Coronary Angiography

Coronary angiography is an X-ray test that shows the inside of the heart’s arteries. It is the most direct way to see whether the arteries supplying the heart muscle are narrowed or blocked, and it helps decide the best treatment.

Shows narrowings or blockages in the coronary arteries
Usually done through the wrist (radial artery) or groin (femoral artery) under local anaesthetic
You are usually awake throughout
Performed in a hospital cardiac catheterisation laboratory (cath lab)
Results guide treatment: medicines, angioplasty or bypass surgery

What is coronary angiography?

The coronary arteries supply blood and oxygen to the heart muscle. During angiography, a thin, flexible tube (catheter) is passed through an artery in the wrist or groin up to the heart. A contrast dye is injected, and X-ray images show how blood flows through the arteries, revealing any narrowing caused by fatty plaque (atherosclerosis).

When might it be recommended?

Your cardiologist may recommend coronary angiography when:

you have chest pain (angina) that is likely to come from the heart, particularly if symptoms continue despite medicines
you have had a heart attack or another acute coronary syndrome, when it is often done urgently
other tests, such as an exercise test or heart imaging, suggest significant coronary artery disease
angioplasty or bypass surgery is being considered and treatment needs to be planned
it is needed before some types of heart valve or other heart surgery

Not everyone with chest pain needs angiography. The decision takes into account your symptoms, examination and the results of other tests.

REAL Coronary Angiography complete procedure video | (Must Watch) Urdu/Hindi

Video · 4:10 · Watch on YouTube

What to expect

Before

You will be told whether to stop eating beforehand and which medicines to take or pause. Tell the team if you have any allergies (especially to contrast dye), kidney disease or diabetes, if you take blood thinners, or if you might be pregnant.

During

The skin over the wrist or groin is numbed with local anaesthetic. You stay awake, and mild sedation may be offered. Many people notice a brief warm feeling when the dye is injected. Tell the team if you feel chest pain or discomfort during the test.

After

A pressure band or dressing is placed over the puncture site, and you rest while you are monitored. When you can go home depends on the findings and on whether any treatment was carried out. Follow the advice you are given about the puncture site and activity, and seek help if you notice bleeding, swelling, increasing pain, or numbness or coldness of the hand or leg.

Benefits and risks

Coronary angiography is a common procedure and is generally safe. As with any invasive test, there are risks. The most common is bruising or bleeding at the puncture site. Less common risks include a reaction to the contrast dye and effects on kidney function. Serious complications such as heart attack, stroke or damage to an artery are rare. Your cardiologist will discuss your individual benefits and risks before the test.

What happens after the result?

Angiography shows whether there is significant narrowing, where it is and how severe it is. Depending on the findings, your symptoms and your overall health, options may include:

medicines and risk-factor control alone
coronary angioplasty and stenting, which can sometimes be done during the same procedure if this has been discussed and agreed with you
referral for coronary artery bypass surgery

Decisions are made together with you, after the results have been explained.

Questions patients ask

Is coronary angiography painful?

Most people feel only the local anaesthetic injection and some pressure. A short warm flush when the dye is injected is common and passes quickly.

Will I need a stent after angiography?

Not necessarily. Angiography is a diagnostic test. A stent is considered only if a significant narrowing is found and stenting is the most appropriate treatment for you.

Is the wrist or the groin used?

Current guidelines favour the wrist (radial) approach where suitable, because it is associated with fewer bleeding complications. The best route depends on your arteries and the procedure.

How do I arrange a consultation?

Call or WhatsApp +92 307 5793387, or see appointments.

References

Vrints C, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024;45:3415–3537. doi.org/10.1093/eurheartj/ehae177 (opens in a new tab)
Byrne RA, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J 2023;44:3720–3826. doi.org/10.1093/eurheartj/ehad191 (opens in a new tab)
Lawton JS, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization. Circulation 2022;145:e18–e114. doi.org/10.1161/CIR.0000000000001038 (opens in a new tab)

This page is general information about the condition or procedure, not personal medical advice. Whether a test or treatment is right for you is decided at your consultation. Medical disclaimer.

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PROCEDURE

Book a consultation with Dr. Qureshi

Clinic at Rawalpindi Institute of Cardiology (RIC), Room 8. Monday to Friday, 3:00 PM to 8:00 PM. Call or WhatsApp +92 307 5793387.