What you can expect

Before the procedure

Before your angiogram procedure starts, your health care team will review your medical history, including allergies and medications you take. The team may perform a physical exam and check your vital signs — blood pressure and pulse.

You'll also empty your bladder and change into a hospital gown. You may have to remove contact lenses, eyeglasses, jewelry and hairpins.

During the procedure

For the procedure, you lie on your back on an X-ray table. Because the table may be tilted during the procedure, safety straps may be fastened across your chest and legs. X-ray cameras may move over and around your head and chest to take pictures from many angles.

An IV line is inserted into a vein in your arm. You may be given a sedative through the IV to help you relax, as well as other medications and fluids. You'll be very sleepy and may drift off to sleep during the procedure, but you'll still be able to be easily awakened to follow any instructions.

Electrodes on your chest monitor your heart throughout the procedure. A blood pressure cuff tracks your blood pressure and another device, a pulse oximeter, measures the amount of oxygen in your blood.

A small amount of hair may be shaved from your groin or arm where a flexible tube (catheter) will be inserted. The area is washed and disinfected and then numbed with an injection of local anesthetic.

A small incision is made at the entry site, and a short plastic tube (sheath) is inserted into your artery. The catheter is inserted through the sheath into your blood vessel and carefully threaded to your heart or coronary arteries.

Threading the catheter shouldn't cause pain, and you shouldn't feel it moving through your body. Tell your health care team if you have any discomfort.

Dye (contrast material) is injected through the catheter. When this happens, you may have a brief sensation of flushing or warmth. But again, tell your health care team if you feel pain or discomfort.

The dye is easy to see on X-ray images. As it moves through your blood vessels, your doctor can observe its flow and identify any blockages or constricted areas. Depending on what your doctor discovers during your angiogram, you may have additional catheter procedures at the same time, such as a balloon angioplasty or a stent placement to open up a narrowed artery.

Having an angiogram takes about one hour, although it may be longer, especially if combined with other cardiac catheterization procedures. Preparation and post-procedure care can add more time.

After the procedure

When the angiogram is over, the catheter is removed from your arm or groin and the incision is closed with manual pressure, a clamp or a small plug.

You'll be taken to a recovery area for observation and monitoring. When your condition is stable, you return to your own room, where you're monitored regularly.

You'll need to lie flat for several hours to avoid bleeding if the catheter was inserted in the groin. During this time, pressure may be applied to the incision to prevent bleeding and promote healing.

You may be able to go home the same day, or you may have to remain in the hospital overnight. Drink plenty of fluids to help flush the dye from your body. If you're feeling up to it, have something to eat.

Ask your health care team when to resume taking medications, bathing or showering, working, and doing other normal activities. Avoid strenuous activities and heavy lifting for several days.

Your puncture site is likely to remain tender for a while. It may be slightly bruised and have a small bump.

Call your doctor's office if:

  • You notice bleeding, new bruising or swelling at the catheter site
  • You develop increasing pain or discomfort at the catheter site
  • You have signs of infection, such as redness, drainage or fever
  • There's a change in temperature or color of the leg or arm that was used for the procedure
  • Weakness or numbness in the leg or arm where the catheter was inserted
  • You develop chest pain or shortness of breath

If the catheter site is actively bleeding and doesn't stop after you've applied pressure to the site, contact 911 or emergency medical services. If the catheter site suddenly begins to swell, contact 911 or emergency medical services.

Nov. 09, 2016
References
  1. Angiogram. Society for Cardiovascular Angiography and Interventions. http://www.secondscount.org/tests/test-detail?cid=def4661c-6a8d-4e13-a7c7-0751770609ee#.V8OOdDUmGLU. Accessed Aug. 29, 2016.
  2. Fuster V, et al., eds. Cardiac catheterization, cardiac angiography, and coronary blood flow and pressure measurements. In: Hurst's The Heart. 13th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com. Accessed Aug. 26, 2016.
  3. Cardiac catheterization. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Cardiac-Catheterization_UCM_451486_Article.jsp#.V8OeeTUmGLU. Accessed Aug. 28, 2016.
  4. Longo DL, et al., eds. Diagnostic cardiac catheterization and coronary angiography. In: Harrison's Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.com. Accessed Aug. 26, 2016.
  5. Cardiac catheterization. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/cath/#. Accessed Aug. 28, 2016.
  6. Goldman L, et al., eds. Catheterization and angiography. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Aug. 28, 2016.
  7. Angiogram. Society for Vascular Surgery. https://vascular.org/print/patient-resources/vascular-tests/angiogram. Accessed Aug. 28, 2016.