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Complications of Diabetes

Having a Coronary Angiogram

 What is a Coronary Angiogram?

A coronary angiogram is a special type of X-ray which looks at the blood vessels of the heart. If you have angina or have had a recent heart attack you may be asked to undergo this test.

Why do I need to have one done?

Blood vesselsYour heart is supplied by a meshwork of blood vessels. One or more of these blood vessels can become blocked off. This block may be partial, allowing some blood to get through, or complete. The angiogram is the best test which allows the cardiologists to see exactly where these blocks occur.

Compare the blood vessels supplying your heart, to the pipes carrying water to your house. If some of the pipes are blocked you would need to know ‘which pipes and where’ before carrying out any repairs.

The cardiologists will use the information obtained from your angiogram, to decide whether you need a bypass operation, angioplasty or medical treatment.

How is an Angiogram done?

Angiograms involve taking special X-rays. Normal X-rays would not show up blood vessels. A type of dye called ‘contrast’ is injected into the blood vessels of the heart which allows us to see them clearly.

What are the risks involved?

The doctors doing the procedure will explain the risks involved in detail before asking you to consent to having this procedure. The risk of complications is very small. About one in every 500 people having an angiogram would have  a complication related to the procedure.

  • Bleeding may occur from the groin
  • Allergic response to contrast
  • Damage to the kidneys may result from the injection of contrast
  • Low blood pressure
  • May provoke a heart attack due to a complete blockage of a blood vessel

Where will it be done?

An angiogram is done in a special laboratory called a ‘cardiac catheterization laboratory’ or ‘cath lab’ for short.

What information will the doctors look for?

  • How many blood vessels are blocked?
  • Where are the blocks?
  • What is the degree of blockage?
  • Are they likely to be treatable by angioplasty?

What happens during the procedure?

Before the test you will be expected to fast overnight or for approximately eight hours.

You will be awake during the procedure though you will not have any pain. You may be given a sedative which will help you to relax.

The catheter (a thin long length of plastic tubing) which is used to deliver the contrast ‘dye’ to the heart is inserted via a large blood vessel in the groin. You will have this area cleaned and a local anaesthetic drug will be injected into the skin so that you do not feel any pain. Once this drug has been injected you will feel pressure and ‘tugging’ at the site but no pain.

The catheter is passed through a large blood vessel in the groin or arm all the way up to the coronary arteries. You may be asked to hold your breath or cough during this procedure.

Once the operator enters the blood vessels of the heart a small amount of contrast will be injected so that the blood vessels show up on the X-rays. Rarely this may cause some discomfort in the chest.

When the test is over

The catheter is withdrawn from the groin (or arm) and pressure applied to the site of insertion to stop any bleeding. Your cardiologist will probably talk to you about the results of the angiogram.

 

Dr Nishan Wijenaike MD FRCP
Consultant Physician (Diabetes & Endocrinology)
West Suffolk Hospitals NHS Trust
January 2006