What is an angiogram?
An angiogram, or angiography, is a cardiac procedure that uses contrast dye to see if your arteries are blocked or narrowed. X-ray technology is also used to view the dye in the arteries and look for blockages.
Your doctor can use coronary angiography to see how blood moves through the arteries supplying blood to your heart. They can also see if you are at risk of reduced blood flow, which can cause angina (chest pain) or a heart attack.
An angiogram is a type of cardiac catheterization, one of the most commonly performed heart procedures. Catheterization refers to procedures in which catheters, thin, hollow tubes are inserted into your arteries under X-ray guidance. If your doctor finds a blockage, they might perform a procedure to remove it and re-open your artery.
Why might I need an angiogram?
Coronary angiography helps doctors identify if and where your arteries have blockages and to what extent. Your doctor might recommend one if you have symptoms of heart disease.
Atherosclerosis can affect arteries throughout your body. When it develops in the arteries supplying your heart, it’s called coronary artery disease, the most common form of heart disease and the leading cause of death in the United States.
If your doctor is concerned about your risk of coronary artery disease, your doctor will usually recommend other less invasive tests first. You may undergo a blood test, stress test or electrocardiogram (EKG or ECG), which measures your heart’s electrical activity.
Your doctor might also recommend an angiogram if you have:
- Abnormal results on a heart stress test
- Chest pain that seems unrelated to other conditions
- Had a recent heart attack
You might have an angiogram before heart surgery to evaluate abnormalities, diseases or obstructions. It is important to note that when it comes to the need for an angiogram, this is general information, and you should follow the specific guidance and instructions given to you by your doctor.
How to prepare for an angiogram
Before your angiography procedure, your doctor will discuss the benefits and risks with you.
They’ll want to have a complete picture of your health, so they might ask about:
- Any medicines you take, including over-the-counter drugs and herbal supplements
- Other health conditions you have
- If you might be pregnant
- Allergies or previous reactions (if any) to contrast dye
Once you schedule your procedure, you may need to:
- Have other imaging scans or tests to measure your blood count, kidney function and clotting ability
- Stop taking certain medications, such as blood thinners
- Stop or adjust your dose of insulin if you have diabetes
Drink plenty of water the day before. Being well-hydrated helps reduce risks associated with the dye. Also, follow your doctor's instructions about eating and drinking. If you live alone, you should ask someone to stay with you for the first night in case you have any problems after your procedure.
The angiography procedure
Your angiogram will take place in a heart catheterization lab (sometimes called a cath lab). Make sure you know when and where to check in for your procedure and arrive on time.
You can usually go home the same day, but this will depend on the results and whether a procedure to remove a found blockage is required.
What are the risks of an angiogram?
An angiogram is generally considered very safe. But like any medical procedure, it can involve risks.
In a small number of cases, the artery used for access can become blocked, or you might experience leakage of blood that forms a blood-filled sac, which requires further treatment. In people with diabetes or kidney problems, contrast dye may damage the kidneys.
Other risks can include:
- Allergic reaction to the iodine dye or anesthesia
- Bleeding
- Blood clots forming on the catheters
- Cardiac tamponade (pressure on your heart caused by blood or fluid building up in the space between your heart muscle and its outer covering)
- Infection
- Injury to an artery
- Irregular heartbeat (arrhythmia)
- Low blood pressure
- Rash, itching or pain at the site of the catheter
- A small risk of damage to your blood vessels or surrounding tissue
- A small risk of a heart attack or a stroke
What to expect after an angiogram
After your test, your doctor will discuss the results with you. They might recommend additional procedures if you have severe narrowing or blockages.
For example, you might need angioplasty or stenting if your doctor did not perform one or both during your angiogram. Or, your doctor may recommend coronary artery bypass graft (CABG) surgery. During CABG, your surgeon takes part of a healthy blood vessel from another part of your body to divert blood flow around the blocked part of the artery.
Your angiogram may show narrowing in your arteries that isn’t restricting blood flow. In that case, you might not need another procedure. Instead, your doctor might recommend medicine and lifestyle changes to prevent plaque buildup from getting worse and address other risk factors associated with coronary artery disease, such as high blood pressure and high cholesterol.