Coronary Arteriography Angiogram - Diagnosing Heart Disease: Heart Disease

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Coronary arteriography (angiogram)

The "gold standard" test used in diagnosing coronary artery disease is coronary arteriography (also called coronary angiography). Coronary arteriography is used to confirm a diagnosis in people who are suspected of having coronary artery disease on the basis of noninvasive tests, such as the exercise tolerance test, or whose tests were inconclusive. It's also recommended for people known to have coronary artery disease, to determine the location and extent of arterial blockages.

Coronary arteriography is a type of cardiac catheterization (a procedure in which a thin tube called a catheter is inserted into a coronary artery). Nearly 1.5 million cardiac catheterizations are performed in the United States each year — mostly in hospitals with special laboratories designed for this purpose.

In coronary arteriography, the cardiologist threads the catheter through blood vessels elsewhere in the body (usually an arm or leg) to the coronary arteries. The physician then squirts a dye that can be seen on x-rays into the coronary arteries. A technician takes x-ray films during the procedure, and these films help reveal whether and how severely the coronary arteries are narrowed (see Figure 4).

Figure 4: Coronary angiogram This angiogram shows a narrowing (see arrow) in the left anterior descending coronary artery.

Although the catheterization itself usually takes an hour or less, health care personnel must keep you under observation for several hours after the procedure to make sure that there is no internal bleeding where the catheter was inserted. If a leg vessel was the point of entry, you must lie down for about four to six hours, usually with a weight compressing the catheterization site. If you don't have angina, internal bleeding, or other complications, you may be able to go home later that day.

Possible risks. Coronary arteriography should not be painful and is remarkably safe when performed by experienced physicians. However, it is an invasive procedure and, as such, involves some risks. The most common complications of coronary arteriography are bleeding where the catheter was inserted or the formation of blood clots in the vessel. Other possible complications include heart rhythm abnormalities, infections, and allergic or kidney reactions from exposure to the contrast dye. Stroke, heart attack, or major bleeding are uncommon.

Last updated:	May 03, 2007