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Coronary angiography

HEART (PCI Brochure)

Coronary angiography is an examination of the coronary arteries Coronary Arteries lie on the outside of the heart and take blood to the heart muscle. These vessels are only a few millimetres wide. Just as an engine needs petrol, the heart needs blood to do its job of pumping blood around the body. 

Coronary artery stenosis is the narrowing of a coronary artery. Slow build-up of fatty plaque within the artery wall can cause the artery to narrow, reducing blood flow. Sudden changes in the plaque may cause angina to worsen or may cause a heart attack.

Coronary angiography identifies the presence, extent and location of coronary artery narrowings. Other tests performed during the coronary angiogram include measuring pressures within the heart chambers, checking function of some of the valves and checking how well the main pumping chamber (left ventricle) is working.

If a narrowing suitable for stenting is found, the interventional cardiologist may then insert a stent. This procedure is referred to as Percutaneous Coronary Intervention (PCI).

 

LCA-NormalRCA-with-irregularities

The first image shows a normal Left Coronary Artery (LCA) which supplies blood to the left side of the heart. The second image shows disease (arrows) in the Right Coronary Artery (RCA) which supplies blood to the right side of the heart.

Before your procedure

Fasting Please stop eating four hours before your procedure time.

Allergies Please inform Intra if you have any allergies to medication or contrast dye at the time of your booking.

Diabetes If you are a diabetic, please tell Intra staff at the time of booking. You may need to discuss your insulin dose with your cardiologist.

Warfarin, Coumadin or any other "blood thinner" If you are taking any of these, please make this known to Intra staff at the time of your booking. Your cardiologist will advise you if you need to stop this medication temporarily for a few days before the procedure.

Other regular medications Continue these unless advised otherwise by your cardiologist. In particular, please continue taking your aspirin.

During your procedure

You will be lightly sedated but awake throughout. In the angiography suite an intravenous catheter (IV line) for the administration of fluids and medication will be inserted into a vein on the back of your hand, or in your arm. You may feel a slight pricking or scratching sensation as the needle goes in, but it should not be painful.

You will feel the local anaesthetic injection into your wrist or groin, then a tiny plastic tube called a catheter is introduced. You should not feel pain at the entry site, but there still may be some non-painful sensations, such as pressure. You should tell the interventional cardiologist doing the procedure if you are experiencing any pain.

Your cardiologist watches the catheter on an x-ray screen as he/she passes the tip of the catheter to one of the coronary arteries. The contrast that is visible on the x-ray imaging is injected into the coronary arteries and video images are recorded on the computer system. When contrast is injected into the left ventricle (pumping chamber), you may feel warm all over for a few minutes.

After your procedure

  • The catheter is removed from the artery and pressure applied.
  • Your cardiologist will discuss their findings with you while you are in hospital or at a follow-up appointment.
  • It is likely that you will be discharged on the same day 
  • Someone must drive you home, or accompany you in a taxi. It is important you do not drive within 48hours after your procedure.

What are the risks?

As with any procedure, there are potential risks involved. Your cardiologist will explain the procedure, discuss possible risks and answer any questions you may have. You will then be asked to sign the consent form. This will occur either at an earlier appointment, or on the day of your procedure.