Angioplasty and stents, coronary artery bypass graft surgery, heart valve surgery, heart transplant depending upon the patient’s condition.