What is coronary angiography/ angiogram (CAG)?

A coronary angiogram is a procedure that uses X-ray imaging to see your heart's blood vessels. The test is generally done to see if there's a restriction in blood flow going to the heart.

Coronary angiograms are part of a general group of procedures known as heart (cardiac) catheterizations. Cardiac catheterization procedures can both diagnose and treat heart and blood vessel conditions. A coronary angiogram, which can help diagnose heart conditions, is the most common type of cardiac catheterization procedure.

During a coronary angiogram, a type of dye that's visible by an X-ray machine is injected into the blood vessels of your heart. The X-ray machine rapidly takes a series of images (angiograms), offering a look at your blood vessels. If necessary, your doctor can open clogged heart arteries (angioplasty) during your coronary angiogram.

As shown in the above picture- Coronary arteries are seen in the fluoroscopy (x-ray). Images and videos taken to find presence of blockages and any other abnormality in the blood vessels of the heart.

Why is it done?

Your doctor may recommend that you have a coronary angiogram if you have:

• Symptoms of coronary artery disease, such as chest pain (angina)
• Pain in your chest, jaw, neck or arm that can't be explained by other tests
• New or increasing chest pain (unstable angina)
• A heart defect you were born with (congenital heart disease)
• Abnormal results on a noninvasive heart stress test
• Other blood vessel problems or a chest injury
• A heart valve problem that requires surgery

Because there's a small risk of complications, angiograms aren't usually done until after noninvasive heart tests have been performed, such as an electrocardiogram, an echocardiogram or a stress test.

What is the risk involved?

As with most procedures done on your heart and blood vessels, a coronary angiogram has some risks, such as radiation exposure from the X-rays used. Major complications are rare, though. Potential risks and complications include:

• Irregular heart rhythms (arrhythmias)
• Allergic reactions to the dye or medications used during the procedure
• Kidney damage
• Excessive bleeding

Generally complications are less likely with expert hands

How do you prepare for it?

In some cases, coronary angiograms are performed on an emergency basis. More commonly, though, they're scheduled in advance, giving you time to prepare.

Angiograms are performed in the catheterization (cath) lab of a hospital. Your health care team will give you specific instructions and talk to you about any medications you take. General guidelines include:

• Don't eat or drink anything 4 hours before your angiogram.
• Take all your medications to the hospital with you in their original bottles. Ask your doctor about whether to take your usual morning medications.
• If you have diabetes, ask your doctor if you should take insulin or other oral medications before your angiogram.

How Much time does it take?

Its done under local anaesthesia , generally takes less than 15 mins for the procedure itself, but total time in and out of the cathlab would be around 1 hour

What happens after Coronary Angiogram?

• If the disease is insignificant, patient can be discharged on the same day.
• If the disease is significant, patient would be advised for PTCA (angioplasty) or CABG (Bypass Surgery) depending on the patient’s medical profile. The decision is made by the patient and his relatives and then things will follow accordingly.