Cardiovascular disease is one of the biggest health problems in the UK today, leading to heart attacks, strokes, and a range of other complications. Angiograms are used to assess the health of the blood vessels and the heart, so that preventative action, such as surgery, can be taken.

An angiogram uses a dye to make the blood visible on x-ray images as it flows through the major blood vessels and the heart. It can show where the flow of blood is impeded by blockages or narrowing of the vessels, and can also show how effectively the heart is pumping the blood, and how well the valves are working.

This article on angiogram / angiogram procedure is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

Reasons for an angiogram

If your GP is concerned about the health of your heart and circulation, he/she will refer you to a specialist who will conduct a series of tests. These include:

  • Blood and urine tests – to check for the presence of certain chemicals that illustrate the health of the heart
  • Electrocardiogram (ECG) – to check the electrical activity of the heart. This produces the ‘heart trace’ that you will be familiar with, along with lots of other data
  • Echocardiogram – to show the pumping action of the heart and its valves

If any of these shows a cause for concern, you will be asked to go into hospital for an angiogram to get a more accurate picture of what’s going on in your heart and blood vessels.

The procedure

Angiograms are usually done as a day case under local anaesthetic. You may be given a sedative to help you relax during the procedure, as you will need to lie as still as possible for up to forty-five minutes to help the radiologist to get clear images.

If you are taking any medication to thin your blood, such as warfarin or aspirin, your doctor will ask you to stop taking this a few days before the procedure.

Before the angiogram procedure, you will usually have heart monitor pads placed on your chest and a blood pressure cuff placed on your arm. This is standard practice and is nothing to be concerned about. You will then have a local anaesthetic injected into your groin area where the doctor will enter your blood vessels. This may sting at first but will soon become numb.

The doctor will then insert a small tube into your femoral vein or artery (depending on which side of your heart or circulation they want to examine) and insert a guide wire into the vessel. This will be used to guide a thin tube, called a catheter, which will be used to deliver the dye accurately to the required area.

Although you will remain awake, you will not feel this moving inside your vessels, any more than you are aware of your blood as it pumps around. The technicians will then take a series of x-rays or short x-ray films as required.

Following the procedure

At the end of the test, it will usually be necessary for a nurse to press on the entry site for about ten minutes, to help stop any bleeding. Again, this is standard practice and nothing to worry about.

After you return from the angiogram, you will need to lie flat for a couple of hours and have your pulse and blood pressure monitored regularly. You can then sit up for an hour or so before you move around. It’s important that you have someone to collect you after your procedure, as you will not be able to drive. You should have someone with you overnight too, especially if you have had sedation.

You will need to rest for a couple of days after the procedure, avoiding any strenuous lifting or exercise, and you shouldn’t drive for at least thirty-six hours.

The results

Your results will usually be sent back to the GP or specialist who requested the tests. In some cases, you may get the results on the day. If this is likely to happen, it would be useful to have someone with you, as sedation can affect your memory and you may not remember clearly what was said.

Complications involved

Thousands of angiograms are carried out every year without incident. However, you should be aware of the following possible complications:

  • The entry site may start to bleed. If you cannot stop this you should apply pressure to the wound and call an ambulance immediately
  • The wound may become sore or infected. Again, if this becomes very swollen or very painful, you should seek immediate medical treatment
  • Very occasionally, there may be complications during the angiogram procedure. For example, the catheter may dislodge a blood clot which may put you at risk of a stroke or heart attack. Such cases are very rare, however, and will be spotted while you are still in the care of the hospital.

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