What is a Coronary Angiogram (CAG)

A coronary angiogram is a medical test that uses X-ray imaging to get a detailed look at the heart's blood vessels. It's often performed on patients who might have restricted blood flow to or from the heart. Angiograms are part of broader heart catheterization procedures used to diagnose and sometimes treat heart conditions. During the test, a special dye is injected into the heart's blood vessels, which makes them visible on the X-ray. If blockages are found, the doctor can also perform angioplasty to open clogged arteries during the same procedure.

What is a Coronary Artery Disease?

• The heart is a powerful muscular organ requiring an adequate supply of oxygen to function efficiently.
• Oxygen-rich blood is carried to the heart through three arteries that branch into a network of smaller vessels.
• Coronary Artery Disease affects the blood vessels (arteries) on the surface of the heart. These arteries bring blood (rich in oxygen and nutrients) to the heart.
• Ageing and other complex factors cause these ordinarily soft and compliant blood vessels to harden.
• In addition, fat, cholesterol, and minerals from the blood are deposited on the inner surface of the coronary arteries.
• When this material builds up, it forms a plaque that may restrict the blood flow through the coronary artery.
• Such plaque may also change the surface of the artery from smooth to rough, and these rough surfaces may stimulate the formation of a blood clot, which may slowly build up and narrow the artery even more.
• A blood clot can also build up quickly and abruptly close off the artery.

Why is the Coronary Angiogram done?

A doctor may recommend a coronary angiogram for a patient if they are experiencing any of the following:

• Symptoms of coronary artery disease, such as chest pain
• Unexplained pain in the jaw, neck, chest, or arms
• Increased or new episodes of chest pain
• Congenital heart defects or conditions present at birth
• Abnormal results from a noninvasive heart stress test
• Chest injuries
• Heart valve issues that may require surgery

What are the Common Risks Associated with Coronary angiogram?

Coronary angiogram are generally safe, but like any medical procedure, they do carry some risks. Although serious complications are rare, there are still a few potential risks, including exposure to radiation. Some uncommon but possible risks are:

• Stroke
• Heart attack
• Irregular heartbeats (arrhythmias)
• Injury to the heart's catheterized artery
• Allergic reactions to the dye or medications used during the procedure
• Kidney damage
• Infections
• Excessive bleeding

Overall, the likelihood of major complications is low.

Why is the CAG Procedure Performed?

• A Coronary Angiogram (CAG) shows where the arteries are narrowed or blocked.
• It is performed to detect obstruction in the coronary arteries in patients with angina or chest pain.
• It may also be performed as the next course of treatment after a heart attack.
• Sometimes, patients with valve disease or holes in the heart undergoing heart surgery may be advised on Coronary Angiography.

What to Expect Before the Angiogram Procedure?

Before your angiogram, your medical team will review your health history, medications, and any allergies. They’ll do a quick physical exam to check your vital signs, like your pulse and blood pressure. You’ll also need to use the restroom and take off any jewellery, glasses, makeup, dentures, or contact lenses.

What to Expect During the Procedure?

During the procedure, you’ll need to lie back and be secured to the X-ray table. X-ray cameras will capture images from various angles. An IV will be placed in your arm to provide sedatives, medications, and fluids. Your heart activity will also be monitored through small electrodes placed on your chest. Based on what the doctor finds during the procedure, they might suggest additional treatments like a stent or balloon angioplasty. The procedure itself typically takes around 10-15 minutes, but it may take longer if combined with other tests. Afterward, some time will be needed for post-procedure care.

What to Expect After the Procedure?

After the angiogram, the catheter is removed, and the incision is closed using a clamp, manual pressure, or a plug. You'll be closely monitored until your condition stabilizes. Depending on your doctor's advice, you may go home the same day or stay overnight. It's essential to drink plenty of fluids to help flush out the dye from your body.

What About the CAG Test Result?

A normal result means adequate blood supply to the heart. An abnormal result is when a Coronary Angiography test shows the following:

• Blockage of coronary arteries
• Places of blockage
• The degree of each blockage

These results can help your doctor decide on the proper treatment for your heart disease. The information in this handout is not intended as a substitute for medical advice but is to be used as an aid in understanding ailment. Always consult your doctor about your medical condition.

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