Coronary angiography is an invasive diagnostic procedure that produces detailed images of the coronary arteries. It is the reference standard for assessing the severity and distribution of coronary artery disease when non-invasive tests are inconclusive or when intervention is being considered.
Why it might be recommended
- Ongoing chest pain despite medical therapy
- An abnormal stress test or CT coronary angiogram
- After a heart attack, to assess underlying anatomy
- Before heart valve surgery in patients with cardiovascular risk factors
What to expect on the day
Coronary angiography is usually performed as a day procedure under local anaesthetic with light sedation. Access is most often via the radial artery at the wrist; the femoral artery in the groin is used in some circumstances. A thin catheter is passed up to the heart, and contrast is injected to image the coronary arteries while X-ray pictures are taken.
The procedure itself takes around 20 to 30 minutes. Most patients are observed for two to six hours afterwards and discharged the same day.
Risks
Coronary angiography is a routine procedure but it is not without risk. The most common complications are bruising or bleeding at the access site. Rare but serious complications include damage to the access artery, contrast reaction, kidney injury, stroke, and vascular complications requiring repair. The overall risk of a major complication is small (well under 1% in most series), but the absolute risk depends on individual factors and is discussed in detail at consent.
After the procedure
You will be given written instructions about access-site care, activity restrictions, and follow-up. You should not drive for 24 hours and should arrange transport home.