Overview

This information is intended to answer some of your questions about having a coronary angiogram. 

A coronary angiogram (cardiac catheterisation) is a procedure that lets us see inside your coronary arteries. They are vessels that supply blood to the heart muscle.

The procedure:

• gives us important information about the structure of your heart and how well it is working
• shows if there are any narrowings or blockages

A coronary angiogram uses X-rays and a substance called a contrast agent, which is added to your blood. The contrast agent shows clearly on the X-rays and allows us to see any blocked areas.

This information covers:

• the benefits of the procedure
• the risks of the procedure
• other possible treatment options
• how to prepare for the procedure
• what happens during the procedure
• what happens after the procedure
• when you can return to your usual activities

If you have any questions or concerns, please speak to a doctor or nurse caring for you.

Benefits of the procedure

Coronary angiograms can help to:

• diagnose heart conditions
• plan future treatment
• do some procedures

They can give information about how effectively your heart is pumping, and about the blood pressure inside your heart.

A coronary angiogram can also help to investigate other conditions, such as congenital (inherited) heart disease. It can be used after a heart attack to help diagnose angina (chest pain caused by restricted blood supply to the heart), or before surgery or a procedure. 

A coronary angiogram is thought to be the best method of diagnosing coronary heart disease. This is when your heart’s blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries.

Risks of the procedure

A coronary angiogram is generally thought to be a safe procedure. However, as with all medical procedures, it involves some risks. They are listed in this section.

Bruising or bleeding

There is a risk of bruising or bleeding under the skin (haematoma) at the wound site. This can take up to a couple of weeks to heal and may cause some tenderness or discomfort.

Damage to the artery at the wound site

If the artery at the wound site is damaged, this is called a false aneurysm. You might need another procedure to fix this, and it could lengthen your stay in hospital. This is an uncommon but more serious complication of the procedure.

Allergic reaction to the contrast agent

It is possible to have an allergic reaction to the contrast agent that we use to make any blockages in your coronary arteries show clearly on X-rays.

It is important to tell your heart specialist (cardiologist) or nurse about any allergies that you have. This includes allergies to foods.

Changes to the kidneys

The contrast agent could affect how your kidneys work, but the risk is very low if they were working normally before the procedure. If you have kidney issues before your coronary angiogram, we may give you fluids to protect your kidneys.

Radiation risks

The procedure uses X-rays to make images of your coronary arteries. They are a type of radiation called ionising radiation. This may cause cancer many years or decades after you are exposed to it.

You might have some skin redness after the procedure that feels like sunburn. We do not expect this to be permanent. The redness might be harder to notice on brown and black skin. 

The amount (dose) of radiation used during a coronary angiogram depends on the reason for the procedure. Your heart specialist believes that the benefit of the procedure is greater than the risk from the ionising radiation.

Radiation and pregnancy

If you could be pregnant, please tell us before the procedure.

We need to do a pregnancy test by taking a urine sample if you have not had a period in the 10 days before the procedure. This is because the coronary angiogram uses X-rays that might be harmful to an unborn baby. 

Serious complications

There is a very small chance of a serious complication due to a coronary angiogram. Possible complications include:

• damage to a coronary artery, or a heart attack caused by blocking off 1 of them. We would try to repair the artery during the procedure, but on rare occasions emergency heart bypass surgery is needed. This is a big operation to improve blood flow to the heart.
• stroke caused by a small blood clot being displaced and travelling to the brain

These risks are thought to be rare, but they are very serious. In very rare circumstances, they can be fatal.

The risks are higher for people who:

• are already unwell
• have severe heart disease
• have lots of other health problems

However, there might be risks if you do not have the procedure. It might not be possible to investigate or treat heart disease. This is something that your heart specialist thinks about carefully. They talk to you about the risks in your case before the procedure.

Other treatment options

There is another way to do a coronary angiogram, using a CT scan. However, in this test, the contrast agent is injected into a small vein in your arm rather than an artery in your groin or wrist. This makes the test less invasive than a traditional coronary angiogram.

A CT coronary angiogram is generally not as effective at showing areas that have narrowed in small coronary arteries or in small branches.

The standard coronary angiogram is still the best way of diagnosing coronary heart disease. Your heart specialist talks to you about the specific benefits and risks of each procedure.

Support and more information

The organisations listed in this section can give you support or more information:

British Heart Foundation

This charity can give you more information on having a coronary angiogram or on any other issues relating to heart disease.

Phone: 0808 802 1234 (freephone, Monday to Friday, 9am to 5pm)
Email: [email protected] 
Website: www.bhf.org.uk

Driver Vehicle and Licensing Agency (DVLA)

The government organisation that is responsible for licensing drivers and registering vehicles in Great Britain.

Phone: 0300 790 6806 (Monday to Friday, 8am to 7pm, Saturday, 8am to 2pm)
Textphone: 0300 123 1278
Website: www.gov.uk/contact-the-dvla
Address: Drivers’ Medical Enquiries, DVLA, Swansea SA99 1TU