All you need to know about an angiogram

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The term “angiogram” refers to a number of diagnostic tests that doctors can use to identify blocked or narrow blood vessels.

Doctors can do an angiogram on different parts of the body, such as:

• the heart, during the diagnosis or treatment of some aspects of heart disease
• the brain, to help diagnose a stroke or the risk of a stroke
• the chest or lungs, for example, to detect bleeding
• the kidneys, to look for high pressure in the renal blood vessels
• the reproductive system, during embolization of tubes or fibroids
• after a trauma to the legs, arms, eyes, or any other body part, to diagnose tears, bleeding, and other problems
• the liver, for example, if a person has cancer

Angiograms also help doctors diagnose a range of cardiovascular diseases, including:

• coronary atherosclerosis
• vascular stenosis
• aneurysms

To perform a traditional angiogram, a doctor will:

• insert a long, narrow tube called a catheter into an artery located in the arm, upper thigh, or groin
• inject contrast dye into the catheter
• take X-rays of the blood vessels

The contrast dye makes blood vessels more visible on X-ray images.

Not all angiograms involve X-ray machines, however. Doctors can also perform angiograms using CT scans and MRI scans.

A doctor may order an angiogram if someone:

• shows signs of a blocked or narrow artery, such as abnormal stress test results
• experiences new or unusual chest pain
• has had a stroke, heart attack, or heart failure
• has or may have other problems that could affect the blood vessels

Angiograms are commonly used to detect heart disease. According to the Centers for Disease Control and Prevention (CDC), heart disease accounts for around 1 in every 4 deaths.

Early diagnosis and prompt treatment can lower a person’s risk of dying from heart disease. Doctors use various tests and procedures, such as angiograms, to identify and treat different types of heart disease.

A doctor can use an angiogram to examine blood vessels and changes that involve the vascular system in almost any part of the body. It can help detect cardiovascular disease, stroke, and other vascular problems.

Doctors use angiogram results to diagnose the following conditions:

• aneurysms, or bulges that develop in weakened artery walls
• atherosclerosis, which occurs when plaque and fatty material collect on the inner walls of the arteries
• pulmonary embolisms, or blood clots in the lungs
• vascular stenosis, which causes abnormal narrowing of the blood vessels that lead to the brain, heart, or legs
• structural problems in the blood vessels or heart that have been present since birth

A doctor may also order an angiogram to:

• evaluate the health of a person’s blood vessels before surgery
• identify blood vessels feeding a tumor
• plan treatments, such as a coronary bypass, stenting, or chemoembolization
• evaluate a stent after placement

The following sections discuss what to expect before, during, and after an angiogram.

Preparation

A doctor will explain how to prepare for an angiogram during the appointment before the procedure. In most cases, people will need to avoid eating and drinking anything the night before the procedure.

People should also arrange for someone to drive them home after they leave the hospital.

It’s important for a person to remember to bring the following items:

• a list of current medications and supplements
• a list of all known allergies
• a current driver’s license or another form of identification
• current medical insurance information

After the person signs in, a nurse will lead them to a private room where they can change into a hospital gown.

The nurse will then insert an intravenous (IV) line into a small vein on the person’s hand or wrist. They will also check the person’s vitals, including their:

• weight
• body temperature
• heart rate
• blood pressure

During the procedure

Before the test, a doctor may administer a mild sedative, which will help the person relax. It will not induce unconsciousness.

The doctor will then disinfect and numb the area of the body where they will insert the catheter. They will make a small cut in the skin and insert the catheter into an artery.

Once the catheter is inside the artery, the doctor will carefully guide it to the blood vessel they want to examine. They will inject the contrast dye through the catheter and take X-ray images of the blood vessel. The person may feel a slight burning sensation when the doctor injects the contrast dye.

After the procedure

After taking the X-ray images, the doctor will remove the catheter and apply steady pressure on the area for about 15 minutes. This ensures that there is no internal bleeding.

