Coronary angiogram

A coronary angiogram is a procedure where a doctor injects a special dye into the coronary arteries of your heart. They will then take a series of x-rays showing the flow of dye through your heart.

Your doctor will check if there is any narrowing of blood flow or blockages in your coronary arteries.

Coronary angiogram is also known as cardiac catheterisation or coronary angiography.

What are the coronary arteries?

Coronary arteries are blood vessels that supply your heart muscles with oxygen and nutrients it needs to function.

If fatty plaque builds up in your coronary arteries, they may become narrowed, causing less blood to reach your heart muscle. If your heart does not get enough blood, it can cause problems such as angina, heart failure or a heart attack.

Your doctor may recommend you have a coronary angiogram if you have chest pain, experience a heart attack or if they suspect you have coronary artery disease.

You might also have a coronary angiogram if:

• you have a congenital heart defect
• you have had a significant injury to your chest
• you have problems with blood vessels elsewhere in your body

Your doctor will give you instructions about how to prepare for your coronary angiogram. These may include the following:

• Pre-tests: Leading up to your procedure, your doctor may refer you for blood tests to check your general health, kidney function and haemoglobin They may also perform an ECG to check your heart function.
• Eating and drinking: You may be asked to stop eating and drinking 6 to 8 hours before your procedure.
• Medicines: You can take most of your regular medicines as usual. If you take blood thinners, diuretics or diabetes medicines your doctor will instruct you when to stop taking them before your procedure.
• Hospital admission: You may need to go to hospital a few hours before your procedure. The admissions team may ask you to remove any jewellery and wear a hospital gown.
• Skin preparation: Usually, the hair at the site of entry of the catheter will be trimmed, to help clean your skin before your angiogram.

A coronary angiogram is performed by a doctor and generally involves the following process:

• You will be taken to an operating theatre or x-ray room and connected to a heart monitor while you have your test.
• A drip will be inserted into a vein in your arm to give you fluids if needed.
• Your doctor may give you a local anaesthetic to your wrist or groin. You may also get a medicine to help you relax, as you will need stay as still as possible.
• Your doctor will insert a long, thin tube called a catheter into an artery in your wrist or groin. The catheter is passed through the artery until it reaches close to your heart. The doctor will then inject a dye into the catheter. You may feel flushed or warm for a few minutes afterwards — this is normal.
• Your doctor will take x-rays as the dye moves through your heart. These can help identify any narrowing or blockages in your coronary arteries.
• If there is any narrowing or blockage, your doctor may choose to treat it immediately by inserting a stent (small expandable mesh tube) to keep the artery open. In most cases, your doctor will discuss this possibility before the procedure, so you can decide whether you would want a stent inserted if warranted by the angiogram findings.

After your coronary angiogram your doctor will remove the catheter and apply pressure at the wound site to stop any bleeding. When your condition is stable, you might move to a recovery or inpatient ward.

You will need to lie flat for several hours to avoid bleeding from the catheter insertion site in your wrist or groin. You may be able to go home the same day, or you may need to stay in the hospital overnight.

The contrast dye will pass through your urine (wee). It is colourless so you will not see it.

You may be sore, tender or have bruising at your wound site. This should go away after 2 weeks.

You will need to arrange for somebody to take you home from the hospital. Once you return home, you should avoid vigorous activity for a few days.

When you are home, if the bleeding at your wound site can't be stopped, or the wound site swells up very quickly, call triple zero (000) and ask for an ambulance.

Generally, angiograms are very safe. However, possible risks include:

• allergic reaction to the dye, causing itchiness, rash or breathing difficulties
• bruising or bleeding at your wound site
• pain
• heart attack
• blood clots, including stroke
• kidney damage

Contact your doctor immediately if you have:

• bleeding
• severe pain
• signs of infection, such as swelling or fever
• chest pain

• The Heart Foundation provides information about heart health and coronary angiograms.
• Learn more about 'a healthy heart diet' if you have heart disease.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.