An angiogram is a medical procedure of detecting blockage in the arterial system using a special contrast material and x-ray imaging system. An angiogram, also called coronary angiography, is a part of the heart or cardiac catheterization procedures, which can be used as both diagnostic and therapeutic purposes.
A coronary angiography is used to diagnose blockages in coronary arteries. A special type of contrast material is injected into the blood vessels of the heart, and the x-ray machine is used to track the movement of the dye through coronary arteries. Any blockage or narrowing of the arteries can then be detected through a series of images (angiograms) taken by the x-ray machine.
Coronary angiography. Image Credit: Pitchyfoto / Shutterstock
Things to Consider Before the Angiogram
An angiogram is generally performed in the cardiac catheterization lab of the hospital. The basic requirement is to measure all vital parameters of the patient before the actual process starts. It is also important to gather all information related to routine medications of the patient. Next, cleaning and preparation of a small area in the groin or arm are carried out.
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The Procedure
The entire process of the angiogram, which lasts for around 30 to 60 minutes, is generally performed under local anesthesia. The patient is instructed to lie on his/her back on the x-ray table. Local anesthesia is given through intravenous injection. Electrodes are generally placed on the chest to monitor heart functions throughout the procedure. The area in the groin or arm from where the catheter (a thin flexible tube) will be inserted is also anesthetized by injecting local anesthetics.
Coronary Angiogram (Full Length Procedure)
At the entry site, a small incision is made to insert a needle (a short plastic tube) into the blood vessel. Next, a catheter is inserted through the needle into the blood vessel and threaded to the heart or coronary arteries. The contrast material, which is easily visible on x-ray images, is then injected through the catheter, and its flow is assessed by the x-ray machine. The images that are captured by the machine are called angiograms.
After the procedure, the catheter is removed along with the needle, and the incision is closed manually.
Observations
The contrast material is used to highlight the heart chambers or coronary arteries. The result obtained from an angiography typically demonstrates the numbers of coronary arteries that are either blocked or narrowed down due to atherosclerosis or other factors. It also indicates the exact location and degree of the blockage. In addition, angiograms can provide information on consequences related to previous coronary bypass surgery.
Why It’s Done
The doctor will recommend an angiogram if the patient manifests symptoms of coronary artery disease like angina or chest pain, the presence of congenital heart disease, chest injury, a heart valve injury, an abnormal heart stress test result, and unstable angina, among others.
Importance
Coronary angiography is a safe medical procedure to assess heart problems. The contrast material is also harmless and can be excreted easily from the body. It provides a detailed overview of the heart and its arteries, which is often very useful for healthcare providers in terms of selecting the best cardiac therapy for the patient.
The most common therapies that can be provided during angiography are balloon angioplasty and stent installation. Balloon angioplasty is done to open arterial blockages. After angioplasty, a stent is generally placed at the site of narrowing if there is insufficient blood flow through the treated artery.
Risk Factors
Although angiography is mostly considered as safe, some risk factors may still be associated with the procedure. Some rare complications related to this technique include heart attack, stroke, arterial injury due to catheterization, abnormal heartbeat, allergy from the contrast material, kidney damage, excessive bleeding, and infection. Immediate medical supervision is recommended if there is bleeding, swelling, pain, or any other discomfort at the catheter site; if signs and symptoms of an infection are present; if there is a change in color or temperature at or around the site of the incision; and in case of breathing difficulties.
Further Reading