A nurse will then take the person back to their hospital room or to the cardiac unit. The doctor may return later to discuss the person’s results.

An angiogram is not usually painful. A doctor may use local anesthesia to numb the area. Some people may need a sedative to help them stay calm. If there is any discomfort, pain relief medication will usually help.

Some people feel slight pressure when the doctor inserts the catheter. Rarely, they may feel discomfort in the chest as the contrast dye enters the area. Nausea and a need to urinate may also occur.

The cost of an angiogram will vary, depending on:

• which part of the body it is for
• the facility and location where the person has the test
• the type of insurance coverage they have

Here, find out how Medicare can help with the cost of managing and treating cardiovascular disease.

Doctors use angiograms to evaluate the flow of blood to the heart, brain, and other organs. An abnormal angiogram result may indicate that a person has one or more blocked arteries.

In these cases, the doctor may choose to treat the blockage during the angiogram.

Most people have a very low risk of developing major complications after an angiogram. However, this invasive procedure does have some risks, which are mainly associated with the process of inserting a catheter into the heart.

According to the National Heart, Lung, and Blood Institute, older adults and people with certain medical conditions, such as chronic kidney disease or diabetes, have a higher risk of experiencing complications after an angiogram.

Risks associated with cardiac catheterization and angiograms include:

• allergic reactions to the local anesthetic, contrast dye, or sedative
• bleeding, bruising, or soreness at the insertion site
• blood clots
• injury to an artery or vein
• damage to the walls of the heart
• acute kidney failure
• infection
• irregular heartbeat
• heart attack or stroke, though this is highly unlikely

People who have had an allergic reaction to contrast dye in the past may need to take medication to reduce the risk of having another allergic reaction. People should take this medication at least 24 hours before the angiogram procedure.

To completely eliminate the risk of an allergic reaction, a doctor can choose to use a different method than the traditional angiogram.

After an angiogram, a person will need to rest for a while.

Tips that may help during recovery include:

• avoiding driving or operating machinery until any sedative has completely worn off
• drinking plenty of water
• avoiding strenuous physical activity for the few first days
• keeping the wound clean and dry
• avoiding taking baths, using hot tubs, or swimming in pools while the wound heals

People should contact their doctor if they suspect they have an infection. Symptoms of an infection include:

• redness, swelling, or worsening pain near the wound
• drainage or discharge from the wound
• fever

During an angioplasty, a doctor inserts an inflatable balloon or mesh splint into a blocked or narrow artery. When it is in the right place, the doctor will inflate or expand the balloon or splint, improving the blood flow in that artery.

Doctors often perform angioplasties during angiograms.

An angiogram is another name for an arteriogram. It is a scan that helps reveal the health of the blood vessels in different parts of the body. It can show if there is a narrowing or blockage of the veins or arteries.

A doctor may use heart catheterization as part of the procedure for a cardiac angiogram. Using a heart catheter and scanning technology, the doctor can collect images known as coronary angiograms or arteriograms. These images can help show if a person has a narrowing or blockage in the blood vessels of the heart.

The doctor will insert the catheter, a long, thin, flexible tube, through the person’s arm or groin, until the tip reaches the heart or the blood vessels near it. Then, they will inject a dye through the catheter into the blood vessels. The dye will help produce clear images of heart and blood vessels.

Doctors use angiograms to examine blood vessels. Angiogram results can help doctors diagnose and treat blood vessel problems and cardiovascular diseases.

During the procedure, a doctor gently guides a catheter through an artery until it reaches the area of the body under investigation. Once the catheter reaches the correct location in the body, the doctor will inject contrast dye and take a series of images of the blood vessels.

Although rare, this procedure does carry some risk of side effects, including:

• bleeding
• bruising
• infection
• blood clots
• injury to an artery or vein
• damage to the walls of the heart
• irregular heartbeat

People should contact their doctor if they experience any of these symptoms after having an angiogram.