Coronary Angiogram
Revising Medical Authors: Daniel
Kulick, MD, FACC, FSCAI and Dennis Lee, MD
Revising Medical Editor: , William C. Shiel, Jr, MD, FACP, FACR
What is an angiogram?
An angiogram is an X-ray image of blood
vessels after they are filled with a contrast material. An angiogram of the
heart, a coronary angiogram, is the "gold standard" for the evaluation of
coronary artery disease (CAD). A coronary angiogram can be used to identify the exact location and severity of CAD.
How is a coronary angiogram performed?
Coronary angiography is performed with the use of local
anesthesia and intravenous sedation, and is generally not significantly uncomfortable.
- In performing a coronary angiogram, a doctor inserts a small
catheter (a thin hollow tube with a diameter of 2-3 mm) through the skin into an
artery in either the
groin or the arm.
- Guided with the assistance of a
fluoroscope (a special x-ray viewing instrument), the catheter is then advanced to the opening of the
coronary arteries (the blood vessels supplying blood to the heart).
- Next, a small amount of radiographic contrast (a solution containing
iodine, which is easily visualized with
X-ray images) is injected into each coronary artery. The images that are produced are called the angiogram.
- The procedure takes approximately 20-30 minutes.
- After
the procedure, the catheter is removed and the artery in the leg or arm is
either sutured, "sealed," or treated with manual compression to prevent
bleeding.
- Often, if an angioplasty or
stent is indicated, it will be performed as part of the same procedure.
What does a coronary angiogram demonstrate?
Angiographic images accurately reveal the extent and
severity of all coronary artery blockages. For patients with severe angina or
heart attack (myocardial infarction), or those who have markedly abnormal
noninvasive tests for CAD (such as
stress tests), the angiogram also helps the
doctor select the optimal treatment. Treatments may then include medications,
balloon angioplasty,
coronary stenting, atherectomy
("roto-rooter"), or coronary artery bypass surgery .
Last Editorial Review: 12/10/2008
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