Angiography

angiography

Last Updated August 5th, 2021

What is angiography?

Also known as arteriography, angiography is a medical imaging test performed to observe how well your blood vessels and heart muscles are functioning. It basically sheds light on the condition of arteries, veins, and the cardiac chambers. It is performed by injecting a radio-opaque substance in the blood and tracking its circulation by x-ray imaging techniques.

Who should undergo angiography?

Angiography is generally conducted to observe if the arteries have become too narrow. Narrowed blood vessels put extra pressure on the heart and can lead to several fatal conditions such as ischemia or stroke. It is also used to detect blockage, swelling, or any malfunction in the heart, brain, abdomen, or legs. Usually, people diagnosed with heart diseases or circulatory diseases such as phlebitis are the ones who have to undergo this procedure.

When does a doctor prescribe an angiography?

If you have been experiencing the following symptoms, your doctor might ask you to undergo this procedure:
Chest pain – constant or increasing in nature.
Radiating pain in the chest, jaw, and arms with no apparent cause.
A person with congenital heart disease
Trauma/injury to the chest area
Abnormal results of the stress test
Angiography is an invasive test and is usually prescribed after the usual non-invasive tests such as EEG and ECG have been conducted. This is considered to be the “gold standard” test for confirming the onset of CAD or coronary artery disease.

What makes a person prone to heart/circulatory diseases?

There are several factors that can increase the risk of cardiovascular diseases – age, tobacco intake, alcohol intake, unhealthy diet (high in sugar and transfat), stress, obesity, sedentary lifestyle, and trauma.

What are the different types of angiography procedures?

Coronary – Liquid injected in the blood vessels of the heart to check for narrowing/blockage.

Fluorescein – Blood vessels of the eyes are tested via angiography to detect eye disorders.

Neurovascular – Arteries and veins of the brain are observed for presence of clots/plaque.

Peripheral – Blood vessels of the legs/feet are studied for peripheral arterial disease


How is an angiography test conducted?

In this process, a dye which can be detected in an x-ray is injected into the bloodstream. Depending upon the suspected condition (ocular or cardiac or neuro), the dye is injected in the respective blood vessels. After this, the x-ray machine captures a series of images at a high speed that depicts the flow of the dye within these blood vessels.
In case of coronary angiography (the most commonly prescribed form of angiography), the radio-opaque dye is inserted via a catheter which is threaded into the forearm (along an artery). The angiography images (angiogram) can reveal if there is stenosis (narrowing of arteries). The access point of the catheter is generally in the arm, but in some cases, it could be in the groin region too. Once the process is over, the radio-opaque dye is automatically flushed from your body via urine.

How long does this process take?

Angiography, though invasive, is a considerably painless procedure. The thin catheter that is inserted in the forearm (or groin region) might sting a bit but beyond that, this is a relatively painless procedure.

Is angiography done under anesthesia?

For adults, this process is not performed under anesthesia but for children, it might be done under general anesthesia. At the site of the insertion of the catheter, a topical anesthetic is applied. Those who are likely to feel more anxious and stressed during angiography can opt for a mild sedative before the procedure.

What should I expect during this procedure?

You will be asked to change into a hospital gown and asked to lie down on a table.

On the area where the liquid will be inserted, a small cut will be made to insert the catheter.

The thin catheter is slowly pushed inside the artery.

The dye is injected into the artery via this catheter.

When this dye is injected, you might feel the urge to urinate for a few seconds.

The x-ray machine takes a series of images

In some cases, angioplasty is performed during the angiography. This involves inserting a small balloon inside the narrowed artery to dilate it.

Once the above steps are done, the catheter is slowly removed and the cut on the skin is covered. Sutures (stitches) are not required.

How to prepare for an angiography?

The hospital or diagnostic center will ask the following question before you undergo this procedure:
Your medical history along with if you are allergic to certain chemicals.
The current medication/s you are on.
They will also try to get a general idea of your overall health by asking you to undergo few physical exams and/or some blood tests.
You need to inform them if you are on viagra.
If you are a diabetic patient, you must ask the doctor if you can take your diabetes medication before the test.
Similarly, it is important to inform the doctor if you are pregnant.
The staff will also explain to you in detail regarding how the angiography procedure is conducted and how to be mentally prepared.
They might also suggest a sedative a day before the test, in case you are feeling overly anxious.
It is advised not to eat anything 5-6 hours before the procedure.Ideally you shouldn’t consume anything after midnight before the day of the test.

What happens after an angiogram is taken?

Once the procedure is complete, you will be asked to take rest. You need to stay still for a few hours in order to prevent bleeding from the cut. Usually, you can go back home the same day but in some special cases, you might be admitted for a day. If the incision has been made in the groin region, you will be asked to lie on your back and rest for 4-5 hours. This prevents excessive bleeding.
It is important to take food and water at proper intervals. Drink adequate water to flush out the dye from the body. Though you can return to your daily routine from the very next day it is advised that you avoid strenuous exercises and lifting heavyweight for a few days.


What are the risks associated with angiography?

This is a relatively safe procedure and most people undergoing angiography don’t feel any adverse side-effects post the procedure. However, some people may experience bruising, soreness, and slight swelling at the site of the catheter-insertion. In very rare cases, the cut on the skin might become infected and require antibiotic treatment


Can people be allergic to angiography dye?

It has been observed that 1 out 50,000 – 150,000 people will develop severe anaphylaxis owing to the radio-opaque dye insertion in the arteries. Such an adverse allergic reaction may result in dizziness, shortness of breath, and loss of consciousness. 1 out of 1,000 people might suffer a stroke (if the dye travels to the brain) and even experience cardiac arrest.


Who is more likely to experience the side-effects of angiography more?

Older population

Those undergoing emergency angiography

Those with kidney diseases

People with a history of serious heart condition

Those with multiple blocked coronary arteries

When can I go home after the angiogram is taken?

You can go home on the same day. In case, angioplasty has been performed during the angiography procedure or there are some other complications, your doctor might ask you to remain admitted for the day.

When can I see my angiogram?

Angiography is an imaging diagnostic tool. It doesn’t provide you accurate information in terms of numbers, unlike blood tests. The concerned doctor takes into account the kind of ailment you have and prepares a written report based on the specific requirement of the case. The time required for a complete angiogram report depends on the urgency and complexity of the case.

What information does an angiogram reveal?

The angiogram report will tell whether or not you have blocked arteries/veins. An abnormal angiogram means you have stenosis, aka, narrowing of arteries and will require angioplasty.

How will I know if my angiogram is normal or not?

The image of the path traced by the radio-opaque dye will provide information on whether your circulation is normal or abnormal. In a normal angiogram, one can clearly see the path traced by the dye. Whereas in case of the abnormal angiogram, the path traced within the arteries will be appeared blurred and blocked.

 

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