Coronary Angiography
What coronary angiography shows, why it may be recommended, how the procedure is performed and what to expect during recovery.
Coronary angiography is an invasive imaging procedure used to examine the arteries that supply the heart. A thin catheter is introduced through an artery, usually at the wrist or groin, and contrast is injected while X-ray images are recorded. The test defines the location and severity of coronary narrowing and can guide decisions about medical treatment, stenting or bypass surgery.
Why Is It Performed?
Angiography may be considered during a suspected heart attack, when symptoms or non-invasive tests suggest high-risk coronary disease, when chest pain continues despite treatment, or before selected heart operations. It is not a routine screening test for everyone with chest discomfort.
Before the Procedure
The team reviews symptoms, previous tests, kidney function, blood count, allergies, bleeding risk and all medicines. Anticoagulants, diabetes medicines and other treatments may require individual instructions. Patients should not stop medication on their own. Pregnancy possibility, previous contrast reactions and kidney disease must be discussed.
How Is It Performed?
After local anaesthetic, an arterial sheath and catheter are advanced to the coronary openings. Contrast outlines the vessels on fluoroscopy. The patient is usually awake and may feel brief warmth during injection. Pressure-wire assessment such as FFR or iFR, or intravascular imaging such as IVUS or OCT, may be used when the significance or structure of a narrowing needs clarification.
If an important lesion is found, treatment may continue with balloon angioplasty and stenting during the same session, but this is not automatic. The clinical setting, anatomy, consent, kidney function and possible benefit of Heart Team discussion affect the plan.
Benefits and Risks
Angiography provides detailed anatomical information and enables immediate treatment in appropriate cases. Possible complications include bruising or bleeding at the access site, artery injury, contrast reaction, kidney injury, rhythm disturbance, heart attack, stroke and, very rarely, death. Individual risk depends on urgency and overall health.
After the Procedure
The access site and circulation to the hand or leg are monitored. Drinking and mobilisation advice depends on the procedure and clinical condition. A wrist procedure often permits earlier mobilisation, while groin access may require a period lying flat. The patient receives instructions about medicines, wound care, activity and the result.
When to Seek Urgent Help
Increasing pain, numbness, coldness or colour change in the access limb also requires prompt assessment.
Frequently Asked Questions
Are angiography and stenting the same procedure?
No. Angiography is diagnostic imaging. Stenting is a treatment performed only when appropriate.
Is general anaesthesia required?
Usually not. Local anaesthetic is standard, with sedation when needed.
Does a narrowing always need treatment during the same session?
No. Some lesions are best managed with medicine, further physiological assessment, planned stenting or bypass evaluation.