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Patrick Kay - Cardiology Consultant

Private Service, Cardiology

Coronary Angiogram

This test is performed by a cardiologist in a sterile operating theatre environment at Mercy Hospital in Epsom.
You will be asked not to eat or drink after midnight the evening before the procedure.
The procedure is performed through your radial artery (wrist) in over 90% of cases.  Infrequently we use the approach though the groin.
You are not given a general anaesthetic but may have some medication to relax you. Local anaesthetic is put into an area of skin where we plan to place the sheath (tube).  A needle and then tube are fed into an artery in the arm or leg and advanced through the blood vessels to the heart.  Dye is then injected so that the heart and blood vessels can be seen on X-ray.  X-rays and measurements are then taken giving the doctors information about the state of your heart and the exact nature of any narrowed blood vessels.  This allows them to plan the best form of treatment to prevent heart attacks and control any symptoms you may have.
With the radial (arm) approach you are free to move around within an hour after the procedure although we like to keep you monitored for approximately 4 hours after the procedure in the vicinity of the ward. 
If the groin is used you will have to lay flat (without bending your legs) while the groin sheath is in place. After the groin sheath is removed, you must lay flat for a period of time to prevent bleeding.

Once the angiogram reveals the exact nature of the problem, decisions can be made on the best form of treatment. If a narrowing/s is/are found, frequently we can fix them by inserting a stent.  Firstly we pass a wire through the narrowing and then squash it open using a balloon.  Finally a stent is deployed to scaffold the artery open. This is a permanent structure and cannot be removed; in fact your body will heal over the stent with time.  Special drug-coated stents have expanded the range and number of narrowings that can be successfully managed by percutaneous techniques, but some problems are still best managed by coronary artery bypass surgery.  Angioplasty does not require a general anaesthetic. Most angioplasties occur immediately after the angiogram and patients stay overnight after the procedure.

This page was last updated at 11:11AM on April 6, 2021.