Coronary Angiography

Coronary angiography is an X-ray test that maps the arteries supplying the heart. A fine tube is passed from the wrist or groin to the heart, dye is injected, and moving X-ray pictures show any narrowing and how severe it is. At Allergy Asthma Foundation it is carried out by an experienced team using current equipment and protocols, with clear information given before, during and after so that you know what to expect at every stage.

This page explains why the procedure is done, how to prepare, what happens on the day, and what recovery and follow-up involve. Your own consultant will go through the details that apply to your situation and answer any questions before you agree to go ahead.

Why it is done

Coronary angiography is usually recommended for one or more of the following reasons:

• Chest pain or breathlessness where non-invasive tests are inconclusive
• An abnormal stress test or CT coronary angiogram that needs confirming
• Assessment before heart valve or other cardiac surgery
• After a heart attack, to plan treatment
• Suspected coronary disease in someone at high risk

It is only offered when the expected benefit clearly outweighs the risks, and the decision is always made together with you. If a simpler test or treatment would answer the question or relieve the problem, that is tried first.

How to prepare

• You will have a check of your fitness for sedation, including your medicines and any breathing or heart problems.
• Do not eat for six hours before, and only sips of water up to two hours before.
• Pause blood thinners only on the team's instruction, and confirm the plan the day before.
• Arrange for an adult to take you home and stay with you overnight; you must not drive for 24 hours after sedation.
• Bring an inhaler if you use one, and a list of your medicines.

What happens on the day

1. A cannula is placed and light sedation is given; you remain awake and able to talk to the team.
2. The wrist or groin is numbed and a thin tube is guided to the openings of the heart arteries.
3. Contrast dye is injected and X-ray images are recorded from several angles.
4. If a narrowing is found and suitable, angioplasty may be done in the same sitting after discussion.
5. The tube is removed and the site sealed with a band or a small closure device.

After the procedure

If the wrist was used you can sit up and eat soon afterwards and often go home the same day; if the groin was used you lie flat for a few hours. Avoid heavy lifting and driving for a day or two and keep the site clean and dry.

You will be given written instructions covering activity, wound or puncture-site care where relevant, which medicines to restart and when, and the warning signs that mean you should contact us or attend the emergency department. A follow-up appointment or a phone review is arranged before you leave.

Benefits and risks

The main benefit is a clear answer or effective treatment that changes what happens next — a firm diagnosis, a blocked passage reopened, symptoms brought under control, or a condition safely monitored over time. For most people the procedure is straightforward and complications are uncommon.

No procedure is entirely without risk. The ones to be aware of for this treatment include:

• Bruising or bleeding at the puncture site
• A reaction to the dye or a temporary effect on the kidneys
• An irregular heartbeat during the test, usually brief
• Rarely, damage to the artery, a heart attack or a stroke

The team is trained and equipped to recognise and manage these, and the consent discussion covers how likely each is in your case and what is done to reduce it.

Results and follow-up

The cardiologist reviews the images during the test and explains the findings to you the same day, along with whether the best next step is medicines, angioplasty or bypass surgery. Your consultant explains what the result means in the context of your symptoms and examination, and sets out the next step — reassurance and discharge, a change of treatment, a further test, or a planned review. With your consent a summary is sent to your family doctor so that everyone caring for you is working from the same plan.

Questions patients ask

Do I need a referral?

You can book a consultation directly to discuss whether coronary angiography is right for you. The procedure itself is arranged by the consultant after that discussion, once you have had time to consider it.

Will it hurt?

Discomfort is kept to a minimum with local anaesthetic, sedation or pain relief as appropriate to the procedure. The team will tell you exactly what you are likely to feel and will stop or pause if you need them to.

How long will I be at the hospital?

Most people are in and out within a few hours; where an overnight stay or a longer recovery is expected, that is explained clearly when the procedure is booked so you can plan around it.

To arrange coronary angiography at your nearest AAF centre, book a consultation online or request a callback. Please bring a list of your current medicines and any previous test results or discharge summaries.