Coronary Angiography (CAG)

A coronary angiography is a procedure that uses X-ray imaging to examine the blood vessels in your heart. The test is typically performed to determine whether there is a restriction in blood flow to the heart.

Coronary angiographies are a type of procedure that falls under the category of heart (cardiac) catheterizations. Cardiac catheterization procedures can be used to diagnose and treat heart and blood vessel problems. The most common type of cardiac catheterization procedure is a coronary angiography, which can help diagnose heart conditions.

A sort of dye seen by an X-ray equipment is injected into the blood veins of your heart during a coronary angiography. The X-ray equipment quickly produces a sequence of pictures (angiograms) that provide a view of your blood vessels. During your coronary angiography, your doctor may open blocked heart arteries (angioplasty) if required.

Why it is done?

Your doctor may advise you to get a coronary angiography if you have:

  • Chest discomfort is one of the symptoms of coronary artery disease (angina)
  • Other tests do not explain pain in your chest, jaw, neck, or arm.
  • Chest discomfort that is new or worsening (unstable angina)
  • You were born with a cardiac defect (congenital heart disease)
  • A noninvasive cardiac stress test yielded abnormal results.
  • Further blood vascular issues or a chest injury
  • A heart valve issue that necessitates surgery

Because there is a minor risk of problems, angiographies are generally conducted after noninvasive cardiac tests such as an electrocardiogram, echocardiography, or stress test.

Risks

A coronary angiography, like most treatments on your heart and blood arteries, has some complications, such as radiation exposure from the X-rays administered. Nonetheless, major difficulties are uncommon.Â

The following are examples of potential hazards and complications:

  • The heart attack
  • Stroke
  • Catheterization artery injury
  • Heart rhythm irregularities (arrhythmias)
  • Allergies to the dye or drugs used in the operation
  • Kidney disease
  • Extreme bruising
  • Infection

How do you prepare?

Coronary angiograms may occasionally be done in an emergency situation. But more often than not, they’re arranged beforehand, allowing you time to get ready.

In a hospital’s catheterization (Cath) lab, angiograms are carried out. Your medical team will provide you with detailed instructions and go through any drugs you take with you. Typical principles include:

  • Eat and drink should be avoided the night before your angiography.
  • Bring all of your prescription drugs in their original containers with you to the hospital. Consult your doctor before taking your morning prescription.
  • Ask your doctor whether you should take insulin or any other oral drugs before to your angiography if you have diabetes.

Before the procedure

Your medical team will go over your medical history, including any allergies and drugs you use, before the angiography process begins. The team could do a physical examination and take your blood pressure and pulse.

You’ll also change into a hospital gown and empty your bladder. You might need to take off your contacts, glasses, jewelry, and hairpins.

During the procedure

You lie on an X-ray table on your back during the treatment. Safety straps may be put across your chest and legs because the table may tilt while the treatment is being performed. Your head and chest will be moved about by X-ray cameras while they take many perspectives of your body.

Your arm’s vein is used to implant an IV line. Along with additional drugs and fluids, you can receive a sedative through an IV to help you unwind. Although you could nod asleep while the treatment is being done due to your extreme drowsiness, you will still be able to be readily roused to follow any instructions.

Your heart is continuously monitored by electrodes on your chest. The quantity of oxygen in your blood is measured by a pulse oximeter and is tracked by a blood pressure cuff.

Your arm or groin, which will be the location of a flexible tube (catheter), may need to have a tiny quantity of hair removed. After cleaning and disinfecting the region, a local anesthetic injection is used to numb it.

A tiny cut is created at the point of entrance, and a sheath—a little plastic tube—is placed into your artery. The catheter is gently threaded to your heart or coronary arteries by being introduced via the sheath into your blood vessel.

You shouldn’t feel the catheter traveling through your body or experience any pain when threading it. If you experience any discomfort, let your healthcare staff know.

Through the catheter, dye (contrast material) is administered. When this occurs, you could experience a momentary flushing or warming feeling. But once more, let your medical staff know if you have any pain or discomfort.

On X-ray scans, the dye is clearly visible. Your doctor can see the flow of the blood as it passes through your blood vessels and spot any obstructions or constrictions. You could undergo further catheter treatments concurrently, such as a balloon angioplasty or stent implantation to widen a narrowed artery, depending on what your doctor learns during your angiogram. Your doctor may use other noninvasive procedures, including ultrasonography, to assess any blockages found.

An angiography typically takes an hour; however, this time may increase, particularly if further cardiac catheterization procedures are involved. Time might be extended by preparation and post-procedure care.

After the procedure

The catheter is withdrawn from your arm or groin once the angiography is complete, and the incision is then sealed by manual pressure, a clamp, or a tiny plug.

You’ll be escorted to a recuperation area where you’ll be watched and tracked. You go back to your own room after your condition has stabilized, where you are continually observed.

If the catheter was implanted in the groin, you may need to lay flat for many hours to prevent bleeding. Pressure may be administered to the incision at this period to stop bleeding and encourage healing.

You could be able to leave the hospital the same day, or you might have to spend the night there. To assist your body rid itself of the dye, drink plenty of water. Have a meal if you’re in the mood for it.

When to start taking your prescriptions, taking showers or baths, working, and engaging in other typical activities, find out from your medical team. For a few days, refrain from laborious occupations and heavy lifting.

Your puncture wound is probably going to be sore for a while. It can have a little bump and a mild bruise.

 

Call your doctor immediately if:

You observe bruising, edema, or fresh bruising at the catheter site.

  • You experience escalating discomfort or agony at the catheter site.
  • You exhibit infection symptoms including redness, discharge, or a fever.
  • The arm or limb that underwent the treatment has changed in warmth or color.
  • Leg or arm weakness or numbness where the catheter was put
  • You have shortness of breath or chest discomfort

Results

Doctors can determine what is wrong with your blood arteries using an angiography. It can:

  • Amount of your coronary arteries that have fatty plaques blocking or narrowing them (atherosclerosis)
  • Identify the blood artery obstructions that are present.
  • Demonstrate how much of your blood arteries are obstructed
  • Verify the outcome of any prior coronary bypass operation.
  • Verify the heart’s and your blood vessels’ blood flow.

Knowing this information can assist your doctor in assessing how much risk your cardiac problem causes to your health and the best course of therapy for you. Your doctor could determine, for example, based on your test findings that you might benefit from coronary angioplasty or stenting to assist unblock blocked arteries. Additionally, in order to minimize the need for a second treatment, angioplasty or stenting may be performed during your angiography.

Coronary Angiography and PTCA at B.P. Poddar Hospital

We are conducting CAG, PTCA and all other percutaneous interventions routinely through the Radial/ Distal Radial Approach making the process less painful with minimal blood loss and accelerated recovery. In terms of the financial aspects, apart from cash, we are accepting all major insurance/TPA, all major corporates and Swasthya Sathi.