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Radiologists and radiologic technologists perform noninvasive coronary angiography. A radiologist is a doctor who specializes medical imaging. A radiologic technologist is a medical professional who is specialized in medical imaging and the care of patients during imaging procedures.

Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

How is coronary angiography performed?

Your coronary angiography will be performed in a hospital or outpatient setting, depending on your condition. It takes several hours and generally includes these steps:

  1. You will dress in a patient gown and lie on a procedure table.
  2. Your team will insert an IV to provide fluids, medications, or a contrast agent.
  3. Your team will attach devices to monitor your heart rate and blood pressure.
  4. For a catheter coronary angiography:
  • Your team takes a small amount of blood for laboratory tests to test kidney function and blood clotting. 
  • Your team may give you sedative medications through the IV to help you relax.
  • Your physician will determine the location to insert the catheter. The catheter is often placed in the artery in the groin. The area will be shaved, cleaned and numbed before a small incision is made. Your physician will insert the catheter and wire through the incision and guide it to the vessel to be examined. 
  • Once the wire is in place, your team will deliver a contrast agent through the catheter and take X-rays as the contrast agent flows through your blood vessels. You may feel a sensation of warmth when the contrast agent is injected.
  • Your team will tell you when to hold still for the X-rays. You may need to hold your breath briefly.
  • When the procedure is complete, your team will remove your IV and catheter and the catheter site will be closed.

  5.  For noninvasive coronary angiography:

  • If MRI is used, your team will give you earplugs because the machine makes loud thumping and humming noises. Closed MRI machines are long cylinders, so your team may give you a mild sedative if you are claustrophobic. The procedure table will slide into the machine for the test.
  • CT machines also have a tunnel, but it is much shorter than an MRI tunnel. The procedure table will slide into the machine for the test. You may need to hold your breath briefly during the imaging procedure.
  • If a contrast agent is used, it will be administered through your IV. You may feel a sensation of warmth when the contrast agent is injected.
  • It is important for you to lie still during the entire procedure. Any movement may cause blurry images. The MRI takes about an hour.
  • You will wait briefly while the radiologist verifies that the imaging is complete. 
  • A member of the team will remove your IV.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. You may feel a pinch or pinprick during the IV placement, but the imaging itself is painless. You will have pain and sedative medications to keep you comfortable during catheter coronary angiography. You may also have sedative medications for MRI procedures if you are claustrophobic. Tell your care team if you are uncomfortable in any way.

What are the risks and potential complications of coronary angiography?  

Complications after coronary angiography are uncommon, but any procedure involves risks and the potential complications. Complications may become serious in some cases. Complications can develop during the procedure or recovery. 

Complications of coronary angiography include: 

  • Abnormal heart rhythms or cardiac arrhythmias
  • Adverse reaction or problems related to sedation or contrast agents, such as an allergic reaction and problems with breathing
  • Bleeding or clotting problems
  • Damage to an artery from the catheter
  • Exposure to radiation, which may be harmful in excessive doses
  • Heart attack
  • Infection
  • Injury from metal objects in or on your body or in the room during an MRI 
  • Low blood pressure
  • Kidney injury from the contrast agent, especially if you have kidney disease
  • Stroke