• What to Expect Before and During an Angiogram

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    Before the Angiogram

    The cardiologist will offer instructions on how to prepare for the angiogram. Often, this is what you can expect.

    • If you take medications, such as blood-thinners, consult with the cardiologist about whether you should stop taking them before the angiogram. Aspirin should be continued.
    • You should be aware of the risks associated with angiogram. Angiograms are generally safe. However, there are risks. Bleeding, infection and irregular heart beat can occur. More serious complications, such as heart attack, stroke and death can occur, but they are rare.
    • If you are allergic to iodine or x-ray dye, you should let your physician know. The contrast dye typically used during the angiogram procedure contains iodine. Some patients may have a minor reaction to the x-ray dye, such as a skin rash or itching. The chance of a life-threatening reaction to the dye is very small. X-ray dye very rarely causes serious or permanent kidney damage, especially if kidney function was normal before it is used. However, those who have weakened kidney function, due to diabetes or high blood pressure, may face a greater risk of further deterioration in kidney function. If it occurs, the deterioration is often temporary.
    • You will be asked not to eat or drink anything for several hours before the procedure.
    • Your blood count, kidney function and how quickly your blood clots may be tested through blood tests.
    • You will receive medications to help you relax before the procedure begins.

    During the Angiogram

    An angiogram typically takes from 45 minutes to one hour. As the procedure begins, a nurse inserts an IV (intravenous line) into a vein in your arm. The IV allows you to receive fluids and medications easily. If you become anxious during the angiogram, you will receive more medications to help you relax.

    During the angiogram, you lie on a table - mildly sedated, but awake throughout the procedure. A specially trained cardiologist, called an interventional cardiologist, performs the procedure. The cath lab will be cool: The temperature is kept low to safeguard the computers that are critical to performing the angiogram.

    After you are relaxed, the doctor will use a small needle to inject lidocaine, a local anesthetic, to numb an area in the groin, or upper leg, or in the arm. This needle prick could be the only pain you will feel throughout the procedure. The procedure is typically painless.

    The femoral artery in the groin - near where your leg bends from the hip - is one of the vessels doctors most commonly use to insert a catheter (a flexible tube that is smaller than the vessels) and thread it through the arteries to the heart to perform the angiogram. Instead of the femoral artery, your doctor may choose to insert the catheter in the brachial or radial artery in the inside of the elbow or wrist.

    From this "access" point in your leg or arm, the catheter is threaded through the arteries to your heart. Since there are no nerves in your arteries, you will not feel the catheter or any pain during the catheterization procedure.

    The x-ray camera helps the physician guide the catheter to your heart. When the catheter is properly positioned, the cardiologist injects a contrast dye (radiographic contrast agent) through the catheter into the heart and its arteries. Most people do not feel the dye injection. However, some feel minor discomfort, typically lasting only a few seconds, in their chest. A few feel lightheaded or nauseous.

    When the x-ray beam passes through the dye, the arteries appear in black silhouette on a white background. If you have blockages, they appear as white areas. The x-ray camera records a "movie" of your heart's pumping chamber and arteries - a movie that can be recorded as a digital image or on 35mm film.

    By enabling the cardiologist to see blood flow and the size, shape and length of any blockages, the angiogram provides vital information for planning the best approach to treating each one.