Coronary angiography is a test performed by inserting a small tube called a catheter via an artery in the wrist or groin until the end of the tube reaches the coronary arteries. It does not require anesthesia. Only a local anesthetic is required. Then a radioactive contrast medium is injected by a small amount into the coronary arteries. Then x-rays are taken to record images of each of the coronary arteries.
Indications for Coronary Angiography
- Severe tightness of the chest like the chest is being compressed by a heavy object.
- Heavy breathing, excessive sweating, exhaustion, angina, blackouts and fainting.
- Pain or numbness toward the arm, shoulder and jaw.
- History or risk of developing ischemic heart disease such as diabetes, hypertension, high cholesterol levels, family history of ischemic heart disease, obesity, smoking and lack of exercise.
- Prior diagnosis of abnormalities from other screenings such as abnormal electrocardiogram and echocardiography results while walking on the treadmill.
Preparations for Coronary Angiography
- Refrain from food and water for at least 4-6 hours.
- If you have to take a regular medication, consult your doctor beforehand whether you can continue the medication or if you have to stop before the test.
- If you have history of drug allergies or seafood, you have to inform your doctor in advance for consideration of administering an anti-allergy drug.
- You should have blood tests first such as on kidney function, red blood cell function and minerals in the blood.
- You should have a lung x-ray along with electrocardiogram.
- Properly urinate before entering the coronary angiography room.
Coronary Angiography Procedure
There are two techniques, namely, to insert a catheter via the wrist or via the groin. Doctors will decide based on the suitability for each patient.
- The wrist and groin are cleaned by using a sterilizing solution. Then the areas are covered with a sterile cloth.
- Doctors will inject a local anesthetic at the site of the catheter insertion. If you experience abnormal symptoms like chest tightness or pain or nausea or vomiting, quickly notify your doctor.
- A small catheter is inserted via the wrist or groin until its end reaches the coronary arteries for testing.
- Doctors will inject a contrast medium into the coronary arteries and record images by using an x-ray machine from multiple angles. (During the injection of the contrast medium, the patient might feel hot flashes for about 10-15 minutes).
Appropriate Practices after Coronary Angiography
If the coronary catheter was inserted by the wrist:
- Pressure will be applied to the wrist to stop the bleeding by use of a wrist strap for about 2-4 hours. After bleeding stops, a nurse will remove the strap. The patient may not remove the strap by himself or herself without the doctor’s permission.
- After coronary angiography, the patient can sit up or walk around and can drink and eat.
If the coronary catheter was inserted by the groin:
- Pressure will be applied to the wound at the groin for about 15-30 minutes to stop bleeding. After bleeding stops, a sticky plaster will be applied to prevent the wound from additional bleeding. Initially, pressure will be applied to the groin and the bleeding will be stopped by the use of a sand pillow (weighing about ½ – 1 kg).
- Do not bend the legs or sit up or stand without your doctor’s permission.
- After coronary artery angiography, the patient can eat and drink.
