Are you scared about a coronary angiogram? Let's find out the details!

Do you sometimes feel chest pain, shortness of breath, or a feeling of heaviness when walking? When you go to see your doctor, he may tell you that you need to do a special test to see if there is any blockage in the arteries that supply blood to your heart (which we call the coronary arteries). One of the most important tests done at such times is the 'coronary angiogram'. Some people feel a little scared and nervous when they hear this name. "Oh, is this a major operation?", "Will it hurt a lot?" "Are there any risks?" Many questions come to mind. So, in this article, we will talk exactly what this angiogram test is, how it is done, how to prepare for it, and everything you need to know about it.

What exactly is a coronary angiogram?

Simply put, a coronary angiogram is a special X-ray test that checks how well blood is flowing through your heart's coronary arteries, the main blood vessels that carry blood to your heart muscle. Just like checking the traffic on a city street to see if there are any blockages, blockages, or narrowings, it checks for any blockages or narrowings in your heart's blood vessels.

During this test, a special dye, or pigment, is injected into the blood vessels and a series of X-ray images are taken. This dye allows the inside of the blood vessels to be seen clearly on the X-ray. It's like shining a flashlight into a dark room and seeing the road. This allows the doctor to see if there is a buildup of cholesterol in your arteries (called atherosclerosis ) that has narrowed or obstructed the flow of blood. This type of blockage is the main cause of a heart attack later on.

Under what circumstances would a doctor ask you to do this test?

Your doctor is likely to recommend this test if you have one or more of the following reasons. Let's take a look at what they are.

The doctor will explain to you why you are being asked to have this test. Ask any questions or concerns you may have about it right away.

How should you prepare before the test?

Although this is not as major as surgery, it does require a little preparation. Your doctor will explain this to you in detail. These are the things you will usually be asked to do:

• Food and drink: You will be asked not to eat or drink anything except water for about 8 hours before the test.
• Medications: If you are taking any medications such as anticoagulants, diabetes medications, diuretics, or sildenafil, your doctor will ask if you need to stop taking them or adjust the dosage in the days before the test. It is important to inform your doctor about all medications you are taking.
• Allergies: If you have ever had an allergy to a type of contrast dye or anesthetic medication, be sure to tell your doctor about it.
• Pregnancy: You should also tell your doctor if you are pregnant or planning to become pregnant.
• Transportation: You will not be allowed to drive the same day after the test. Therefore, if you are going home that day, it is important to arrange for someone to drive you.

What happens during an angiogram?

This is the biggest question everyone has. "What's going on inside?" Imagine, this is something that is very planned and done carefully. Let's see what happens step by step.

1. Preparation: First, you will be given a hospital gown and asked to lie down on a special bed in the examination room.

2. Sedation: Then an IV tube (cannula) is placed in a vein in your arm, and a sedative is given through it. This will help you relax and take away your fear and anxiety. But you will not lose consciousness, you will be conscious enough to listen to what the doctors say, cough a little when they tell you to, and hold your breath.

3. Heart monitoring: ECG stickers are placed on your chest and your heart rate is monitored throughout the test.

4. Numbness: Next, the doctor will choose to insert a small tube into a blood vessel in your groin or wrist. The area will be numbed with a local anesthetic. So you won't feel any pain. However, you may feel a slight tingling sensation as the doctor works.

5. Insertion of the catheter: After anesthesia, a very thin, flexible tube, called a catheter , is inserted through the selected blood vessel.

6. Journey to the heart: The cardiologist then looks at the X-ray screen and very carefully guides this catheter through your blood vessels to the coronary arteries in your heart.

7. X-ray and dye: Once the catheter is in place, a special dye is injected into the vein through the catheter. When the dye is injected, you may feel a slight warmth or a burning sensation for a few seconds. This is normal and should not be alarmed. As the dye is passed through the vein, an X-ray machine (called fluoroscopy ) will rotate around you and take pictures.

8. Identifying blockages: Because the dye makes the inside of the blood vessels clearly visible on X-ray, the doctor can see exactly whether the veins are clogged, narrowed, or obstructing blood flow due to things like cholesterol and fat.

Typically, this entire process can take between 30 and 50 minutes.

Can I get treatment during the test?

Yes. Sometimes, if the doctor sees a blockage, he or she can treat it right away. A balloon is sent to the blockage and inflated to widen the artery ( angioplasty ). Then a small mesh-like device ( stent ) is placed in the area to keep the artery from narrowing again. But this is not always done. Sometimes, the doctor may decide that it is better to do another treatment at a later date.

What happens after the test?

When the test is finished, the doctor will remove the catheter. Then, to stop the bleeding, they will apply pressure and a bandage to the site where the catheter was inserted. Most people can go home within a few hours of the test, even the same day. However, if the test is complicated or if it is done during the day, you may need to stay in the hospital that night.

You may feel a little tired after you go home. The area where the catheter was inserted may be a little sore and bruised for about a week. Your doctor will advise you to rest and avoid strenuous activity for two to three days.

Could there be any risks involved in this?

As with any medical procedure, there is a small risk. But remember, serious complications are rare. Especially if the test is performed in a hospital with experienced doctors who perform this test regularly.

Who may be at slightly increased risk?

• For those over 65 years of age
• For those with diabetes
• For those with kidney disease

If you have any questions about these risks, talk to your doctor before the test and be well informed.

How do I know the results of the test?

In most cases, your doctor will tell you the results as soon as the test is finished.

• Normal Result: This means that there are no blockages in your coronary arteries and that blood flow is good. If so, the cause of your symptoms may be something else.
• Abnormal Result: This means that there is a blockage or narrowing in one or more veins. The doctor will explain to you exactly which vein is blocked, where it is, and how severe the blockage is. It may be expressed as a percentage (for example, 70% blocked).

If the results are abnormal, what do you do next?

If there is a blockage, your doctor will explain to you the best course of action. This may include:

• Angioplasty and stenting
• Starting medications
• Lifestyle changes, such as changing your diet and exercising
• Bypass surgery (Coronary Artery Bypass Surgery - CABG)

What time do you want to see the doctor again?

After you go home, pay attention to where the catheter was inserted. If you have any of the following symptoms, call your doctor immediately.

• If there is excessive bleeding from that area
• If the swelling increases
• If you see signs of infection, such as skin discoloration or pus
• If you feel difficulty in blood circulation in your arms or legs

It's normal to feel scared when you're told you need an angiogram. But remember, the information from this test will help your doctor determine the exact condition of your heart and plan the treatment that's right for you. So talk to your doctor about any questions or concerns you may have about this. They're there to help you.