Coronary angiography shows blockages in the heart's arteries; angioplasty with a stent opens them to restore blood flow, often without open-heart surgery.
Overview
Coronary angiography is an X-ray test that uses a contrast dye to show the arteries that supply blood to the heart. It tells the cardiologist exactly where and how badly an artery is narrowed or blocked.
If a significant blockage is found, it can often be treated in the same sitting with coronary angioplasty (PTCA). A thin balloon is used to widen the narrowed artery and a small mesh tube called a stent is usually placed to keep it open. Because it is done through a small puncture in the wrist or groin, most patients avoid open-heart surgery.
Who needs this treatment?
- Chest pain or breathlessness on exertion (angina) that suggests narrowed heart arteries
- A heart attack, where opening the blocked artery quickly can save heart muscle
- An abnormal ECG, echocardiogram or treadmill test (TMT)
- Before major surgery or valve treatment when heart arteries need to be checked
- Symptoms that continue despite medicines
Benefits
- Gives a clear picture of the heart arteries to guide the right treatment
- Relieves chest pain and improves exercise capacity
- Restores blood flow quickly during a heart attack
- Small puncture instead of a large surgical cut; most patients walk within a day
- Shorter hospital stay and faster return to routine than bypass surgery
How it is done
Before the procedure
You will have blood tests, an ECG and usually an echocardiogram. Tell the team about diabetes, kidney problems, allergies (especially to contrast dye) and blood thinners you take. You will be asked not to eat for a few hours.
During the procedure
The procedure is done in the cath lab under local anaesthesia, so you stay awake. A thin tube (catheter) is passed from the wrist or groin to the heart arteries and dye is injected while X-ray pictures are taken. If angioplasty is needed, a balloon is inflated at the narrowing and a stent is placed. You may feel brief chest discomfort when the balloon is inflated.
After the procedure
The puncture site is pressed or sealed to prevent bleeding and you are monitored for several hours. Most people stay in hospital for one to two days after angioplasty.
Recovery and aftercare
Most people return to light activity within a few days and to work within about a week, depending on their condition and job.
- Take blood-thinning medicines exactly as prescribed; do not stop them without asking your cardiologist
- Avoid lifting heavy weights with the arm or leg used for the procedure for a few days
- Follow a heart-healthy diet, stop smoking and stay active as advised
- Attend follow-up visits and cardiac rehabilitation if recommended
Frequently asked questions
It is done under local anaesthesia, so you feel only a small prick at the puncture site and some pressure. Most patients find it much easier than they expected.
That depends on the number, position and type of blockages. After the angiogram, the cardiologist will explain whether angioplasty, bypass surgery or medicines alone is the best option for you.
A stent stays in the artery permanently. Taking your medicines regularly and controlling risk factors such as diabetes, blood pressure, cholesterol and smoking help keep the artery open.
This page gives general information. Whether a treatment is right for you, and what it involves, depends on your condition; your doctor will explain the options after examining you.