Coronary Angiography
Why is this done?
Coronary angiography is done to examine the blood supply to the heart muscle.
The heart is a muscle pump that receives its blood supply via the coronary arteries. The coronary arteries supply the heart muscle with blood rich in oxygen and nutrients to allow the heart to pump efficiently. In some people, fatty deposits called atheroma build up inside the lining of the coronary arteries over time to cause narrowed areas. These narrowed areas may restrict blood flow to the heart muscle so that it becomes starved of oxygen or “ischaemic”. This lack of oxygen or “ischaemia” can cause the chest pains known as “Angina Pectoris” and more commonly referred to as Angina. Angina may occur at rest but is typically brought on by exertion or stress because the heart muscle demands more blood and oxygen under these circumstances.
What does it involve?
An experienced Cardiologist usually carries out coronary angiography as a day case procedure. The patient is asked to starve for 4 hours prior to the test. Routine blood tests are taken, looking particularly for abnormalities of blood clotting and kidney function. The procedure takes place in a Cardiac Catheter Laboratory with the patient awake and continually monitored. After a local anaesthetic to the skin, a fine plastic tube called a catheter is inserted into a peripheral artery, usually the femoral artery at the top of the leg or the radial artery in the wrist. The tube is gently passed up to the heart under X-ray guidance. A contrast solution is injected through the catheter and a moving X-ray picture of the coronary arteries called an angiogram is acquired. A series of angiograms are taken from different angles to build up a comprehensive picture of the coronary arteries. The catheter is then withdrawn and pressure is applied to the arterial puncture site or a closure device such as a collagen plug is inserted. Usually, the procedure takes 10-15 minutes. Patients rest for a few hours afterwards but can usually go home the same day.
What information does it give?
This angiogram allows the Cardiologist to define the size and shape of the coronary arteries and establish whether there is any significant coronary artery disease. If coronary artery disease is identified then the Cardiologist will advise on the best course of treatment. If the disease is mild then no surgical treatment is required, but if it is severe then coronary angioplasty (PCI) or coronary artery bypass surgery (CABG) may be recommended. During angiography the function of the cardiac chambers and the pressure within them can also be assessed.
What are the possible complications?
Serious complications are rare. The puncture site in the groin or wrist may bruise or very occasionally may become infected. Rarely people may have an allergic reaction to the contrast solution. The risk of complications may be increased in individuals with certain medical conditions. The cardiologist will advise you of your individual risk and will only advise the procedure if the potential benefits outweigh the risks.
Serious rare complications include:
· Myocardial infarction or “heart attack”.
· The need for urgent bypass surgery.
· Stroke.
· Death.