What you can expectBy Mayo Clinic staff
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During the procedure
For the procedure, you lie on your back on an X-ray table. Because the table may be tilted during the procedure, safety straps may be fastened across your chest and legs. X-ray cameras may move over and around your head and chest to take pictures from many angles.
An intravenous (IV) line is inserted into a vein in your arm. You may be given a sedative through the IV to help you relax, as well as other medications and fluids. You'll be awake during the procedure so that you can follow instructions. Throughout the procedure you may be asked to take deep breaths, hold your breath, cough or place your arms in various positions.
Electrodes on your chest monitor your heart throughout the procedure. A blood pressure cuff tracks your blood pressure and another device, a pulse oximeter, measures the amount of oxygen in your blood. You may receive medication (anticoagulants) to help prevent your blood from clotting on the catheter and in your coronary arteries.
A small amount of hair may be shaved from your groin or arm where the catheter is to be inserted. The area is washed and disinfected and then numbed with an injection of local anesthetic. A small incision is made at the entry site and a short plastic tube (sheath) is inserted into your artery. The catheter is inserted through the sheath into your blood vessel and carefully threaded to your heart or coronary arteries.
Threading the catheter shouldn't cause pain, and you won't feel it moving through your body. Tell your health care team if you have any discomfort.
Dye (contrast material) is injected through the catheter. When this happens, you may have a brief sensation of flushing or warmth. Don't be alarmed if you feel your heart skipping beats — that's a frequent occurrence during angiograms. But again, tell your health care team if you feel pain or discomfort.
The dye is easy to see on X-ray images, and as it moves through your blood vessels, your doctor can observe its flow and identify any blockages or constricted areas. Depending on what your doctor discovers during your angiogram, you may have additional catheter procedures at the same time, such as a balloon angioplasty or a stent placement to open up a narrowed artery.
Having an angiogram takes about one hour, although it may be longer, especially if combined with other heart catheter procedures. Preparation and post-procedure care can add several more hours.
After the procedure
When the angiogram is over, the catheter is removed from your arm or groin and the incision is closed with manual pressure, a clamp or a small plug.
You'll be taken to a recovery area for observation and monitoring. When your condition is stable, you return to your own room, where you're monitored regularly. You'll need to lie flat for several hours to avoid bleeding. During this time, pressure may be applied to the incision to prevent bleeding and promote healing. Sometimes, the plastic sheath that was first inserted into your blood vessel is left in place for several hours or even overnight if you've had angioplasty or stent placement. If you received anticoagulants during the procedure, removing the sheath too soon could trigger heavy bleeding.
You may be able to go home the same day, or you may have to remain in the hospital for a day or longer. Drink plenty of fluids to help flush the dye from your body. If you're feeling up to it, have something to eat. Ask your health care team when you should resume taking your medications, bathe or shower, return to work, and resume other normal activities. Avoid strenuous activities and heavy lifting for several days. Your puncture site is likely to remain tender for a while. It may be slightly bruised and have a small bump.
Call your doctor's office if:
- You notice bleeding, new bruising or swelling at the catheter site
- You develop increasing pain or discomfort at the catheter site
- You have signs of infection, such as redness, drainage or fever
- There's a change in temperature or color of the leg or arm that was used for the procedure
- You feel faint or weak
- You develop chest pain or shortness of breath
If the catheter site is actively bleeding or begins swelling, apply pressure to the site and contact emergency medical services.
- Eastwood J. Nurse's role in the cardiac catheterization laboratory. In: Moser DK, et al. Cardiac Nursing: A companion to Braunwald's heart disease. Philadelphia, Pa.: Saunders Elsevier; 2007:339.
- Angiogram. Society for Vascular Surgery. http://www.vascularweb.org/vascularhealth/Pages/angiogram.aspx. Accessed Dec. 16, 2010.
- Cardiac catheterization. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cath/cath_all.html. Accessed Dec. 14, 2010.
- Coronary angiography. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/ca/ca_all.html. Accessed Dec. 14, 2010.
- Kern MJ, et al. Physiological assessment of coronary artery disease in the cardiac catheterization laboratory: A scientific statement from the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology. Circulation. 2006;114:1321.