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Reasons for the Procedure
There are many reasons why a doctor might order this test. If you have had symptoms of coronary artery disease or chest pain, the test can be used to determine the cause of these symptoms. If you have had angina in the past and now have worse chest pain or new chest pain, the test can help to determine why your pain is increasing. Heart valve problems, chest injuries, and heart defects can also be monitored with the use of this procedure. This test is not usually ordered unless non-invasive tests such as CT scans and MRI scans have been performed first without resulting in a diagnosis.
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If you are scheduled for the coronary angiogram procedure ahead of time, you will be asked not to drink or eat anything afr midnight on the night before your procedure. You should ask your doctor if you should take your prescribed medications as usual or if you should hold off on taking those medications until the procedure has been completed. Diabetics in particular should check with their doctors to see which medications can be taken before the procedure and which ones should not be taken until the angiogram has been completed.
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During the angiogram procedure, you will be positioned on your back and you may have straps fastened across your chest and legs to preserve your safety. An IV line will be inserted into one of your veins and you may be given a sedative to help you stay calm. However, you will remain awake during the test so that you can listen to the doctors and nurses and follow their instructions. Some of the instructions you may receive include directions to hold your breath or move your arms.
Electrodes will be placed on your chest so that your heart can be monitored during the procedure. Your blood pressure and the amount of oxygen in your blood will also be measured during this test. The catheter insertion site is washed and then numbed with a local anesthetic. Once a small incision has been made, a plastic sheath is inserted into an artery or vein. This sheath serves as the entryway for the catheter that will be threaded to the coronary arteries or the heart.
Once the catheter is in place, contrast material will be injected. This may cause flushing of the face or a warm sensation throughout the body. It may also cause you to feel like your heart is skipping beats. If you feel any pain, you should let the nurse or doctor who is in the room with you know so they can make you more comfortable. The dye will move through your blood vessels, allowing the doctor to identify any blockages or areas of obstruction.
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After the coronary angiogram procedure, the incision can be closed with a plug or clamp, or a nurse may use manual pressure to close it off. You will be observed and monitored in the recovery room and then returned to your hospital room for monitoring. After an angiogram procedure, you must lie flat for several hours. Your discharge time will depend on your condition and whether any other procedures are scheduled.
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Because an incision is made and a catheter is inserted into a blood vessel, there are some risks to this procedure. You may experience irregular heart rhythms or an allergic reaction to the contrast used during the procedure. More serious complications include stroke, heart attack, kidney damage, infection, and blood clots.
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Mayo Clinic. "Coronary Angiogram." Accessed 30 June 2009.