A coronary angiogram is the procedure that is the gold standard for assessing the degree of a possible narrowing of the arteries of the heart. The procedure takes about 30 minutes to do and is performed in a cardiac catheter lab. Usually you are awake for the procedure, but you can ask for sedation if you are very anxious.
The procedure is performed either from the top of the leg or from the wrist. Local anaesthetic is given to numb the skin, then a small tube called a catheter is passed up towards the arteries to the heart. There are no nerves inside the arteries so generally this is painless. Sometimes with the radial approach (from the wrist) there can be a little spasm of the artery, which can be uncomfortable. This can usually be dealt with by using smaller sizes of the catheter or giving medication to dilate the arteries.
The reason for choosing either a radial (wrist) or femoral (top of the leg) approach is based on a number of factors including the consultants preference, the risk of bleeding and the presence of peripheral vascular disease (furring up the arteries in the legs).
The catheter is directed to the opening of the coronary arteries and then dye is injected in. An x-ray machine shows real time pictures of the artery filling with dye which demonstrate the presence of a narrowing. Several sets of pictures are taken to ensure nothing is missed.
Afterwards, the wrist approach requires the wearing of a small tight wrist band for about 1 hour. If the approach used was from the top of the leg then either manual pressure is required at the access site for about 10 to 15mins or a small closure device is used to block off the hole made by the catheter. However the patient will need to lie flat for up to 4 hours.
It is advisable to take a few days off after the procedure before returning to heavy manual work.
Angiograms are quite routine procedures but we can all get quite anxious at times. I would be happy to answer any questions you have.