Coronary Angiogram for your Heart. Do you know what it is?
When the doctor recommends a coronary angiogram to someone close
to you, the initial reaction is denial and non acceptance. Some
people also believe that anyone who undergoes this test would
invariably have to go through bypass surgery. Others believe
that it will be painful, requiring prolonged hospital admission.
But the truth is that it is a simple X-ray of the heart blood
vessels, virtually painless and requires a short stay. Coronary
angiogram is one of the most accurate tests in the diagnosis of
Coronary Artery Disease (CAD). It is used to pinpoint the
location and severity of CAD and is relatively safe. A coronary
angiogram is the 'gold standard' for evaluation of CAD. The test
is done in a special laboratory called a cardiac catheterization
laboratory, which is similar to an operating theater.
How is a coronary Angiogram performed?
The procedure will begin with the physician inserting an
intravenous line into a blood vessel in the patient's arm.
Coronary angiography is performed with the use of local
anesthesia and is generally not terribly uncomfortable. During a
coronary angiogram, a small catheter (a thin hollow tube with a
diameter of 2-3 mm) is inserted through the skin into an artery
generally in the wrist. Guided with the assistance of a
fluoroscope the catheter is then advanced to the opening of the
coronary arteries, the blood vessels supplying blood to the
heart. Next, a small amount of radiographic contrast, which is
easily visualized with X-ray images, is injected into each
coronary artery. The images that are produced are called the
angiogram.
The procedure takes approximately 10-15 minutes. After the
procedure, the catheter is removed and the artery at the wrist
is treated with manual compression to prevent bleeding.
Risks and Benefits
Coronary Angiogram is the only test, which allows precise
quantification of the severity of CAD to optimally take
decisions for the treatment. In appropriate patients, the
therapeutic information learned from the angiogram is far more
valuable than the relatively small risk of the procedure. There
is a small but finite risk of serious complication from coronary
angiography, as it is an 'invasive' test, but in the hands of
experienced physicians, this risk is quite small (well below one
per cent). Following the test the patients will be given
instruction from their physician regarding exercise and
exertion, care for the incision area and the use of medications.
Long Term Outlook
Treatment depends on the diagnosis made after the angiography.
Narrowed coronary arteries can be treated during the angiogram
itself by angioplasty. Another option for severely narrowed
coronary arteries is a bypass operation. A coronary angiogram,
which is normal, is as precious as the one that shows disease. A
normal angiogram rules out a life threatening disease and is an
impetus for the further continuation of a healthy lifestyle.