Diagnostic Cardiac Catheterization (Coronary Angiogram)

About the Procedure

A Cardiac Catheterization (Coronary Angiogram) is a procedure to diagnose or obtain information about heart function. A contrast material is run through the patient's heart arteries and by using X-ray technology, its flow can be watched on a video monitor. While there are many purposes for this procedure, the detection and treatment of stenosis, a build-up of plaque, along the walls of the arteries is the most common. If information obtained during the catheterization is of serious concern, the physician may choose to treat the patient immediately and avoid putting him/her through another procedure. Some other reasons for a cardiac catheterization are to confirm or quantify a heart ailment or its severity, for guidance during heart surgery, to biopsy tissues, or to determine intervention options when a patient is experiencing a heart attack.

Performed in the catheterization lab of a hospital or other facility, the actual procedure takes thirty minutes. Patients are awake during the procedure, although lightly sedated. An incision is made in either the groin or in the arm near the elbow, a catheter is pushed through the artery until it reaches the heart and a contrast fluid is injected. X-ray permits observing the dye as it flows along with the blood and helps identify areas of blockage or narrowing. Other observations about the structure of the heart and its functions can be detected or confirmed at this time as well. At the conclusion of the procedure, the catheter is removed and firm pressure is applied to the groin incision. Stitches or other closure options are used if the incision was on the arm.

What to Know Before the Procedure

When procedures involve the heart and its primary vessels, serious risks are always involved. Although rare, some of the complications of a cardiac catheterization include blood clots, stroke due to dislodged plaque, arrhythmias, heart attack, accidental puncture of a blood vessel, and infection. Prior to a catheterization, the physician assesses the patient’s overall health as well as the severity of the heart ailment before determining if they are able to safely undergo the procedure.

Preparation for the procedure includes routine pre-operative tests such as a chest x-ray, ECG, urinalysis, and blood work. All prescription medications, over-the-counter drugs, vitamins and herbal supplements taken by the patient are reviewed and the patient is advised if additions or changes are to be made. Although most patients are discharged the same day, they should be prepared for an overnight stay should it be necessary. Patients are advised to arrange for someone to drive them to their destination following discharge.

What to Know After the Procedure

When the incision is in the groin, it is covered with a bandage after 15 minutes of applied pressure, and the patient is taken to a recovery area. They must lay flat for two to six hours to prevent bleeding after which there is a period of observation before the doctor will determine if the patient can be discharged or must remain overnight. If the incision was in the arm, it is bandaged and the patient must hold the arm out straight for one hour prior to observation and doctor assessment. Drinking fluids is advised for the remainder of the day to rid the body of the dye. The physician will discuss the results of the catheterization and make recommendations for future treatment. Activity is limited for 24 hours with no heavy lifting. Normal activities may be resumed when the doctor advises.

If you Need to Travel Outside of your Local Hospital

Finding a skilled physician with excellent credentials and experience is critical in avoiding serious complications and should be a determining factor in choosing where the catheterization will be performed. Patients must be prepared to remain hospitalized in the event an angioplasty is performed and should inquire as to restrictions on activities and travel in such an event.