Cardiac Catheterisation and Coronary Angiography

Angiogram / Catheter test

The purpose of an ‘angiogram’ or ‘catheter’ test is to obtain important information about the severity and distribution of any narrowing in the coronary arteries. Information obtained will allow your heart condition to be treated appropriately. The procedure will vary from patient to patient as it is tailored to individual needs.

The procedure is usually performed as a ‘day case’ in which case you will be admitted to hospital, have the procedure and go home on the same day. However, it may be necessary for you to remain in hospital overnight. You will not be able to drive after the test for 24-48 hours.

What is involved?

You will be requested to fast before the test is performed and a sedative tablet may be given before the procedure to relax you. The procedure takes place in a fully equipped x-ray room and takes between 20 minutes and one hour.

The catheter is a long thin flexible tube, roughly the diameter of the lead in a pencil and 3 feet in length. Following an injection of anaesthetic into the skin, it is inserted into a blood vessel at the groin. It will float painlessly inside the blood vessel to the heart. X-ray pictures allow the position of the catheter to be checked and most patients are fascinated to watch the procedure on the video screen.

X-ray videos are recorded while a liquid is injected into the heart and coronary arteries via the catheter. You will be aware of a hot flushing feeling, an odd taste and a feeling of having passed urine. You will be warned when to expect this and it will last for a few seconds. You may experience chest discomfort briefly. This does not mean that anything is going wrong, but you should inform the doctor. Depending on the findings, it may be recommended that you have a stent placed in a narrowed artery. This will usually be
performed at the same time. When the test is over, the catheter is removed and pressure is applied to the wrist or groin . You will return to the ward and may have a drink and something to eat. Your will be required to lie in bed for two-to-four hours if the catheter was placed in the groin.

Are there any risks involved for you?

Complications are rare. The most common is mild bruising at the wrist or groin. This is usually painless and clears completely within a week or two. Very occasionally, this bruising is more severe and uncomfortable but again will resolve quickly. Very rarely (less than 1 in 1000 cases), the artery at the wrist or groin may be damaged and require an operation to repair it. Damage, by the catheters, to the coronary arteries may cause severe angina or a heart attack but is very rare (2 in 1000 cases). Similarly, allergic reactions to the X-ray liquid are very rare (1 in 1000 cases) and settle quickly with medication. Other rare complications include an irregular heartbeat (3 in 1000 cases), a stroke (1 in 1000 cases) or death (1 in 1000 cases). Be reassured that the test will not be recommended unless the benefits to be gained from it outweigh the risks involved.

Alternatives to the Procedure

The alternative is to manage your heart condition without the additional information. There is not usually any alternative test available. This test is generally considered the ‘gold standard’.

The consequences of not having the procedure: It may be more difficult to treat your heart condition without the information that is provided by this procedure. You may prevent yourself from having potentially beneficial treatment.

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