What is an angiogram?
An angiogram is a test in which special dye is injected into an artery, allowing the artery to be seen on x-ray. The specialist can then examine the pictures and decide if the arteries look normal or blocked. A coronary angiogram refers to the test being performed to look at the heart vessels.
Why would I need an angiogram?
You may have been experiencing symptoms such as angina (chest pain) or your specialist may have other reasons to think you could have narrowing of your coronary arteries. An angiogram will tell the specialist how much narrowing has occurred and can help decide an appropriate treatment plan, such as angioplasty or bypass grafting.
What do the coronary arteries do?
The heart is a large muscle that pumps blood around the body. To keep the heart pumping, it needs oxygen and nutrients to be constantly delivered to it, in the form of blood. This blood gets to the heart muscle through large arteries that course around it (the coronary arteries). The arteries can therefore be thought of as the 'pipes that bring fuel to the heart pump'. Without adequate fuel, the pump will fail.
How do the coronary arteries get blocked?
The arteries can become narrowed by atherosclerosis - this is fat that has been laid down on the inside of the artery. The fat can build up, blocking the flow of blood in the artery. This reduces how much blood gets to the heart, causing cramp-like pain in the heart muscle. This pain is felt as chest pain called 'angina'. As the blockage worsens you may start to feel short of breath at rest. Eventually, the artery may completely block, causing part of the heart muscle to die - a heart attack.
Artery blockage is more common in older people, but can still happen in younger life. Risk factors for such heart problems include:
Whilst you can't change your family history and genes, the other risks can be reduced by not smoking, exercising regularly, eating healthily and having a healthy body weight.
How is an angiogram performed?
The procedure is usually performed under local anaesthetic. The anaesthetic is injected into the groin area, making a patch of skin go numb. A small cut is made in the skin, allowing a thin plastic tube to be inserted through and into the groin artery. The tube is then passed up the artery, towards the heart. Once the tube is in place, you will be asked to take a deep breath and hold it. The dye is then injected and x-ray pictures are taken.
The dye may cause a warm, flushed feeling to spread from your head to your toes. It can also occasionally cause chest tightness or 'flutters' - these are very common and your specialist will be closely monitoring you at all times.
Occasionally the groin artery will not be used, and the artery at the wrist can be used instead.
You will usually be allowed to go home on the same day.
What are the risks of having a coronary angiogram?
Bruising - the thigh may be bruised and tender for a few days after the angiogram
Kidney damage - whilst any damage is usually temporary, it can rarely be permanent and may need treatment
Allergy to the dye - this is rare, but can occur. It is important to tell the specialist if you have any allergies, especially to shellfish
Artery damage - rarely the leg artery can be damaged during the procedure, and may possibly need further treatment
Heart attack - whilst this procedure aims to reduce this risk, the strain of the operation can, in about 1 per 1000, cause an attack.
Stroke - the average risk is about 1 in 1000, although can be greater if you have had previous strokes.
Death - the risk is about 1 in 1000, but can vary according to how fit you are, age and other risk factors.
Other SurgeryWise articles
You may also be interested to read our articles on angioplasty or bypass surgery
Read an account of a patient's Real Experience of angiography
Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.
The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer