Coronary Angiography

What is coronary angiography?

Coronary angiography is a procedure that allows your doctor to take a picture or image (an angiogram) of the blood vessels (arteries) that supply your heart muscle. Doctors use coronary angiography to study the arteries of your heart that are obstructed, blocked, or narrowed, and diagnose the underlying cause.

Coronary angiography is only one method used to diagnose a variety of heart and vascular diseases, disorders and conditions. You should discuss different screening options with your doctor or healthcare provider to best understand which option is right for you. 

Types of coronary angiography

The types of coronary angiography procedures include:

• Catheter coronary angiography is an angiographic procedure that involves inserting a catheter into a vessel in your groin or arm. The catheter wire is then fed, or guided to the area to be examined. X-rays are used to produce the angiogram or picture of the vessel.
• Noninvasive coronary angiography uses computed tomography (CT), and sometimes magnetic resonance imagining (MRI) or ultrasound, to produce the angiogram. CT involves radiation exposure but MRI and ultrasound methods do not.

Catheter coronary angiography, and in some cases, noninvasive coronary angiography, use a contrast agent, sometimes called a dye. This is administered intravenously (through an IV). The contrast agent greatly improves the quality of the image produced.

Other procedures that may be performed

In addition to coronary angiography,your doctor may also recommend one or more additional procedures to diagnose or treat certain conditions. The following procedures may be performed during a catheter coronary angiography procedure:

• Angioplasty to widen a narrowed or obstructed vessel
• Blood clot removal by injecting clot-dissolving medications into the artery via the catheter
• Cardiac catheterization to examine the interior of the heart chambers, the heart valves, and evaluate heart function
• Stent placement with a mesh tube, which is permanently inserted into the blood vessel to keep the vessel open

Because noninvasive coronary angiography techniques do not use a catheter, these procedures cannot be performed during the actual angiography, but may be recommended as additional treatment.

Why is coronary angiography performed?

Your doctor may recommend coronary angiography to diagnose and possibly treat a variety of diseases and conditions of the heart and its blood vessels. Your doctor uses coronary angiography to evaluate the function of the heart, heart valves, and the major blood vessels of the heart. Coronary angiography is also used to determine the underlying cause of various symptoms that can be related to abnormal heart function, such as chest pain. Coronary angiography helps your doctor plan the best treatment for you and monitor your progress after treatment. Diseases and conditions of the heart and blood vessels include:

• Aortic stenosis, a disorder of the valve between your heart and your aorta. Your aorta is the main artery leaving your heart.
• Blood clots, or coronary thrombosis
• Chest pain due to abnormal heart function, atherosclerosis (hardening of the arteries), or other conditions
• Coronary artery disease (CAD), a buildup of plaque on the walls of the coronary arteries that supply blood to the heart
• Coronary blood vessel malformations. Your doctor may use coronary angiography to identify the specific defect.
• Heart attack, which is largely due to atherosclerosis or a blood clot blocking blood flow to the heart
• Heart failure when the underlying cause cannot be determined by other tests
• Unclear stress test results for symptoms such as shortness of breath or chest pain
• Unstable angina, which is chest pain that occurs suddenly in the absence of activity. Unstable angina is primarily due to atherosclerosis, or hardening of the arteries that supply the heart.