Coronary angiography

Coronary angiography is a test used to find out how much narrowing there is in your arteries. Learn what to expect and when you might get a stent.

What is angiography and how is it done?

Angiography is an imaging test that uses X-rays to view your body’s blood vessels. The X-rays provided by an angiography are called angiograms. This test is used to study narrow, blocked, enlarged, or malformed arteries or veins in many parts of your body, including your brain, heart, abdomen, and legs.

A coronary angiogram is an X-ray of the arteries in the heart. This shows the extent and severity of any heart disease, and can help you to figure out how well your heart is working.

With this information, you and your doctor can talk through your treatment options. These may include angioplasty (stents), bypass graft surgery or medications. 

What happens during coronary angiography?

To create the X-ray images, your doctor will inject a liquid dye through a thin, flexible tube, called a catheter. The doctor threads the catheter into the desired artery from an access point. The access point is usually in your arm but it can also be in your groin.

The dye makes the blood flowing inside the blood vessels visible on an X-ray and shows any narrowed or blocked area in the blood vessel. The dye is later eliminated from your body through your kidneys and your urine.

How long will an angiography take?

You can expect the test to last half an hour, although it can sometimes take longer. During your procedure, you’ll be monitored by a heart monitor that records your heart rate and rhythm. If you feel unwell or experience discomfort at any time, you should tell a member of the hospital staff.

If you do have a stent put in (angioplasty) during your angiography, it will take a bit longer.

When can I go home after angiography?

You may need to stay in hospital for several hours or overnight following the procedure. You may be asked to drink fluids to prevent dehydration and flush the dye from your kidneys.

Before going home, a nurse will teach you how to check the site for bleeding and explain what to do if this does happen. If the groin was the site used, you may be asked to avoid heavy lifting and straining for a week to prevent bleeding.

Risks involved with angiography and angioplasty

As with all medical procedures, there are both risks and benefits associated with having a coronary angiography and angioplasty.

Talk to your doctor, nurse and other health professional about the risks and benefits for you, and any concerns you may have. Your healthcare team can give you more information about your individual circumstances and level of risk.

Minor complications may include:

• Bleeding under the skin at the wound site – this should improve after a few days, but please contact your GP if you are concerned
• Bruising – it is common to have a bruise from the catheter for a few weeks
• Allergy to the contrast dye used, causing symptoms such as a rash  – you should discuss any allergies that you have with your cardiologist before having the procedure.

More serious complications are uncommon, but may include:

• Damage to the artery in the arm or groin from the catheter, possibly affecting blood supply to the limb
• Heart attack 
• Stroke 
• Damage to the kidneys caused by the contrast dye
• Tissue damage caused by X-ray radiation if the procedure is prolonged
• Serious bleeding
• Death.

You are more likely to develop complications based on:

• Your age – the older you are, the higher your risk
• If the procedure was planned or is emergency treatment – emergency treatment is always riskier because there is less time to plan it and the patient is unwell to start with
• If you have kidney disease – the dye used during an angioplasty can occasionally cause further damage to your kidneys
• If you have one or more blocked coronary arteries
• If you have a history of serious heart disease.

If the pictures from your angiography show a narrowing or blockage that can be treated immediately, your cardiologist may decide to continue and put a stent in at once (angioplasty), as part of the same procedure. 

Find out more about stents and angioplasty