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CORONARY ANGIOGRAM


What is a Coronary Angiogram?

Coronary Angiogram is an X-ray study of your heart (coronary) vessels that involves the insertion of soft, tiny plastic tubes called a catheter, via the groin or wrist blood vessel. This procedure is carried out in the cardiac catheterisation laboratory. The purpose of the study is to confirm the presence of CAD (Coronary Artery Disease) and to locate the exact site of blockage and its severity.


How is the Procedure Carried Out?

Your doctor will administer local anaesthesia to numb the skin insertion site which may be on the groin or wrist. A catheter is inserted through the blood vessel and advanced to the heart (coronary) blood vessel.The catheter is then manipulated by the doctor to engage the opening of the heart artery. Special “X-ray dye” called contrast is then injected through the catheter into the heart artery. The contrast allows the doctor to visualise images of the heart arteries and/or heart chambers on the X-ray monitor.


Any “blockage” (stenosis) of the heart artery would reveal as a narrowing or “underfilling/nonfilling” of the blood vessel.Important to note: Coronary angiogram is a largely pain-free procedure.


Preparations before the procedure -

The night before:

Refrain from food and water for 6 hours before the procedure.


Day of procedure:

Take your usual medicine with some water but omit your diabetes medicines.

Empty your bladder

Changed into hospital gownYou will also need an intravenous (IV) plug inserted into a vein on your hand.


During the procedure:

You will be given a local anaesthesia to numb on the area (groin or arm). A soft catheter is then inserted into an artery and up to the heart. The catheter is advanced through the aorta to reach the opening of your heart artery and willbe placed there.


Angiogram pictures will then be taken from different angles with multiple “dye” injections. You will notice the X-ray tube be turning around you in different directions.


Your doctor will communicate with you during the procedure as you will be awake. The procedure usually takes around 20-30 minutes to complete.


You may feel:

Slight pressure as the catheter is put in. Some may feel slight burning sensation over the chest region when dye is injected through the catheter.


What Happens After That

The catheter will be removed. An experienced nurse will apply direct pressure where the catheter was inserted for 15 to 30 minutes to stop bleeding from the punctured artery. A pressure dressing will be applied after the manual compression. You will be sent back to your ward.


You may feel slightly sore where the catheter was inserted or from lying on your back. You will be asked to lie flat (not to sit up) for at least 6 hours after the procedure. If at any time that you notice bright red blood on your dressing, please notify the nurse immediately. You should also bring to her notice if your arms or legs feel cold, numb or painful. If you need to cough or sneeze, gently press on the puncture site before doing so.


Potential Risks (rare) with Coronary Angiograms

Vascular Injury/Bleeding

Injury to the blood vessel or bleeding may occur (less than 1% of cases)

Contrast-related Issues

Some patients may develop an allergic reaction to the contrast (dye) used. Kidney dysfunction is a known potential complication from contrast exposure. The risks may be higher if you already have kidney disease but your doctor will give you preventive agents to protect your kidneys.


Infection at the incision site may occur although this is rare. Rare Complications

Rare complications like stroke or death may occur although they are extremely rare (less than 1%).


Discharge Home

Slight pain over the incision site. Slight bruising is common at the incision site. Bathe and do other activities as usual. Bleeding, swelling, numbness or tingling around the spot where the catheter was placed. These are common and usually go away in 2-3 weeks. Refrain from lifting heavy objects or engaging in strenuous exercise for a few days after the procedure.


If there is increased swelling, gently compress on the incision site and refrain from putting excessive pressure on the affected limb.


You Should Go A&E if:

The incision site is increasingly painful swollen, red or bleeding. There is discharge from the incision site or you develop fever (more than 38 degree)


Unusual bleeding e.g. blood in your urine or black stools.

* You should arrange for a relative or friend to fetch you home.

* You are discouraged from driving home yourself.

* You are advised to keep your follow-up appointment with your doctor.

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