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What is a coronary angiogram or angioplasty?

An angiogram is an X-Ray examination using contrast medium, which will show if there is any significant narrowing or blockage in the heart arteries. An angioplasty is the treatment for this narrowing. A balloon is passed into the blocked part of the artery using a thin tube (called a catheter) and inflated to increase blood flow through it. A stent is a small, thin, metallic mesh tube which can be implanted to keep the narrowed artery open. The stent remains in the artery and becomes part of the artery wall.


The procedure

The angiogram is normally done on the same day of admission. You will be advised not to eat or drink anything about 3 hours before the angiogram. An IV (intravenous line) is put in a vein in your arm. Medicines to make you sleepy can be given through the IV to make you more comfortable. The angiogram is performed under local anaesthesia either via the wrist (radial approach) or the groin (femoral approach). The catheter is advanced to the heart arteries and an angiogram is performed with injection of contrast medium so that the artery flow is visualised on the X-Ray. The angiogram can take about 10-15minutes to perform. A discussion between the cardiologist, patient and family members then takes place. A decision is then made whether to intervene with angioplasty or stenting. The angioplasty or stenting will then take about an additional one hour.

After the angiogram or angioplasty

If no angioplasty is needed, the sheath at the wrist or groin will be removed immediately after the procedure. If angioplasty was performed, the patient will usually be monitored in the cardiac ward overnight and the sheath removed after a few hours after the procedure for the effect of IV blood thinners to disappear. If stable, the patient can be discharged the next day.


Risks or complications

Angiography is a safe procedure with low complication rates. Possible risks include:

  • Bruising – A small bruise is common at the site of the catheter insertion. There is a chance that the bruise may become large and uncomfortable. Please return and seek advice from the doctor.

  • Contrast allergy – medicine to counteract this reaction can be given at the time of procedure

  • Stroke or life-threatening event - the overall risk is low (<1%) and depends on the condition of the patient. In an emergency situation when a life-saving procedure must be done, the benefits may still outweigh the risks

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