Angiography

An angiogram is an x-ray of a blood vessel and coronary angiography is now a routine test for heart patients. Often this is done as a day case in hospital or if the patient has been admitted to hospital as an emergency, it may be done during that admission or at a later date depending upon the clinical circumstances. In 2005 angiography is a very safe test and should not be traumatic. It involves inserting a catheter usually into the artery at the top of the leg just below the groin (the femoral artery) or sometimes through the artery just by the thumb in the wrist (the radial artery). The Cardiologist will manipulate the catheter into the heart guided by an x-ray tube that sits over the patient’s abdomen and chest. The catheter is not a camera but is only a specially shaped tube with holes at either end. The Cardiologist will place the catheter into the orifice of the coronary arteries and inject iodine containing liquid down one end which passes out into the artery on the other end and this shows up on x-ray which is stored, most commonly nowadays on a compact disc. Because the heart is three dimensional the x-ray tube will move to the right, to the left and to the middle in order that we can take pictures of the arties in several different views. The figure shows a picture of the right coronary artery and the left coronary artery. At some stage a picture of the pumping chamber of the heart will also be taken and this may produce symptoms such as slight warm flush. The whole procedure takes about 30 minutes. Figure 5 shows a normal angiogram of the left coronary artery.

Figure 5: Angiogram of a normal left coronary artery. The left main artery divides into to large branches, the left anterior descending (LAD) that supplies the front of the heart muscle, and the circumflex that supplies the back wall.