What is an Angiogram?

An angiogram involves the taking of several sequential X-ray images of the blood vessels which look like an X-ray “movie” of blood vessels. X-ray images can also be taken of the pumping chambers of the heart to see how they function. Blood is normally invisible to X-ray. In order to visualize the blood vessels or heart chamber with X-ray, a special dye must be directly injected into the specific vessel or chamber before the X-ray/images are taken.

The dye is also called a “contrast agent” and is injected via a thin tube called a catheter which is inserted through a small puncture in the skin into an artery in the leg or arm and guided using X-ray/images to the required area. Apart from injecting dyes to take the required X-ray pictures, the catheters can also be used to measure internal blood pressures, oxygen saturation in the blood and even the electrical signals in the heart, all of which are indispensable in diagnosing various life threatening conditions affecting the heart.

Angiograms of the blood supply to the heart itself is the most common diagnostic procedure done at ACI’s Cath Lab. It is used to look for blockages to the blood supply to the heart. It is the most important test used to plan the treatment of coronary heart. You can click on this link to see what angiograms look like.

Angiograms can also be taken of any other blood vessel in the body and is commonly used to look at the blood supply to the legs, kidneys, lungs and brain to diagnose and plan treatment for abnormalities in these areas. See listing below of all the common types of angiogram.

How do I prepare for an Angiogram?
If you have been scheduled for an angiogram, you will be given an appointment to meet with one of our nurses before the procedure, to discuss the relevant details. This is an exercise we at ACI call

“Cath Education”.

During Cath Education, the following issues, among others, will be discussed:

Medical history, including whether or not you have asthma, allergies or kidney disease.
Allergic reactions to any drugs or foods (e.g. Shellfish)
The current medications you are taking. You may need to discontinue certain medications before the test, such as medications that thin the blood (e.g. warfarin, plavix or aspirin).
You will need to fast four to six hours prior to your test.
You may need to shave certain parts of your body where the catheters will be inserted.
You may undergo various tests before the angiogram, including certain blood tests, an electrocardiogram and chest X-Rays.

Angiogram Procedure
Usually, you would be admitted to hospital the morning of your angiogram at least two hours before your scheduled procedure. Most scheduled procedures are performed on time. However, your scheduled procedure time may be delayed if there are emergency cases. An area of your body is required to be shaved (usually the groin) and this will be checked and cleaned with a special solution. An intravenous (IV) drip will be placed in your arm to help with the administering of medication. In some instances, a small tube (urinary catheter) will be placed in your bladder to drain your urine. ECG electrodes will be placed on your chest arms and legs.

Once in the Cath Lab, you lie on a special table. A heart monitor records your heartbeat during the test. The doctor may give you some medication to help you relax during the procedure. The doctor then injects a small amount of local anaesthetic around the test site to numb the area. A small catheter is inserted through the skin into the blood vessel. The doctor watches the progress of the catheter via X-rays transmitted to a computer monitor. You can’t feel the catheter going through the heart because there are not enough nerves in the blood vessels. Once the catheter is in place, a small amount of X-ray sensitive dye is injected through it. Further X-rays are taken as the dye goes through the blood vessels. You may feel a warm flush or tingling as the dye is injected. The angiogram lasts for approximately forty (40) minutes.

What should I expect after an angiogram?

A pressure dressing is placed on the test site for around four hours and a sand bag or other special device may be used to apply pressure to the puncture site.
Alternatively at ACI, we give you the option to use a special closure device to immediately seal the puncture site and minimize the healing time after the procedure.
Your blood pressure, pulse, breathing and wound site are regularly checked and recorded.
Intravenous fluids may be given for a short time, although you are encouraged to eat and drink as soon as you feel able.
You will have to lie on your back for three to four hours, keeping your legs as still as possible.
You will be told by the nurses when you can sit up and when you can walk after the procedure.
The nurses will then give you detailed instructions of what to do and what to look for when you go home and then you will be discharged.