Angiogram

Published with the inputs from Dr Raghuram A Krishnan , Senior Consultant, Cardiology, Baby Memorial Hospitals- Kozhikode

A angiogram is a diagnostic procedure used to evaluate the blood vessels supplying the heart. It is a test and not a treatment. The procedure helps doctors determine whether there are blockages in the coronary arteries and assess their severity.

The findings of a coronary angiogram help guide further treatment. Depending on the results, some patients may require medications alone, while others may be advised to undergo angioplasty or coronary artery bypass surgery (CABG).

What is a coronary angiogram?

A coronary angiogram is a diagnostic test used to evaluate the condition of the heart's blood vessels. It helps identify whether there are blockages in the coronary arteries and is not a treatment for removing those blockages.

Who may need a coronary angiogram?

According to the doctor, a coronary angiogram may be recommended for:

• Patients with chest pain
• Patients with a minor or major heart attack
• Patients who experience breathlessness while walking or climbing stairs
• Patients who feel heaviness in the chest during physical exertion
• Patients with a burning sensation in the chest during physical activity
• Patients with pain in the upper back, below the jaw, or pain radiating to the arms during strenuous activities
• Patients with heart failure
• Patients who are unable to perform an exercise stress test
• Patients with abnormalities in their ECG or echocardiogram

In patients with less severe symptoms, an exercise stress test (Treadmill Test or TMT) may be performed first. If the test is positive, a coronary angiogram may then be advised.

Why is a coronary angiogram performed?

The main purpose of a coronary angiogram is to determine whether there are blockages in the coronary arteries, which supply blood to the heart.

According to the doctor, these blockages are caused by cholesterol deposits, most commonly due to the accumulation of LDL cholesterol and, in some cases, triglycerides within the walls of the blood vessels.

What information does a coronary angiogram provide?

A coronary angiogram helps identify:

• Whether blockages are present
• The percentage of blockage
• Which coronary arteries are affected

The results help determine the next stage of treatment.

What treatments may be recommended after a coronary angiogram?

Depending on the angiogram findings:

• Medications may be sufficient if the blockages are not severe.
• Angioplasty may be recommended for significant blockages.
• Coronary artery bypass surgery (CABG) may be advised in some cases.

How is a coronary angiogram performed?

The procedure is performed by inserting a thin plastic tube called a catheter through a major artery in the wrist or the leg. The catheter is guided to the heart and into the aorta.

An iodine-based contrast dye is then injected through the catheter. As the dye flows through the coronary arteries, continuous X-ray images are taken to visualize the blood vessels and identify any blockages.

Is a coronary angiogram painful?

According to the doctor, a coronary angiogram is generally a painless procedure.

Before the catheter is inserted, a local anaesthetic is administered at the insertion site. Patients may feel only a slight pin-prick sensation while the anaesthetic is being given.

How long does a coronary angiogram take?

The procedure usually takes around 10 to 20 minutes, and in many cases it can be completed within 5 to 10 minutes.

What should patients expect after the procedure?

If the angiogram is performed through the leg artery, patients generally require 4 to 6 hours of complete rest afterward.

If the procedure is performed through the wrist artery, patients are usually fit for discharge within 3 to 5 hours. They are advised to avoid heavy work with that hand for a couple of days, but prolonged bed rest is generally not required.

Is a coronary angiogram a safe procedure?

According to the doctor, a coronary angiogram is a safe, commonly performed, and largely painless procedure that plays an important role in diagnosing heart disease and guiding appropriate treatment.

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If you are experiencing chest pain, breathlessness during physical activity, or have been advised to undergo a coronary angiogram, consult the Cardiology specialists at Baby Memorial Hospital (BMH) for a comprehensive evaluation and personalised treatment plan.

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