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Angiography

What is it?

A coronary angiogram is an X-ray which looks at the arteries around the heart to determine whether there are any blockages in them. The procedure is performed from the artery in the groin under local anaesthetic, meaning that you will be awake but drowsy after a sleeping tablet premed. It is performed under sterile conditions with all members of the team dressing in sterile theatre clothes. The initial local anaesthetic injection in the groin stings a little but after this there should be no discomfort. Once the area is numb a small catheter is placed in the artery in your groin and fed up the heart under X-ray guidance. There are no nerves inside the blood vessels so you will not feel this. Contrast dye which can be seen by X-rays is then injected through the catheters into the coronary arteries and a series of pictures are taken. The X-ray machine will move around you to view the arteries from a number of different positions to identify any narrowing’s. The last X-ray shows how well the heart contracts by examining its ability to expel a larger volume of contrast. This produces a warm feeling or hot flush which lasts a few seconds. We will warn you when this is coming. At the conclusion of the procedure we remove the catheter and press on the groin artery to allow it to seal. This takes about 10 minutes. You will then be required to lie flat for 4 hours but can get up and walk around later that day.

How long does it take?

Usually the test takes about 30 minutes with a further 10 -15 minutes required for pressing on the groin to seal the artery.

 

What preparation do I need?

You will need to have fasted for at least four hours but it is OK to take your usual tablets with a sip of water on the morning of the test. You doctor will arrange some blood tests a day or two earlier to check salt levels, kidney function and your blood count unless you are to be admitted to hospital the afternoon before in which case the blood test will be done in hospital. Generally all tablets are continued on the morning of the test with the exception of diabetic tablets and fluid tablets such as chloride moduretic and lasix.

You should notify us if you are diabetic or taking Warfarin tablets.

What are the risks?

A coronary angiogram is an invasive test which has some risks which have been assessed by your Doctor to be acceptable in order to provide important information about your heart arteries. The main risk is of a large bruise in the groin 1/100 (a small bruise is not uncommon). Surgery to repair the femoral artery is required 1/600. Stroke, heart attack, allergic reaction or other serious complication occurs in less than 1/1000 pts. Death at coronary angiography is rare (less than 1/5000).

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