If you (or someone you care about) has been advised to get an angiogram, you probably have some questions and concerns beginning with the basic question: what is an angiogram, and why is it needed?
What is an Angiogram?
An angiogram is a radiological procedure.
There are actually two types of angiograms. Both use advanced x-ray technology to deliver images of arteries to a monitor.
Computed tomography angiography (CTA) is noninvasive, meaning that there are no incisions made on the body. Patients are given a local sedative to numb the chest area, and an IV is inserted into the arm to run an iodine-based dye to highlight the arteries. The patient lies on a platform that moves into a tube where an x-ray machine takes pictures from several angles.
A conventional coronary angiogram is an invasive procedure also used to view artery damage and blockage and to treat with angioplasty or stents. The procedure involves inserting a catheter and wires in the arm or groin area that are threaded to the treatment area. The procedure is also done with a local sedative and with dye delivered through an IV. The patient may be strapped on a bed if the procedure requires them to be tilted for x-ray machines to get a better view.
Patients might be given nitroglycerin to dilate or widen, the arteries, or a beta blocker to slow the heart rate.
A coronary angiogram requires more preparation because it is invasive.
Who Do Physicians Recommend for Angiograms?
CT angiography is recommended to evaluate patients considered to have a low or intermediate risk for heart disease. It’s a diagnostic tool that sometimes follows an echocardiogram or stress test, or is performed instead of these tests.
A computed tomography angiography (CTA) can be done as an emergency service for patients who arrive at the hospital or emergency room during or after cardiac arrest (heart attack).
Conventional angiograms are more often used for patients who show a high risk for heart disease and have one or more of these symptoms:
Unexplained pain in the chest, jaw, arm, or neck; other tests are often performed to rule out injury, temporomandibular joint disorder (TMJ), Lyme disease, etc.
Increased chest pain
Heart defect or congenital heart disease
Damaged heart valve
Blood vessel problems resulting from a chest injury
Abnormal results in other diagnostic procedures
Will the Angiogram Be Painful?
Some patients find angiograms to be uncomfortable, but few describe either procedure as actually painful. For most patients, the hardest part is remaining still throughout the procedure.
The dye may initially deliver a burning feeling as it makes its way into the arm and to the chest. And patients who have a catheter and wires inserted in the groin area might feel a little sore afterwards. They are usually asked to remain flat on their backs for a few hours to prevent bleeding.
Patients may also notice bruising in their arms from the IV.
Some people get claustrophobic inside CT scan tubes, so physicians might prescribe a medication to help them relax. Very often, patients wear headphones so technicians can speak to them to provide reassurance. Many hospital radiology departments also offer music to patients inside the tube!
Angiograms are certainly far less traumatic than more invasive surgeries. While there is a risk for any medical procedure, they are pretty rare in an angioplasty. Because it involves radiation, physicians usually won’t recommend it for pregnant women.
But angiograms deliver some of the most accurate diagnostics we doctors have, and allow us to share results with patients and families almost instantly.