What to expect during an angiography

Pain in the chest or left arm is a classic symptom of heart disease. When your doctor tells you that you have to undergo an angiography, it can be quite alarming. Dr Vijay Surase, a renowned cardiolog

By: Dr Vijay Surase | | Updated: February 24, 2015 7:02 pm

Pain in the chest or left arm is a classic symptom of heart disease. When your doctor tells you that you have to undergo an angiography, it can be quite alarming. Dr Vijay Surase, a renowned cardiologist on our panel, tells us about the procedure and what a patient going through it should be prepared for. Also Read - Aspirin use likely to reduce death risk in severe COVID-19 patients - Here’s how!

A coronary angiography or CAG is a procedure done to check for any blockages that might be present in the coronary arteries (blood vessels of the heart). It is a diagnostic procedure necessary to determine a further line of treatment. Also Read - Two aspirins a day can reduce cancer risk in persons with Lynch syndrome: Study

When you first visit your cardiologist, he will schedule the procedure as per the urgency of the situation. You will then have to fill out the necessary formalities. Also Read - Beware: Blue lips, creased earlobes and ring around the iris may indicate heart disease

During your consultation with the surgeon, be sure to inform him/her about any allergies you might have. The forms you fill out before the procedure will also have this information. This is a step to ensure that you are not given any medication that may cause an allergic reaction during the angiography.

On the appointed day, make sure you have someone with you to take care of your belongings during the procedure. Alternatively you could keep your jewellery, and other valuables at home. It is mandatory that you do not wear anything metallic to avoid intereferences during the procedure. This would include dentures, glasses, jewellery etc.

Read more about causes, symptoms, diagnosis and treatment of heart disease.

Be sure you carry all your previous reports, angiography CD (if you have had one before), doctors’ notes and prescriptions. This is important information as your surgeon will need them to gauge your present health status, and plan for any emergencies accordingly.

On the day of the procedure, you will be asked to sign a form called ‘informed consent’. This form is basically a declaration that you have consented to have the procedure, you have been informed about the risks and will not hold the hospital responsible for any mishap during the procedure.

To prepare you for an angiography, your surgeon will order a nurse or ward boy to shave the upper part of your thigh and groin, a part of your hand and in some cases the chest as well.

You will be asked to fast for at least 5-6 hours before the procedure. If you are on a liquid diet you will be asked to fast for only about 2-3 hours before the procedure. You will also be asked to empty your bladder just before you are wheeled into the catheterization lab for the procedure.

If you are on medication for heart disease, you can take your regular morning dose with a few sips of water. Be sure not to drink too much water at this time, as it could cause you to vomit after the procedure. Do not take any anti-diabetic medication on the day you are going to have the angiography.

An angiography is done under local anesthesia and mild sedation. A local anesthetic injection is given on the upper part of thigh (most often the right thigh). This will feel like a pinprick and you will feel a short sting at the site. You will also be administered a sedative or anti-allergen by the anaesthetist, through IV cannula (Intravenous cannula) on your arm, you might feel a short burning sensation at the site. The rest of the procedure is pain free and usually lasts for about 20 minutes.

Once you are wheeled into the catheterization lab, you will be made to lie down on a narrow table. The doctor will then proceed to drape you (cover you with sterilized cloth), while leaving the area where the procedure is to be performed exposed. In the case of an angiography, it is most often the groin. Since the catheterization lab is maintained at a temperature of 20^oC, you will be provided with a blanket. In case you feel excessively cold, ask the nurse for a warmer or extra blankets.

Your surgeon will then temporarily attach ECG leads to your chest and a blood pressure monitor cuff to your hand. You might feel a little pressure on your hand due to this. It is a precaution taken to monitor your vital signs during the procedure.

Once the procedure is about to start, your surgeon will be wearing a special catheterization lab suit which has a surgical mask, cap and gown. Apart from your primary doctor, a team of other doctors including anesthetist, surgeons from other specialties and other trained staff and nurses will be present around you.

As the procedure starts you will be asked to take deep breaths and hold it for a few seconds, in a few instances you may also be asked to cough three to four times. Your doctor will then inject a contrast dye into your body. This is mainly to help assess the exact location and extent of the block. You might feel a temporary warm sensation in your throat and neck, which will last only for a few seconds.

During the procedure, you will be conscious, and you will be able to talk to your doctor. You might also be allowed to watch the procedure being done. In such a case, make sure you do not move your arms or legs. Do not try to touch the surgical site. This may lead to contamination of the area, and introduction of infection into your body.

A special C-arm camera will rotate around your head, neck and chest and might make some noise. Your doctor will also move the table on which you are lying to aid proper visualization.

Either during or after the procedure, you will be told about the extent of the blockage and the line of treatment you might require. If you have family present with you, they will be asked to speak to the doctor through a viewing window, and will be updated about your condition.

After the procedure is completed, your doctor will apply a pressure bandage to the area. This is done mainly to stop excessive bleeding, which might occur when an artery is punctured. Usually there is nothing to worry about at this stage, but make sure you inform your doctor about any excessive bleeding you might notice, if you feel dizzy even two hours after the procedure or have any sort of palpitations or discomfort.

In most cases an angiography is a very safe procedure, but like all invasive procedures, there are a few risks that you should be well informed about. If your doctor finds a block in any of the blood vessels leading to the heart he/she will suggest either an angioplasty or bypass surgery.

Click here to read about the most common questions on angioplasty.

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Published : June 12, 2013 12:56 pm | Updated:February 24, 2015 7:02 pm

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