An angiogram is a common procedure performed in the cardiac catheterization lab (cath lab) that looks at blood flow in the heart's arteries to help identify and assess blockages.
Your physician may order an angiogram if you have stable coronary artery disease with symptoms and have an abnormal stress test. Angiograms are also used in those with acute coronary syndrome, which is a more urgent condition where blood flow is acutely reduced in the heart, such as during a heart attack.
During your angiogram, you will have a dedicated care team who has specialized training in providing care in the cath lab. Team members typically include:
Once you are prepped and in the cath lab, you may receive some sedative medicine to help you relax and reduce anxiety during the procedure. Then, your cardiologist will give local anesthesia in the area where the catheter will be inserted, usually in the wrist or the groin.
The cardiologist will insert a sheath, which is a plastic tube that stays in the blood vessel and helps with inserting the catheter. Once the catheter is threaded up into the blood vessels of the heart, the cardiologist will inject contrast (or dye) to look for blockages.
"Depending on the estimation of any blockages, we may proceed further with additional testing or treatment," said Srini Potluri, MD, medical director of the cardiac catheterization lab at Baylor Scott & White The Heart Hospital – Plano.
If blockages are less than 50 percent, medication may be recommended to prevent the blockages from worsening. For blockages between 50-70 percent, the cardiologist may use additional testing during the angiogram, such as a test called fractional flow reserve (FFR) or intravascular ultrasound (IVUS), to determine the severity of the blockage.
If you have a blockage of more than 70 percent and have had an abnormal stress test, the cardiologist may use angioplasty, where a balloon is used to push open the blockage, and stenting.
"Blockages are not all the same; some are easy to fix and some are more difficult," Dr. Potluri said. "If the blockage is very hard to fix, we have different modalities or equipment to help us."
For difficult blockages, your cardiologist may use a cutting balloon that has tiny blades or a laser to cut into plaque. For those with severely calcified arteries, a tool is available to sand down the calcium buildup. These tools are then followed by a normal balloon and stent placement.
When any needed treatment is complete, the catheter is removed from the incision site. At Baylor Scott & White Heart – Plano, 60 percent of people go home the same day after their cardiac catheterization procedure.
"At Baylor Scott & White Heart – Plano, we do over 5,000 of these procedures every year," Dr. Potluri said. "We have good outcomes, and if additional treatment is needed, we have access to surgeons and a wide range of ancillary services."
Learn more about how we diagnose and treat heart conditions in the cardiac catheterization lab at Baylor Scott & White Heart – Plano.
Physicians are members of the medical staff at one of Baylor Health Care System's subsidiary, community or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor Scott & White The Heart Hospital – Plano or Baylor Health Care System.