Coronary Angiography: Pre  Procedure Information.

Coronary angiography has be come an important procedure in knowing the condition of your coronaries. As we have seen, coronaries are the arteries that supply blood to your heart. A smooth blood flow through these arteries is needed for normal functioning of the heart. The coronary angiography is the best test to estimate the degree of blockages in the coronaries.

What is done during a coronary angiography?

During this procedure, your cardiologist would inject a dye in the coronary arteries. This dye is detectable on an x ray picture and gives a good idea of how the blood is flowing in the coronary arteries. There are 2 main branches of the coronaries, namely the right coronary and the left which are turn by turn injected with the dye.

During the angiography, the contractile function of your heart also can be accurately measured.

Your cardiologist can reach your coronaries through 2 approaches. Firstly the Femoral artery, which is a big artery in your groin and the second possible approach is through the radial artery which can be felt at your wrist. Both the approaches are equally safe and your cardiologist will suggest the best approach suitable for you based on his evaluation of your arteries.

What are the important things that your cardiologist notes before the procedure?

Before doing the procedure, your cardiologist ensures that your kidneys are normally functioning. In very few proportion of patients the dye used during the procedure may cause a rise in the blood Creatinine levels and this is more common when there is a preexisting kidney disease. Your cardiologist may take extra precautions while doing the procedure if he finds that there is a possibility of injury to the kidneys.

Your cardiologist also would like to see how your clotting system is functioning, in case you have certain anticoagulants in your prescription. If needed, your cardiologist would recommend certain changes in the dosages.

What should you know about the procedure?

The coronary angiography usually lasts for 20 to 40 minutes after your doctor has begun the procedure.

You will need to spend the entire day in the hospital for the procedure.

Before the procedure, the attendants would remove the hair from the area which would be used as an approach (groin or wrist). You will be with an empty stomach before the procedure starts. You would be given certain relaxation medicines before the procedure; however you would remain awake and would be able to communicate with your doctor. The procedure area is air conditioned and you could feel a bit cold.

Once you are taken on the Cath-Lab Table, your doctor would anesthetize the area to be pricked. This will make the area numb and you would notice no or minimal pain during the procedure.

As the procedure is being performed, your doctor would instruct you to hold your breath at times. This is the time the dye is flowing through your coronaries. You may feel a hot flushing sensation for 30 seconds at this time.

After the procedure, you would be shifted to a recovery area. You would be having a tight bandage dressing over the approach area with some additional weight placed on it. This may seem uncomfortable for a few, but is necessary to prevent bleeding from the punctured site.

You would be asked to lay flat with your legs straight (femoral approach) for 4 to 6 hours after the procedure. During this phase the sheath will be removed and tight dressing would be reapplied. The staff nurse and the doctor would monitor your blood pressure and the pulse in the arteries of your feet and hands at regular intervals. You would be requested to report immediately if you notice any wetness or bleeding in the dressing area.

You can start with light meals one hour after the procedure.

In case no immediate after procedure is planned, you could be discharged on the same day or early next day after the dressing is removed. You may take a bath freely after removal of the dressing.

The doctor would discuss the findings of the procedure during his post procedure rounds.

Coronary angiography has become a routinely performed procedure and one neednot have any fears about it.