Coronary Angiography - Overview

A coronary angiography is a test that uses medical imaging to view the organs and blood vessels of the patient’s body to find out if you have a blockage in a coronary artery.  The test is done by using an X-Ray based technique, like fluoroscopy (Immediately obtains moving pictures using X-Ray). Your doctor will be concerned that you’re at risk of a heart attack in case you have unstable angina, atypical chest pain, aortic stenosis, or unexplained heart failure. During the test a contrast dye will be injected into the arteries with the help of a catheter (thin, plastic tube), while your doctor watches how blood flows through your heart on an X-ray screen. It is also known as a cardiac angiogram, catheter arteriography, or cardiac catheterization. 

Based on the results of the test, your doctor may decide that you would benefit from having coronary angioplasty or stenting to help clear clogged arteries. To prevent needing another procedure it’s also possible that the following treatments could be done during your angiography:

Coronary Angioplasty: It is a non-surgical procedure to widen blocked or narrowed coronary arteries, and restore the blood flow to the heart muscles. It is performed to open narrowed or blocked blood vessels that supply blood to the heart. These blood vessels are called the coronary arteries. Typically, a catheter placed on a guide wire is inserted inside the blocked artery to help widen it. Angioplasty is also known as Percutaneous Coronary Intervention (PCI) and Percutaneous Transluminal Coronary Angioplasty (PTCA). 

Stenting: In this procedure a tiny tube called stent is inserted into a blocked passageway to keep it open. This stent restores the flow of blood or other fluids, depending on where it’s placed. These stents are made of either metal or plastic. Stent grafts are larger stents used for larger arteries that may be made of a specialized fabric. Stents can also be coated with the help of medicines to help keep a blocked artery from closing.

Coronary Angiography - Symptoms

Your doctor may recommend you a coronary angiography if you have the following symptoms :

  • When chest pain becomes worse and occurs more often also known as unstable angina.
  • Chest pain or any kind of discomfort known as Angina.
  • Problem with heart valve that requires surgery.
  • Heart failure
  • Atypical results of heart stress test
  • After a recent heart attack.
  • Unbearable pain in the chest, arm, jaw, or neck.
  • Congenital heart disease – problem in heart present from birth.
  • Chest injury or other problems with blood vessels.
  • Coronary thrombosis or Blood clots.

Coronary Angiography - Pre-Procedure

Before your angiography procedure starts, your doctor will review all your medical history, including allergies and medicines you take. Your Doctor may pconduct a physical exam and check your vital signs — blood pressure and pulse.

In some cases, the test is performed on an emergency basis. Generally, though, they’re scheduled in advance, giving you time to prepare.

The test is performed in the catheterization (cath) lab of the hospital. Your health care team will give you a few instructions before the actual procedure and talk to you about any medications you take. General guidelines include:

  • You should not eat or drink anything after midnight before your angiogram.
  • Take all the medications that you are taking to the hospital with you and ask your doctor about whether or not to take your usual morning medications.
  • If you have diabetes, ask your doctor if you should take insulin or other oral medications before the test or not.
  • If you are or might be pregnant.
  • If you breast feed (you are not allowed to feed your baby for a day or two, as the dye might still be in your sy ). 

Coronary Angiography - During Procedure

Coronary Angiography usually takes 30 minutes to 2 hours to be performed. The procedure is performed in the X-ray room. You will be asked to lie on the X-ray table, that has a few cameras that can move around your chest area for taking pictures. Sedatives will be given to you via the intravenous line (IV) instered in your arm. You will be asked to stay awake during the procedure so that you can do deep breathing, coughing and move your arms. Catheter is inserted into your blood vessel via arm or groin. Catheter will be tactfully threaded to your coronary arteries. Blood pressure and oximonitor will be used your blood. Anticoagulants will be given to ensure there is no blood clotting on the catheter or coronary artery. You will feel a brief flushing when a contrast material (dye) will be inserted in your body through the catheter. The dye moves through your arterties and the doctor observes the flow. X-ray images will be taken continously.

Coronary Angiography - Post-Procedure

Once your Angiography test will be finished you’ll need to lie flat for a few hours to avoid bleeding if the catheter was inserted in the groin. During this time, pressure may be applied to the incision to avoid bleeding and promote healing.You are allowed to go home the same day, or you may have to remain in the hospital overnight. You will be advised to drink plenty of liquid to help flush the dye from your body. If you’re feeling up to it, you can then have something to eat.Ask your doctor when you can resume taking medications, bathing or showering, working, and doing other normal activities. You should avoid strenuous activities and heavy lifting for several days.

Coronary Angiography - Risk & Complications

As with most procedures are performed on your heart and blood vessels, a coronary angiography has some risks and complications, such as radiation exposure from the X-rays used. Major complications are rare, though. Potential risks and complications are as follow:

  •  Irregular heart rhythms (arrhythmias)
  •  Kidney damage
  •  Excessive bleeding
  •  Infection
  •  Heart attack
  •  Stroke
  •  Injury to the catheterized artery
  • Allergic reactions from the dye or medications used during the procedure.

More Info

A coronary angiography test can help doctors to know what’s wrong with your blood vessels and Show how many of your coronary arteries are blocked or narrowed by fatty plaques (atherosclerosis). The cost of coronary angiography test ranges from Rs. 12000 – 25,000 approx.

Coronary Angiography - Doctors

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    Procedure Cost in USD Stay in Hospital Stay in India Total Days
    Angiography 300-400 1 day 2 days 3

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