A coronary angiogram is an X-ray procedure that is used to examine the arteries in the heart. Contrast dye is injected through a long, thin tube (catheter) into these arteries. Then X-rays are taken to show any blockage in these arteries.

You may have this procedure if you:

  • Are having chest pain, or other symptoms of angina, and you are at risk for heart disease.

  • Have an abnormal stress test or test of your heart’s electrical activity (electrocardiogram, or ECG).

  • Have chest pain and heart failure.

  • Are having irregular heart rhythms.

A coronary angiogram or heart catheterization can show if you have valve disease or a disease of the aorta. This procedure can also be used to check the overall function of your heart muscle.

Let your health care provider know about:

  • Any allergies you have, including allergies to medicines or contrast dye.

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.

  • Any problems you or family members have had with anesthetic medicines.

  • Any blood disorders you have.

  • Any surgeries you have had.

  • Any history of kidney problems or kidney failure.

  • Any medical conditions you have.

  • Whether you are pregnant or may be pregnant.

  • Whether you are breastfeeding.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.

  • Allergic reaction to medicines or dyes that are used.

  • Bleeding from the insertion site or other places.

  • Damage to nearby structures, such as blood vessels, or damage to kidneys from contrast dye.

  • Irregular heart rhythms.

  • Stroke (rare).

  • Heart attack (rare).

What happens before the procedure?

Staying hydrated

image
Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods, such as meat, fried foods, or fatty foods.

  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.

  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.

  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.

  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them. Aspirin may be recommended before coronary angiograms even if you do not normally take it.

  • Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

  • Do not use any products that contain nicotine or tobacco for at least 4 weeks before the procedure. These products include cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.

  • You may have an exam or testing.

  • Plan to have someone take you home from the hospital or clinic.

  • If you will be going home right after the procedure, plan to have someone with you for 24 hours.

  • Ask your health care provider:

    • How your insertion site will be marked.

    • What steps will be taken to help prevent infection. These may include:

      • Removing hair at the insertion site.

      • Washing skin with a germ-killing soap.

      • Taking antibiotic medicine.

What happens during the procedure?

image

  • You will lie on your back on an X-ray table.

  • An IV will be inserted into one of your veins.

  • Electrodes will be placed on your chest.

  • You will be given one or more of the following:

    • A medicine to help you relax (sedative).

    • A medicine to numb the catheter insertion area (local anesthetic).

  • You will be connected to a continuous ECG monitor.

  • The catheter will be inserted into an artery in one of these areas:

    • Your groin area in your upper thigh.

    • Your wrist.

    • The fold of your arm, near your elbow.

  • An X-ray procedure (fluoroscopy) will be used to help guide the catheter to the opening of the blood vessel to be used.

  • A dye will be injected into the catheter and X-rays will be taken. The dye will help to show any narrowing or blockages in the heart arteries.

  • Tell your health care provider if you have chest pain or trouble breathing.

  • If blockages are found, another procedure may be done to open the artery.

  • The catheter will be removed after the fluoroscopy is complete.

  • A bandage (dressing) will be placed over the insertion site. Pressure will be applied to stop bleeding.

  • The IV will be removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.

  • You will need to lie still for a few hours, or for as long as told by your health care provider.

    • If the procedure is done through the groin, you will be told not to bend or cross your legs.

  • The insertion site and the pulse in your foot or wrist will be checked often.

  • More blood tests, X-rays, and an ECG may be done.

  • Do not drive for 24 hours if you were given a sedative during your procedure.

Summary

  • A coronary angiogram is an X-ray procedure that is used to examine the arteries in the heart.

  • Contrast dye is injected through a long, thin tube (catheter) into each artery.

  • Tell your health care provider about any allergies you have, including allergies to contrast dye.

  • After the procedure, you will need to lie still for a few hours and drink plenty of fluids.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.