Coronary angiography

Answer 1

Although many angioplasties are performed by puncturing the vessel through the skin, others are done by surgically exposing the site of entry. Direct view of the vessel's puncture site aids in monitoring damage to the vessel

Answer 2

arterial puncture is typically made in the femoral artery, and the cardiologist uses a guide wire and catheter to perform a contrast injection and x-ray series on the coronary arteries. The catheter may also be placed in the left ventricle

Answer 3

Definition

Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through your heart.

Alternative Names

Cardiac angiography; Angiography - heart; Angiogram - coronary

How the test is performed

Coronary angiography is usually done along with cardiac catheterization.

Before the test starts, you will be given a mild sedative to help you relax.

An area of your body, usually the arm or groin, is cleaned and numbed with a local numbing medicine (anesthetic). The cardiologist passes a thin hollow tube, called a catheter, through an artery and carefully moves it up into the heart. X-ray images help the doctor position the catheter.

Once the catheter is in place, dye (contrast material) is injected into the catheter. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages in blood flow.

The procedure may last 30 to 60 minutes.

How to prepare for the test

You should not eat or drink anything for 8 hours before the test starts. You may need to stay in the hospital the night before the test. Otherwise, you will check in to the hospital the morning of the test.

You will wear a hospital gown. You must sign a consent form before the test. Your health care provider will explain the procedure and its risks.

Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material in the past, if you are taking Viagra, or if you might be pregnant.

How the test will feel

You are awake during the test. You may feel some pressure at the site where the catheter is inserted.

Occasionally, a flushing sensation occurs after the dye is injected.

After the test, the catheter is removed. You might feel a firm pressure at the insertion site, used to prevent bleeding. If the catheter is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding. This may cause some mild back discomfort.

Why the test is performed

Coronary angiography is done to find a blockage in the coronary arteries, which can lead to heart attack. It may be done if you have unstable angina, atypical chest pain, aortic stenosis, or unexplained heart failure.

Normal Values

There is a normal supply of blood to the heart and no blockages.

What abnormal results mean

An abnormal result may mean you have a blocked artery. The test can show how many coronary arteries are blocked, where they are blocked, and the severity of the blockages.

What the risks are

Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.

Generally the risk of serious complications ranges from 1 in 1,000 to 1 in 500. Risks of the procedure include the following:

• Cardiac arrhythmias
• Cardiac tamponade
• Trauma to the artery causing a hematoma
• Low blood pressure
• Allergic reaction to contrast medium
• Hemorrhage
• Stroke
• Heart attack

Considerations associated with any type of catheterization include the following:

• In general, there is a risk of bleeding, infection, and pain at the IV site.
• There is always a very small risk that the soft plastic catheters could actually damage the blood vessels.
• Blood clots could form on the catheters and later block blood vessels elsewhere in the body.
• The contrast material could damage the kidneys (particularly in patients with Diabetes).

Special considerations

If a blockage is found, your health care provider may perform a percutaneous coronary intervention (PCI) to open the blockage. This can be done during the same procedure.

Answer 4

Definition

Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through your heart.

Alternative Names

Cardiac angiography; Angiography - heart; Angiogram - coronary

How the test is performed

Coronary angiography is usually done along with cardiac catheterization.

Before the test starts, you will be given a mild sedative to help you relax.

An area of your body, usually the arm or groin, is cleaned and numbed with a local numbing medicine (anesthetic). The cardiologist passes a thin hollow tube, called a catheter, through an artery and carefully moves it up into the heart. X-ray images help the doctor position the catheter.

Once the catheter is in place, dye (contrast material) is injected into the catheter. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages in blood flow.

The procedure may last 30 to 60 minutes.

How to prepare for the test

You should not eat or drink anything for 8 hours before the test starts. You may need to stay in the hospital the night before the test. Otherwise, you will check in to the hospital the morning of the test.

You will wear a hospital gown. You must sign a consent form before the test. Your health care provider will explain the procedure and its risks.

Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material in the past, if you are taking Viagra, or if you might be pregnant.

How the test will feel

You are awake during the test. You may feel some pressure at the site where the catheter is inserted.

Occasionally, a flushing sensation occurs after the dye is injected.

After the test, the catheter is removed. You might feel a firm pressure at the insertion site, used to prevent bleeding. If the catheter is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding. This may cause some mild back discomfort.

Why the test is performed

Coronary angiography may be done if you have:

• Angina for the first time
• Angina that is becoming worse, not going away as fast, occurring more often, or happening at rest (called unstable angina,)
• Aortic stenosis
• Atypical chest pain, when other tests are normal
• Heart failure
• Recent heart attack

Normal Values

There is a normal supply of blood to the heart and no blockages.

What abnormal results mean

An abnormal result may mean you have a blocked artery. The test can show how many coronary arteries are blocked, where they are blocked, and the severity of the blockages.

What the risks are

Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.

Generally the risk of serious complications ranges from 1 in 1,000 to 1 in 500. Risks of the procedure include the following:

• Cardiac tamponade
• Irregular heart beats
• Injury to the coronary artery
• Low blood pressure
• Allergic reaction to contrast dye
• Stroke
• Heart attack

Considerations associated with any type of catheterization include the following:

• In general, there is a risk of bleeding, infection, and pain at the IV site.
• There is always a very small risk that the soft plastic catheters could actually damage the blood vessels.
• Blood clots could form on the catheters and later block blood vessels elsewhere in the body.
• The contrast dye could damage the kidneys (particularly in patients with diabetes).

Special considerations

If a blockage is found, your health care provider may perform a percutaneous coronary intervention (PCI) to open the blockage. This can be done during the same procedure, but may be delayed for various reasons.

References

Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007;116:2762-2772.

Davidson CJ, Bonow RO. Cardiac catheterization. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 19.

Reviewed By

Review Date: 05/23/2011

David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington.

Answer 5

Sodium fluorescein dye is then injected with a syringe into a vein in the patient's arm. The dye travels through the patient's body and into the blood vessels of the eye

Answer 6

Radioactive material is injected into the bloodstream. A device that uses gamma rays to produce an image of the radioactive material (gamma camera) records pictures of the heart