What is coronary angiography?
Coronary angiography is a radiological examination that displays images of the coronary and arterial vessels that wrap around the heart and carry blood to the heart muscle. It is a diagnostic procedure that is conducted through the introduction of a contrast agent in the bloodstream, which makes the coronary arteries visible to the machine. The coronarography involves the introduction of a catheter, a thin, flexible tube, which is inserted in the blood vessels to the point where it must release the contrast material. Thanks to the advance of digital technology, it is now possible to obtain images of the circulatory function by minimizing the use of contrast.
What is the purpose of coronary angiography?
Coronary angiography is an examination used to evaluate cardiac function. It determines whether the coronary arteries are normal (patency) or blocked by clots, narrowing (stenosis) or plaques of cholesterol (atheroma).
It is recommended when the patient has:
- Chest pain (angina pectoris) or angina pain in the arm
- A genetic defect from birth (congenital heart disease)
- Defects in a heart valve
- Heart failure
Angiography precedes surgery. Moreover, it may precede or be associated with angioplasty, which involves the introduction of a stent to restore the blood flow in an obstructed vessel. It is useful to evaluate the possible complication of surgery. Another diagnostic method is to monitor the results of an intervention (follow up) as in the case of a bypass.
Coronary angiography does not require any special preparations; it is performed on an empty stomach and on an inpatient basis.
Which patients can undergo coronary angiography?
The contrast material may cause allergic reactions, but the percentage of these reactions is very low. In any event specialists will provide the most appropriate directions. Generally, specialists are extra cautious regarding the status of women of childbearing age.
Is coronary angiography painful or dangerous?
Coronary angiography is an invasive examination, however, the use of increasingly advanced technology greatly reduces the risks. The pain related to the injection of contrast material or catheter is minimized by local anaesthesia. Patients may experience a sensation of warmth after the injection of the contrast material.
How is the exam performed?
Coronary angiography is performed through the introduction of a catheter, generally from the femoral artery, the radial artery (wrist) or from the brachial artery (elbow). Local anaesthesia is administered at the point of entry of the catheter. The femoral artery is a preferred point of entry because it is a large artery and the catheter can pass more easily through the dilation system without the need to isolate the artery and then to cut the skin. Then it goes up to the heart and the catheter is positioned at the beginning of the coronary artery. The contrast material is then injected into the catheter to provide a better view of the course of the artery itself and allow visualization of any obstructions. The visualization of the procedure is followed on a screen. Once the catheter is removed, doctors must perform a femoral compression on the artery to stop the blood flow and allow the formation of a clot that closes the small inlet hole by using an elastic bandage. The patient is discharged within 24 hours.